Mac says, a good travel insurance policy is an absolute requirement -
The part he left off was "for me", for him. Insurance, any kind, is playing the odds. When you buy it you're betting you'll have a disaster. When you don't you're figuring the likelihood of a dire event is low. If you take an occasional trip of short duration and can afford insurance, sure, why not. When the number & length of trips begins to mount and the budget becomes more of an issue then maybe not. It's called self-insured and is my insurance of choice. I'm betting that I won't need a stent or get run over by a tuk tuk. If I'd bought insurance starting years ago I'd have spent more on insurance than repatriation would cost so I'm ahead now no matter what happens and I'm comfortable with the implications.
I don't think it's ever useful to tell someone that an expense or purchase is an absolute requirement for everyone. It simply is not true. Horror stories don't help anyone, do it or this could happen TO YOU. The question is one of comfort, is a traveler comfortable with a low degree of risk and only they can decide.