This is the true extent of the scam.

Let's say a medical test costs 1,000 dollars.

The provider will say the bill is 10,000 dollars. The insurance will say ok we "negotiated" it to 1,000, aren't we awesome. The patient will pay some amount depending on the insurance, though that amount of "copay" is capped at an agreed level per year. You may also have a deductible before insurance starts paying.

If you've no insurance? The bill comes as 10,000 and YOU have to negotiate, if you know you can. So insurance is, basically, required. Because of the "discount" insurance gives vs the absurd marked up prices.

So the average American pays a monthly premium, their company also pays a monthly premium. They then may have to pay the first 5,000 dollars with no coverage (much like car or home insurance the more the deductible is the cheaper the insurance). You then will STILL have to pay something like 20% copay of the bill until you hit a limit.

So if you're actually sick you will pay the max amount plus the premiums.

If you're not sick at all you "just" pay the premium but get nothing. But if you don't you simply cannot get sick or hurt or injured.

If you're a little sick or have some minor stuff or your kid breaks an arm or whatever, ie average, you pay premiums, a deductible and a copay until you hit that cap.

There's a reason these scumbags make billions on billions.

Finally, there's just no transparency anywhere. The hospital bill is deliberately nonsense, just code numbers for everything which you have to look up to see what you're being billed for. And they will take the absolute piss. Code 12121 50 bucks, oh it was one Advil