I resisted paying for premium (out of spite) until very recently and only because my girlfriend complained.
I have been astounded at how scammy those ads are. There is a major class of ads that make fairly significant bullshit medical claims and I’m semi convinced the purpose is not for someone to make money but to wage psychological warfare on vulnerable people. Another class of ads says “the US government is going to collapse and that’s why you should buy a freedom battery” and the ad couches itself as a battery advertisement but how many vulnerable people hear that in the background 16 times a day and don’t end up subconsciously accepting some part of it?
In any case it’s all a manipulative cesspool and it’s bizarre to me that a property that Google otherwise values is willing to sling such slop at its users. I suspect a large part of this is that the executives who run YouTube never see their ads.