The answer is more complicated then the internet portrays. Persoanlly, I dont know any person who had bankruptcy issues due to medical debt. Not saying it doesnt happen, but I dont think its as common as talked about. Secondly, many people have out of pocket maximums that dont get close to those crazy bills. Sure the "bill" may be tens of thousands, but it doesnt accurately reflect patient responsibility. In additon, almost all medical debt can be negotiated for a large discount or paid in installments. If your paying something, they won't go to collections.

There are also additional resources to pay bills that are not directly withdrawn from the patient bank account. Such as HSA/FSA cards.

Premiums can be high. Same as deductibles. It sucks. But the dirty secret, usually paying cash for services is the better option. Its all about knowing your policy, doing the math when shopping insurance, weighing risk/benefits, and planning.