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.
When I found out I had to take off my shirt in 'Teen' movie I panicked and hit the gym. I was like 'It's going to be on film documented for my children to see. I can't be 140 pounds. I need to put on a little bit of muscle.'