Hey all, I’m British so I don’t really know the ins and outs of the US healthcare system. Apologies for asking what is probably a rather simple question.
So like most of you, I see many posts and gofundmes about people having astronomically high medical bills. Most recently, someone having a $27k bill even after his death.
However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They’re just some elaborate dance between insurance companies and hospitals. If you don’t have insurance, the cost is lower or removed entirely. Supposedly.
So I’m just asking… How accurate is that? Consider someone without insurance, a minor physical ailment, a neurodivergent mind and no interest in fighting off harassing people for the rest of their life.
How much would such a person expect to pay, out of their own pocket, for things like check ups, x rays, meds, counselling and so on?
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“However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They’re just some elaborate dance between insurance companies and hospitals. If you don’t have insurance, the cost is lower or removed entirely. Supposedly.”
Partial Truth.
Healthcare providers have negotiated prices for services. These prices are negotiated per insurer.
Blue Cross and Blue shield will pay them X dollars for Deep Sleep anesthesia. United Healthe care will pay them a different amount. Medicare will pay them yet a different amount. Bob’s backyard healthcare will pay more because they don’t have buying power.
If you walk in without coverage, the provider “can” charge you a reduced rate. They are not required to. They do NOT universally offer that.
If you get the procedure done anyway, agree to pay and cannot pay your health bill, the provider “can” just let you off the hook or reduce your rate. They do NOT usually do that. That’s the exception.
If you go to a provider that accepts your insurance (they all do not) and book a procedure, the provider has to get the procedure covered by the insurer. If the insurer decides not to cover the procedure, you can call the provider and try to create a grievance. The back-and-forth is maddening.
My local doctor said I needed a colonoscopy (it’s just that time, no emergent issues)
My insurer authorized the procedure but not the anesthesia.
The office offered to pay out of pocket for the anesthesia ($1200), but I declined because I couldn’t afford it. They also offered to set up payments if I paid 50% upfront, but I declined because that didn’t help me. I can’t take on another $100 / month for 12 months.
I spoke with the GI doctor, a second GI doctor, and my General Practitioner. They all said that people here really don’t get the procedure without anesthesia, and it was a bad idea for both the doctor performing the procedure and for me.
I contacted the insurer, but they refused. Another GI doctor contacted the insurer, but they refused.
My insurer decided in January that they will not cover anesthesia for a colonoscopy unless someone can prove you’re frail enough it might kill you.
We have federal laws that mandate insurers to cover the anesthesia for this procedure, but state-level insurers (hint: they’re all state now) don’t have to follow their rules.
So here I am, two years late for a colonoscopy, wondering if I have pre-cancer or cancer brewing down there, but can’t manage to pay for what is considered by all providers here a necessary part of the procedure.
It’s not great here.
You need to consider your health first and only. You get the anesthesia and then you either ignore the bills or pay a little bit what you can. Either way eventually you’ll be able to close it out by paying maybe half.
Alternatively, you can tell the doc to either give you the anesthesia for free or go with the insurance attitude and have the procedure without it and - should something go wrong because it is not what you are supposed to do - then you have yourself a juicy malpractice suit for them.
The investors who make money from this bullshit write our laws. That’s the problem. We allowed it to happen by having such dumb fucking morons for citizenry who vote for these monsters who then turn around and rape them. And then they vote for them again. Our people are mostly absolute morons who can’t think for themselves and so they follow the shiniest trinket they obey the loudest voice with the bleached smile and the most promises.
And yes, conservatives are to blame and yes, there are awful liberals as well but the simple truth is republicans need to fucking die. They are a deadly cancer to our society because all they do is ruin everything except their own pockets.
Doc will not provide anesthesia for free. The insurance company will not budge.
I’m not in a situation where I can just keep hopping over doctors while they all send me to collections, even though $600 is too much to swallow at the moment.
If I do end up with any form of GI cancer, a lawsuit against the insurer seems pretty reasonable.
The people here already spoke of the option of medical tourism, can’t you look up that ? A colonoscopy is not some advanced tech, any decent hospital in latin america will be able to do that. Since you earn US dollars, you could research about making a trip to Mexico (possibly the cheapest option, because it can be done by bus or car), Cuba (possibly the cheapest too, because of the conversion rate and short plane distance), Brazil, etc for the travel, lodging and procedure (and even a little tourism too if you have the time and will XD ).
I’m mid-atlantic. Procedure + flight + basic accommodation is still around 2/3 of the anesthesia. Medical tourism works well when you’re uninsured or when the whole procedure isn’t covered. Sadly, I’m already paying a fortune for the insurance. It’s a mid-high plan Blue Cross. F’ing insane they’re taking this line.
I’m really sorry for your situation. I would personally just get it done, commit to paying them and then just stretch it out maybe a few bucks at a time. Your health is more important. But I do wish you the best of health.
I was on Medicaid for many years but I’m really lucky now my wife is in the teachers union and we have very decent insurance. But the entire system is a big stinking chaotic farce to which the terms “broken” and “mayhem” are even too light to apply.
But as long as our government is in the employ of the 1% nothing is gonna change. We seriously need to start stringing up some billionaires and take their money for everyone.
I have Blue Cross and Blue Shield. a mid-upper tier plan. They just decided to stop covering this.
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https://www.anthem.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_a050126.html
Anthem BCBS classifies it as not medically necessary so they will not pay for it since April of this year.
Jesus. That’s disgusting.
Edit: Hang on I just skimmed that document it seems to indicate it IS considered medically necessary.
Edit edit:
* Prolonged or therapeutic endoscopic procedure requiring deep sedation such as endoscopic retrograde cholangiopancreatography (ERCP) or repeat colonoscopy due to tortuous colon; **or** * A history of or anticipated poor response due to cross tolerance or paradoxical reaction to standard sedatives used during moderate (conscious) sedation specifically due to narcotics or benzodiazepines; **or** * Increased risk for complication due to severe comorbidity (American Society of Anesthesiologists \[ASA] class III physical status or greater. See Appendix for physical status classifications); **or** * Individuals over 70; **or** * Individuals under the age of 18; **or** * Pregnancy; **or** * History of drug or alcohol abuse; **or** * Uncooperative or acutely agitated individuals (for example, delirium, organic brain disease, senile dementia); **or**Uncooperative or acutely agitated individuals. Tell the doc to tell the insurance that it makes you crazy without it and you can’t tolerate it. Jeez is your doctor new at doing these things? That’s what they do they submit whatever criteria is accepted that they don’t have to prove with charts.
The insurance companies having more say than doctors about what procedures you can and can’t get is peak insanity, and yet here we are.
Plus all of that negotiating is baked into the end costs which is why in the US on average we spend twice as much on medical care with worse outcomes and not everyone is covered.
It really depends. Some people have insurance that limits their liability to $500 or whatever for hospital visits, but if so they probably are paying a lot out of each paycheck for that.
I have family coverage and this plan pays essentially zero towards anything, except pays 100% of the annual wellness visits to GYN, GP, and dermatologist, any vaccines considered preventative too. Then there is a "deductible " of 6,850 per person with a maximum of 8,000 a year, then it would then pay 80% of anything above that $8k until we paid $16k, then it would cover 100% of anything above that. So basically it really is “insurance” not healthcare.
Which would be ok except that the plan itself costs almost $7k a year in premiums. I am not getting that much value out of it. And that’s not even the total, my employer is paying some too!
So most years this costs us in total maybe 8,000, the premiums plus a couple of visits and any drugs.
The only people winning in this system are the insurance companies, the one who owns our plan made revenue of $371 billion last year and a net PROFIT of $22 billion.
Oh and as you are asking about uninsured, I was for a long time, and you have to negotiate your own prices in that case, argue for a cash price. And hope nothing big happens. The mammogram cost almost $600 when I had to get a diagnostic one, colonoscopy $1,500. Childbirth, at home with midwife including all prenatal about $8k. Doctor visits between $80 and $200.
Firstly, thanks everyone for all the responses. I appreciate it, and I hope that some of you felt better after having a vent.
American friend predictably says there’s a problem with “healthcare literacy” and that you just don’t have to pay the bills and they probably won’t chase it up. I don’t beleive that at all.
I figured it might be interesting to share how much I pay for stuff up here in Scotland.
I have a decent well paying job so I pay some money to the NHS in taxes, specifically ~£2000 a year. I get antidepressants and doctors appointments completely free from that. Dental I don’t get free because my income is too large, but it’s only like £20 for most routine things. I have a free eye test booked next week, and I splurged £10 extra to get fancy 3D imaging stuff done.
I do require mental health treatment though, and the NHS doesn’t cover that for autistic people (as a competence issue, rather than a policy choice). A session with a counsellor costs £45 per hour for me privately.
Honestly, the surprising thing to me isn’t that you have an insurance system (Switzerland has a similar thing, iirc), it’s just how inflated prices are compared to here.
American friend predictably says there’s a problem with “healthcare literacy” and that you just don’t have to pay the bills and they probably won’t chase it up. I don’t beleive that at all.
healthcare literacy is an understatement and i’m glad you quoted it, you literally have to be a full time lawyer reading through this shit with a career SPECIFICALLY in handling health insurance to be able to understand it. Outside of that you’re literally just guessing that it’ll work.
Maybe someday i or someone else can found a thing like “open healthcare” providing that information for free in a fully publicly accessible manner. Why it isn’t legislated, i don’t know.
We pay $500 a month for family “health care” because we’re forced to. Every doctor visit I go to I get a $40 bill just for walking in the door, on top of paying for my medicine copays. It really sucks.
on the one hand - my wife and i didn’t have insurance when my oldest was born, as i was doing contractor work overseas. Between one thing and another over the course of that year, we paid like $8k in medical expenses, including all the obgyn visits and the actual delivery, plus a hernia repair for me. The hospital was very easy to work with. Our income was very high so it was not exactly a burden. (8k was about 2% of total salary)
on the other hand - this year, with insurance we’re going to pay about $6k in insurance premiums and $8k in medical expenses before we hit our deductible (~7% of total salary)
on the gripping hand - last year we had really excellent insurance. we paid a total of $1200 for the year in premiums, $50/pay period, and our deductible was only $2k. (~1% of total salary)
So it definitely varies a lot
n the other hand - this year, with insurance we’re going to pay about $6k in insurance premiums and $8k in medical expenses before we hit our deductible (~7% of total salary)
First world countries spend like $6,000 - $8,000 per person on care for better outcomes. The US pays more in employer subsidies and premiums than other countries pay altogether for medical care, and they don’t have to worry about it at the point of service.
thanks for explaining things i already know, and that have no fucking bearing on the question OP asked.
this isn’t “whose health care experience is better and less costly” - the question was “what does US health care cost”, which is the question i answered.
You left out the absolutely massive amount of costs hidden by employer subsidies by focusing on the point of service costs.
Also, your username checks out.
My experience is pretty similar to others. Basically, if you have insurance (most people do, and there are lots of government subsidies to help afford it), and you’re relatively healthy, it’s predictable. If you get seriously ill, or have chronic health problems, the expenses can quickly bury you.
I’ll add one thing about pharmacies. The same medication can be $300 at one place, and $40 next door. You just never know. There are also pharmacy discount programs that can radically reduce the price. I had one that was around $150 with the insurance, then the pharmacist performed some type of incantation on the computer, and suddenly it was about $16 without the insurance.
nobody actually pays those bills. They’re just some elaborate dance between insurance companies and hospitals.
Sometimes there is an elaborate dance between the two on pricing. Sometimes the insurance company dances on its own to determine why the service is not covered.
If you don’t have insurance, the cost is lower
Depends what you mean by cost. insurance is always out to make money, that means paying less, and negotiating lower prices with providers. However, there are some situations where it benefits both the service provider and the insurance provider to inflate the initial price, and negotiate a steep “discount” to a final price (a portion of which the patient pays) that is higher than the non-insurance price. But I don’t remember the exact details, and I may be conflating this with some other healthcare industry scheme.
or removed entirely. Supposedly.
If a hospital is nonprofit, I believe they are required to have a (self determined) charity care policy that they must follow. If you make below a certain amount, you can apply for relief, but that also applies for to after-insurance costs, not just no-insurance costs. For-profit hospitals will rake you over the coals and send collections after you. Part of the problem with charity care, is that you may have to ask for it, and few people know enough about it to do so. And you may have to ask for it in the right way. If you aren’t specific enough, they may offer you “financial assistance” which is just a payment plan. Then they’ll treat you the same as a for-profit hospital would.
If you’re interested in a deeper dive, the Arm and a Leg podcast is a great show about healthcare costs in the US.
It’s bad, a large percentage of bankruptcies in the USA are for medical reasons and a large percentage of those did in fact have insurance. The system is broken.
I have insurance. Just to give you perspective. I had a video call for some mental health diagnosis. I now have a bill of $568 dollars. Reminder, this is WITH insurance. I have to pay that out of pocket. And I even have to set up additional appointments. Which will be probably around the same price.
I also have an inhaler. I had a doctor’s appointment to get a refill on my medication because I don’t have to use the inhaler too much (meaning I don’t have to refill often). I try to stay healthy and workout and only have to use it when working out/exercising. $300 dollars for the appointment. Another $212 for the actual medication that I picked up. In the last 30 days I have blown over a grand on medical. And I’m not even sick/unhealthy.
My wife on the other hand has very expensive monthly medication for a rare disease. She hits her max out of pocket every year which is 5k. Which we just have to pay forever. If I was on her healthcare plan, we would end up paying 10k every year just for healthcare.
I would say on a regular year. We pay around 7k in healthcare costs with our insurance (depending on how healthy I am throughout the year). On a light year 5.5k.
Is it possible to get health insurance with no copay at all in the US? My insurance in Berlin is about 1500€ per month, for which my employer pays half. If I lose my job, the unemployment office pays it and the price drops to 100€. The same happens if my salary drops, because the insurance cost is a percentage from my salary.
But if I came to the US, what kind of insurance would I get with $1500 per month?
When I was on welfare, I got Medicaid. (Free health insurance from the government.) I chose the plan with no copays or deductibles. It was nice.
They had another plan where the copay was $3. I had it before I moved to the no copay plan. It’s fine, but being on welfare at the time, every dollar counted.
Now I have my employer plan and my copays range from $15 - $50, depending on the type of appointment I see. I pay about $1k/month in premiums.
Typically you have a choice between public Medicare/Medicaid, high deductible health care plan through work. Or co pay plan through work. And as for per month. It really depends on the job. Everything depends on where you work. If you work at a company with good healthcare you will probably pay more. But have a lower max out of pocket.
If you want I could look up what I pay on a monthly basis for my healthcare and get back to you.
Like the whole stress of needing to pay anything if needing medical help… If I would avoid that, it is worth even a bigger monthly pay.
Like, in Berlin I can just walk to a doctor, to a hospital or to a pharmacy, plug my insurance card to a machine and it is all settled. I never see any money changing hands, or at maximum 10 euros copay if getting expensive prescription drugs.
Completely removing the stress of having a huge bill suddenly is worth the money I put into the insurance every month.
Oh totally agree with you. Our system is sooooo dumb. Plus, this is all just the payments for the actual healthcare and how it interacts with my insurance. This does not include the insurance premiums I pay every paycheck.
I spend all of this on top of my insurance premiums.
Yeah if you make less than 10k/yr or something, sometimes you can get state health insurance and it covered everything for me.
On average they actually spend $12.500 per year (total, PPP adjusted, at leat that’s the number for 2022)
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
You as a Brit spend $5.500 (also adjusted) (And as a bonus, at the same time you’re also expected to live 2.8 years longer than the average American.)
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The United Kingdom provides public healthcare to all permanent residents, about 58 million people. Healthcare coverage is free at the point of need, and is paid for by general taxation. About 18% of a citizen’s income tax goes towards healthcare, which is about 4.5% of the average citizen’s income. Overall, around 8.4 percent of the UK’s gross domestic product is spent on healthcare (an amount of around 0.18984 trillion GBP). UK also has a
growing private healthcare sector that is still much smaller than the public sector.( http://assets.ce.columbia.edu/pdf/actu/actu-uk.pdf )
So it should be more like £1.200 for you?!
And I think the study I linked is total healthcare expenditure. So it also covers the extra private insurance and the medication you buy that isn’t covered at all. I’m not 100% sure.
But yeah, that’s how statistics works. For everyone who pays less than the average, there has to be someone who pays more than the average. And I also think it should work with solidarity. Rich people can afford to pay more.
Plus the Brit coverage is universal while the US has a significant number of uninsured. We pay double on average including for those that aren’t covered at all. Even though the long lines myths are overblown for countries with universal care, it is important to remember that in the US a lot of people never get the care and we still have massively long wait lines unless we can afford to be first in line. The wealthy have a fast pass.
it is important to remember that in the US a lot of people never get the care and we still have massively long wait lines unless we can afford to be first in line
This is really important for non-Americans to understand. Yeah there are waits to see specialists and so forth in countries with a public system. We also have waits…but it’s for people who can’t afford the procedure. They have to wait until they can afford it, and if they can’t they simply have to live with their condition indefinitely or until it’s bad enough that they go to the emergency room. People who are uninsured go to the emergency room for everything because, legally speaking, they can’t turn you away. They have to at least diagnose and stabilize you. Because these people are broke, they generally end up not paying the bill, which means everyone else’s costs go up.
You couldn’t devise a worse system if you tried.
I spend more than that just for insurance for two. Actually using it costs far more. Strep? $250. Video call a random person when I’m in bed after puking my brains out? $100 for a five minute call where they tell me to drink water. Minor surgery? Thousands of dollars in bills sent between two months and two years after the surgery.
I really wish you people that it’ll become better one day. It’s just a rip-off and and a way to funnel money from normal people to the rich. Looking at other countries, you could do away with the scary bills. And on top have an extra free $5.000 each year. Per person. And I think it’s extra cruel to rip off people with their health.
Currently $1700/mo for a very healthy, young, family of three. That comes with a $5000 deductible per person (or maximum out-of-pocket of $13000 for the family).
Oversimplification, but we basically pay $33,400 per year before insurance kicks in to cover costs.
That’s ridiculous, yes. But my last uninsured trip to the ER was for an unbearable stomach pain. The 4 hour visit consisted of a shot of pain killer, a scan that showed nothing, and observation by a couple of nurses during that time. I got a RX for some chalky pill and was told to cut back on NSAIDS and alcohol. Fair enough.
The bill from the hospital was $16,000 for the bed, nurses, and scan. Then there were separate bills for the radiologist and the ER doctor, and some lab work bringing the total to ~$17,500.
I currently do not have insurance because I cannot afford it. People treat me like I’m crazy for being overly cautious about getting COVID-19, but without insurance , I could easily go bankrupt if I get it.
American healthcare is truly awful.
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that is insane… I had diverticulitis and had a ER visit also here in chile… RX and everything I think the total account was something like 250 usd… of which I paid maybe 30 usd because of my health coverage plan… how can it be 50 times more expensive ?? I pay 80 usd for my plan monthly.
A lot of it depends on what insurance you have and what insurance you have depends on who you work for.
I had EXCELLENT coverage with Kaiser Permanente, and other than a couple of hundred dollars a pay check and an in-office co-pay for treatment, I never had a bill.
When I had my heart attack, the Emergency Room was $150. 8 days in the hospital and open heart surgery from the head of the department was $100. The prescriptions and all the oxygen bottles I could carry was $100.
4 weeks into recovery, my company got bought. :( The new company didn’t do Kaiser in Oregon. If I lived in California or Washington, I would have been fine, not Oregon.
So they switched my insurance to Aetna which meant I lost all of my doctors and had to start over at a new hospital. Kaiser is members only and I was no longer a member.
Naturally I started having complications, congestive heart failure. That was an ER visit followed by 7 days in the hospital.
Under the new insurance, they start by paying 80% and there is an out of pocket maximum of $6,500. Once you pay that, all other treatment is free the rest of the year. No co pays, nothing.
So I hit my $6,500 about 1/2 way through January. Goodbye signing bonus! But all the other complications I had the rest of the year were covered 100%.
Now… if I had NO insurance? 15 days in the hospital x 2 hospitals? Open heart surgery? All the tests and such? 24 oxygen bottles? A million dollars, maybe more?
I had a surgery that ended up costing a few thousand dollars after insurance and we have ok insurance at work.
You’re fucked if you don’t have insurance, which is common for a lot of the working class.
It cost us almost $4000 to have our first kid and we have pretty damn good (the premiums were not insignificant either) healthcare. No complications, no surprises, typical short hospital stay (like 3 days).
Was that pre ACA? When we had our kid, we only paid a $175 hospital stay copay. Granted… we’re very lucky with the insurance coverage provided by my employer, but we were under the understanding that the reason we didn’t have OBGYN copays and otherwise throughout the pregnancy was because the ACA made sure it was covered.
2018 major private university insurance! Kind of wild tbh still. When I saw the bill I asked my partner to see how much was pulled from their paycheck each month and to show me their plan. I made adjustments since we definitely were not getting good value so I at least wanted more cash on our pocket.
On top of your premiums, any insurance through a job means the job is paying thousands of dollars a year to insurance instead of paying you on top of what you paid.
Eh not thousands but yes upwards of $800-$1500 typically if the plan is good.Read it as a month not a year lol you’re correct
I think you may have read that backwards.(didn’t see edit till I finished posting so I’m keeping the rest)If the plan is ‘good’, then the part the employee ‘pays’ each month is low and could be in the hundreds each year before paying for any care they actually receive. But the employer is shouldering the rest of the costs behind the scene as part of the cost to employ. That means whatever they spend on insurance is money not going to your income so it really doesn’t matter if it is paid directly by the employer or employee, that is all smoke an mirrors.
As an example for state employee plans from 2020:
While health insurance premiums varied greatly across the states, the average per-employee per-month premium was $959; states paid an average of $805 (nearly 84 percent) toward premium contributions.
This means the insurance company is collecting $959 dollars per state employee per month just to have them on the plan ($11,508 /yr) -The state is paying $808 per month ($9,696 /yr) -The employee is paying $154 per month ($1848 /yr)
This is all before office copays, medicine, emergency room copays, hospital bills, care clinic visits, and any service where you pay something to access service. This is generally decent to good insurance in the US and we pay well over the cost per person in other countries just to be insured.
To drive home that this is not an outlier, this is the cost that each country spends on health care per person United States $12,555 Switzerland $8,049 Germany $8,011 Norway $7,898 Netherlands $7,358 Austria $7,275 Belgium $6,600 Australia $6,597 France $6,517 Sweden $6,438
Everyone in Sweden is covered for healthcare, they don’t need to pay at the point of service, and they spend about half of what the US does on average including the uninsured.
TL;DR: mine is $660/month for health, $42/month for dental
Most folks in the US aren’t aware of how much they pay for health insurance. I live in California, where law requires full time employees (>30 hrs a week, >130 hrs month) be provided some amount of health insurance. The type of coverage varies not just from job to job, but also within the same job the employee must often choose their own plan from several company selected options at varying price tiers and types/amount of coverage. Usually the employee only sees the amount of the monthly cost that THEY are responsible for, which is then automatically removed from their paycheck. What most folks are unaware of is that the employer is also paying some of the cost (which is the part that the law makes them do). The part that makes it extra frustrating to deal with an already broken and overly expensive system, is that the rate paid by employers is negotiated in bulk with the insurance providers. Larger employers (national corporations with hundreds of thousands of employees) are paying much less than an individual or small employer would. This is the one of the largest reasons becoming unemployed is so dangerous in the US. In addition to not having income for food or housing, people often forego health insurance due to the expense. If you lose (or leave) your job you’re eligible to keep your current insurance plan for 18-36 months with COBRA (Consolidated Omnibus Budget Reconciliation Act, which is such a ridiculous backronym that I had to google it just now). This is often the only time people realize the true cost of their insurance as the entirety of it is then passed on to them directly (at the employer negotiated rate) and it shows up as a new monthly bill.
I recently left my employer to start my own business and discovered that my true cost of insurance is ~$700/month ($660 Health/$42 Dental). Keep in mind, this doesn’t mean that I have zero medical bills should I actually visit a doctor or hospital. This is pretty good health insurance, but I still have to pay $5,000 out pocket (annually) before it kicks in at the full coverage amount. Since I had ear surgery earlier in the year and hit that limit, and wanted to be able to continue seeing the same doctors I had for already scheduled follow ups, I decided to keep the same insurance. That $5,000 isn’t the only expense that landed on my shoulders, there’s a bunch of rules that I honestly don’t fully understand and I’ve probably ended up paying somewhere between $7,500-$10,000 for the surgery I had (in addition to the monthly premium).
The main reason I keep paying insurance (in addition to the fact that you’ll now be charged a penalty on your taxes if you go uninsured for a month), is my fear that you mentioned in the original post. Having a car hit me while I’m walking down the street and ending up with a $50,000 visit to the emergency room is a very real possibility without health insurance. California recently limited ambulance rides to a maximum cost of $1,200, so that’s… good?
The tax penalty is (was? Sounds like it’s gone away from a quick google.) still significantly less than insurance premiums for a lot of people.
