Reply #1: If the rich and powerful are allowed to opt out of a national system

[Warpy]

you can bet they will make sure that system is underfunded precisely to prove that it doesn't work.

The only way a rich man should be allowed to opt out of a national health insurance system is by leaving the country, something he can't do if he's facing an emergency like a heart attack. He's going to make sure that system is up to par if he realizes underfunding it is going to lead to his death.