If I turn down the job that requires 60 hours a week, they will likely find someone who is willing to do that. It's partly from a week job market, partly because people are so bad at understanding their own financial situations, and partly because the availability of financial leveraging systems like financing and credit.
And, of course, a company that's willing to take on an employee who's willing to work 20 unpaid hours a week probably also has a lower level of quality demand on a per-employee basis. What's particularly infuriating about this is that they could probably pay a more qualified candidate more money and get better work, and yield the results of two poor candidates. Essentially, companies are stepping over dollars to pick up dimes, and execs are laughing all the way to the bank. How pointless.
For many people, especially those with families (not to mention those with family members with medical issues) the healthcare issue really does leave them beholden. It also stifles entrepreneurship.