Well, I have no knowledge of Andrew's personal situation, and I probably wouldn't talk about it if I did. But for people in Andrew's general situation, here's

Well, I have no knowledge of Andrew's personal situation, and I probably wouldn't talk about it if I did. But for people in Andrew's general situation, here's how it goes. They might have insurance --- which is often obtained through the employer, but doesn't have to be. (And which might pay for only certain procedures, or only for doctors and hospitals who have a prior arrangement with the insurance company; also, many policies will pay most of the bill, but not all of it.) Insurance obtained through employers is often a better deal, since the employer is insuring a group. However, there's nothing yet requiring them to have insurance. (The Obama administration's reform bill will require it, but that provision is not yet in effect, and is already being subjected to court challenges.) If they don't, they're personally on the hook. And losing access to employer-sponsored healthcare plans is indeed a disincentive to people who might otherwise want to strike out on their own.