It ends up being a really terrible game. You get treated, and then you get presented with an outrageously high bill. You then have two options - negotiate with

It ends up being a really terrible game. You get treated, and then you get presented with an outrageously high bill. You then have two options - negotiate with the billing company, or go bankrupt. A large number of people take the latter[1]. The result is that the hospital then has to eat the costs of the procedure... which it then responds to by jacking up the price even further for everyone else, knowing full well that most of the uninsured patients who get the even higher price won't be able to pay that, either. The hospitals then use this increased price to negotiate better rates with the insurance companies. So, you do get the treatment you need, but it nukes your finances, and everyone else ends up paying for it anyway in this ad-hoc, incoherent, uncoordinated mess. [1]http://www.cnbc.com/id/100840148 http://www.cnbc.com/id/100840148