You cannot drive a system that's going to be aiming at preventing illness if everyone is not in it. The whole gaming of health insurance and health care in America is based on that fundamental principle: insure people who aren't sick and you don't have to pay more money on them.
Our economic system run for profit and waste and based primarily on the extractive industries is the cause of climate change. We have wasted the earth's treasure and we can no longer exploit it cheaply.