This may have been true pre-ACA, but it isn't the reality now. It's now a system where wealthy, government employees, and the poor (i.e. subsidized) have acces

This may have been true pre-ACA, but it isn't the reality now. It's now a system where wealthy, government employees, and the poor (i.e. subsidized) have access to full care, and most of the middle class just goes without. In the past 5 years, I've gone from a decent $20 copay to a employer-sponsored high deductible to currently a fully out of pocket deductible of $2k before insurance pays a cent. I've begun rationing my prescriptions and simply skip the doctor unless it's a true life-or-death situation. The deductible for co-workers with a kid or two is something like $5k. That's on top of probably $10k in premiums a year.