Land of the free eh? If your not insured to step out of your house, you damn well better not do it! You could require insurance, but then people would die, or you'd have law suits or some other bureaucracy. Letting someone die on a mountain does not make economic sense(look at the lost income tax revenue alone). Slapping the person with a $100k bill could cripple them financially which may result in lost tax revenue though surely less then death. My suggestion is EDUCATION, don't require insurance, require boy/girl scouts(or a 1 hour test). British Columbia just put in a pleasure craft boating license for the same purpose.
Society shouldn't be about making people pay their way, it should be about what is most economical. If it costs 500 billion to fix a 50 billion dollar drug problem, don't do it, its a waste of time.