Health insurance in the US is typically provided by the employer and covers the whole family, so there's a general assumption that everyone has it and it will c

Health insurance in the US is typically provided by the employer and covers the whole family, so there's a general assumption that everyone has it and it will cover some part of the cost. Medical services quote high to get as much as they can from the insurance, knowing (since everyone should have insurance) you won't be paying the whole amount. Obamacare was in part meant to cover the people missed by this. But they're required to provide emergency services even to people without insurance, and the cost isn't set in stone. It can be reduced (happened to a family member, he called and asked and I think he said they just did it even without proof) or "financial assistance provided" (says this right on a recent one I have). Haggling isn't really much of a thing here so I'd guess most people don't know those are options, or if they do are embarrassed to let people know they have financial troubles.