As an American currently working with healthcare data, I’m familiar with the abundant failings of the US healthcare system. But I think it’s a mistake to think

As an American currently working with healthcare data, I’m familiar with the abundant failings of the US healthcare system. But I think it’s a mistake to think that it’s completely unavoidable and take a fatalistic attitude and feel like you always have a sword hanging over your head. As far as I can tell, it’s avoidable, but you need to get decent insurance before you’re sick, and to save up money to help you ride out times when you’re not making money (as well as pay the deductible/out of pocket portion). This is definitely expensive, and if you make no money, it can be difficult (though you'd then likely qualify for Medicaid). But many Americans do make quite a lot, and spend everything they make (and more) during the good times, even if they pull in >$100k/yr. Consumerism has a much stronger hold here than it does in Europe. EDIT: A bit more, since I didn't really address your comment about out of network charges. In the event that you get balance billed for some surprise out of network charge despite going to an in-network facility, you likely don't have to pay it, even though they're invoicing you. Contacting your insurer about it will likely take care of it. And if it turns out that you do need to pay it, hospitals are generally willing to accept $0.10-0.20 on the dollar for self-payers who can't pay, before they send it to collections. You don't have to pay the retail price, which is totally made up and has very little relation to what they'd accept. This is largely due to their adversarial relationship with the insurance companies, which force them to accept the lesser of their retail price and their contracted rate. Think of the high prices as the starting point in their negotiations. I fully agree that the US healthcare system is very messed up, and that what I'm saying sounds insane and unnecessary. I wish we had a single-payer system in the US (with optional private insurance on the side). Fortunately, it seems like people are getting sick of this, and we're getting closer to getting that. I just wouldn't take the attitude that the world is totally fucked, so you should live for today.