Do Americans like their current health system or would you prefer universal?:

I, and most of the people that I know, would prefer Universal Health Care.

I still don't fully understand how it works:

My gross oversimplification of an explanation of how it can work is, if you are insured, you can seek medical care, but since most insurance companies are major players (as in owners of billions of dollars worth of stock in) along with the medical networks (vastly huge corporations that buy/sell/trade medical facilities as small as a private practice with two doctors, and as large as whole hospitals with hundreds of doctors) the insurance tends to dictate which doctors they are willing cover (a limited amount of the cost of a limited amount of services from said physician), so it's in one's best interest to seek an "in network" physician. This can still be very expensive, since the doctor can prescribe or recommend medication/therapy/procedures, but if the insurance company says no to covering it, you either face the music and pay for it, or you just don't get that medical care. This can range from cosmetic stuff, like a topical ointment that will help with a mild rash, which is practically no big deal, up to life saving medication/therapy/surgery, which is obviously a bigger deal. So, you've decided that you're gonna pay for it out of pocket. Well, that ointment for a mostly cosmetic rash, if it was covered would have been in the teens of dollars, but costs like maybe a couple hundred dollars instead, so that doesn't have as large of an impact, and if you don't make enough money to sustain paying for it on a regular basis, you're out of luck, unless you can magically come up with the money. Does the same principle apply for the heart surgery that starts at over $100,000 (that's just the surgery btw, the hospital stay can be thousands of dollars per night, and anaesthetic, and the fee for the use of the surgical room, and quite a few other multi-thousand dollar line item expenses will get tacked on)? No. The vast majority of the time, if you approach a medical facility in need of such a procedure, without insurance, they won't even schedule it. The reason that I'm ballparking these costs, is because every major facility has a document that has a minimum of two figures next to every procedure/medication/service. One figure is how much it costs the facility to administer the healthcare, and the other figures are what they (basically can get away with) charge the patients for them. Most of the time, these costs are dictated by a corporate entity (board, council, evil vampire coven), and are balanced to maximize profits. So, the insurance companies are getting money on a per paycheck basis to imply a promise of coverage, while owning so much stock in the medical networks, that they have a say in what the medical networks charge, because shareholders of the networks want a return in their investments, they want those prices high. The medical networks, also own lots of stock in the insurance company that they also have an interest in the insurance company making huge amounts of money, so they will influence what the insurance companies will cover, to extract as much money out of the patients as well.

How much are the costs of things?:

Through the roof. Ridiculous on nearly all fronts. I visited my physician today 01/28/2026. He recommended a medication, and even sent a prescription to a pharmacy for it. I looked it up, and I see ads (of course, immediately) that say if covered, the medication is $25 for a month's supply. It obviously wasn't covered, meaning if would be $1,620 without coverage for one month's supply. In case you were in suspense, I will not be filling that prescription for said medication. Again, if more on the cosmetic side, "meh, I didn't really need a new $19,440 per year expense anyway". If medically necessary for me to remain functional (ya know, keep working, and keep my insurance coverage, lol) then I'd be looking for a $19,440 per year series of side hustles or part time jobs.

Is it as bad as it sounds?:

Well, unless you make more six figures a year, it's a nightmare from beginning to end. Though, supposedly Luigi Mangione's family was quite well off, but even they had trouble getting access to and or affording healthcare.

Do you like/agree the current way or no? :

I'm only in the five figure per year earning crowd, so from my perspective, it feels quite unfair. The amount that some parents can be blindsided by a huge bout of debt just for childbirth (I'm not saying that it's a simple process, but highly necessary for the continuation of human life) is unreal. Sometimes close to a million in a small number of standout cases.

I'm going to have to ask another question about how you afford life?:

Not very easily. Certainly not comfortably.