Because insurance companies are having to carry so many policies on high risk/high cost people, many companies (even small ones) are self-insuring in order to lower the risk pool they are exposed to and lower the costs.  Many unions do this also.
You just cannot tell the working person that they have to pay more to subsidize someone or group’s lifestyle-they will reject it.
Many, many of our national health problems are drinking, smoking, and overeating related as well as high-risk activities of many types.  Those are lifestyle choices.
You also cannot open the American debt line to foreigners- legal or illegal jumping at the chance to get US taxpayer funded health care.  The illegal problems would climb at an even higher rate than now.