This is the precise opposite of how it works for a lot of people in the US. I've been on both sides of this, with two incidents a few days apart on either side

This is the precise opposite of how it works for a lot of people in the US. I've been on both sides of this, with two incidents a few days apart on either side of student insurance expiring. Hospitals charge uninsured people a ridiculous amount, then mark it down anywhere from 50-98% (Yes, I had a bill that was adjusted 98%) based on negotiations with insurance companies. Uninsured people get hit with the full, absurd inflated costs as bills. They then have the privilege of begging the hospital for a markdown or a payment plan (turned down completely in my case as an unemployed graduate student because I couldn't afford my own place and lived with parents). The bills don't show up for anywhere from three weeks to three months, and there is no indication of what is owed until they end; Nobody's able to tell you on command what things cost before 'coding' things at their leisure. One hospital visit that does any nontrivial diagnostic work may incur dozens of separately billed "services" running through different providers and individual doctors. That begging the hospital for a markdown only applies to them, three-quarters of the others won't accept anything short of the full amount. I thought this system was a bad compromise, but then I got sick. The system is absolutely ridiculous, the victim is given an open-ended debt("If we think of anything else you owe us we'll call you", & "No, we can't give you an itemized bill for 'services'") in dozens of segments with little room for argument or inspection, and threatened monthly with destruction of his financial livelihood. Don't support single payer healthcare? Try a major acute illness on for size and see if your opinions change. This system of "insurance", whatever it was supposed to solve, is utterly broken unless you happen to be healthy. PS: My state is apparently recognized as one of the best in the nation on this topic, I can only imagine what it's like in North Dakota. A lot of people's lives have been ruined by a medical system that makes it downright impossible for the average person to tolerate getting sick. PPS: I think of hospitals as somewhat predatorial now because this will fall worst on an honest, ignorant, unemployed person who attempts to pay his debts - the way one is advised by financial experts to deal with it is to either declare bankruptcy, or make small monthly payments, an option which appears nowhere on your bills (which demand payment immediately), and which the hospital will not either volunteer or agree to when requested. Token payments above some undefined percentage of the debt will prevent them from sending the bill to the collections agency. So if you know this, a major illness might be roughly equivalent to an unexpected student loan, but with the stress of destroying one's health and future health insurance. If you don't, or if you acquire a chronic illness which requires extended care, you acquire a permanent black cloud raining down acid on your financial future.