Yeah anyone who looks at lifetime bills in America Vs Europe and thinks the American system is better because it's "not actually free in Europe" is completely delusional imo.

It's free at the point of delivery. The whole of society pays for the whole of societies health care. As you mention it can mean young people paying more than they currently cost (although let's not ignore the young people who do have serious issues and likely wouldn't have a big employer funded healthcare plan), but when you're older you're paying way less than you cost, and don't have all the anxiety about whether you can afford a preventative treatment, or if your medical bills will bankrupt you and make you homeless at age 70. That's well worth the up front minor expenditure that comes out of your taxes and isn't noticiable to me.

American salaries are higher, but they tend to spend (what looks to me at least) as a similar amount on taxes and healthcare as people in Europe do, but have much less to show for it.

You technically can fall out off the system, bit it rarely happens. Not sure about the details though.

https://www.vdk.de/deutschland/pages/themen/gesundheit/82041/rueckkehr_zur_krankenversicherung_nicht_aufschieben?dscc=ok