Not having health insurance is not an excuse. In Germany you are required by law to have it.
In Germany, does your health insurance cost >$600 per month for 1 person if your employer or government doesn't subsidize it (for example, if you are self-employed and earning more than minimum wage from it)? Because that's the case in the US.
There are upper limits for the national health insurance which is based on a fixed percentage of your monthly income. I've passed that border this year (earning around 66 k€/year) and from now on, I will not have to pay more, so my procentual share actually goes down from now on.
If I'd marry now, my wife and any children would also be covered by my percentage, it's called "family insurance". Pretty fair after all. (Some limitations apply, but if my wife would stop working, she would be covered through my insurance.)