When it comes to healthcare, at any point in time most people cost very little, but there is a small group of very sick people who cost a lot. Pretty much everyone will fall into this small group of costly healthcare consumers at some point in their lifetime, and they have almost no control or ability to anticipate when that will be. Heart attack, pregnancy, cancer etc. can all shift someone into the high cost group. Sure, there will be some unlucky people who spend more time in the costly group and some very lucky people who remain relatively low cost throughout their lives, but we have no way of knowing who that will be. This is what we call "an information problem", using applied economic speak. Because we don't know how much we would need to save to pay for our healthcare needs or when we may need it and because we can all anticipate being high cost healthcare consumers at some point, it makes sense to enter an insurance pool.
When you have a large insurance pool where there are lots of people who do select in based on some reason: (employment, residence, citizenship etc.) aside from health status, you create a system where the healthy transfer money to the sick (because remember, most people are relatively healthy most of the time) with the knowledge that when they are sick, the healthy will in turn transfer money to them. The bigger the insurance pool, the more healthy people there will be to transfer money to cover the very sick, and the less costly one major illness will be for everyone. This is why the individual insurance market is so inefficient. It creates a system where more of the sick select into the insurance pool, and the relatively healthy stay out. This is also why the individual mandate is an important component of healthcare reform from the perspective of the insurance companies. They need healthy people in their pool to keep premiums low and ensure a profit.
In terms of the wealthy paying for the poor, the evidence is more mixed on this case. You can argue from a public health perspective the wealthy benefit from the poor having healthcare coverage. When people are able to get treatment for infectious diseases more quickly, it reduces the likelihood that the diseases will spread. Also, immunizations are an important aspect of preventive care. Children with certain diseases are unable to tolerate vaccines and have to rely on herd immunity to keep them well, if access to immunizations is reduced, herd immunity becomes less likely, and these children are more likely to get sick. This becomes especially true with the current cultural movement against immunizations that some more well off families are participating in. Preventive care also reduces the strain on our emergency systems, freeing up medical personnel for true emergencies. Finally, a healthy workforce is a productive workforce so greater healthcare coverage of low-income families is good for business' bottom line.
A recent ground-breaking study from the National Bureau of Economic Research evaluated the impact of Medicaid coverage on low-income Americans and found that despite the issues with lower acceptance of Medicaid by doctors and healthcare providers, individuals on Medicaid had better outcomes than those without insurance. They got better health coverage, had better mental and physical health status, and were financially more stable. The study used a randomized design to avoid selection bias, and is a very strong study methodologically. This paper illustrates the importance of health insurance, especially for individuals and families who are already struggling.
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