Risk is not the only factor. Premium cost is probably the more important one for most. If someone can afford the $40k deductible option, but not the $5k option, you’ll just have to accept the risk. Increasing earnings significantly right now is harder than hoping medical bankruptcy won’t matter in the long run.

30% of US households make less than $50k. That’s more than 100,000,000 people in homes with less than $3.6k/mo for all living expenses. The stories you ask for are simply inevitable