Oh wow, I encountered this exact problem today for the first time. It's absolutely insane!

I went for a routine doctor's visit a month ago, and paid the $30 copay or whatever it was before the visit. Today I got a bill for $208 where my insurance covers $193, which comes out as them wanting exactly $15 extra from me.

I have Kaiser insurance, I went to a Kaiser facility, saw a Kaiser doctor. It is completely incomprehensible to me how they couldn't know that my visit was actually going to be $45 beforehand, such that I could have paid that instead of the $30 I did. The $208 is obviously just a bullshit number some system pulled out of its ass, and the insurance coverage is just bullshit - 15. I don't get it, it's pure madness!

yes.. another 1K. I blame doctors and insurance companies (but mostly the latter.. the former was taken for a ride long ago by the latter). An example of just how ridiculous this is: my son (who is almost 15), was recommended to have a 'pediatric echocardiogram'. The children's hospital that I took him to (a Tier 2 facility in insurance parlance.. which roughly means that my insurance company doesn't own them) indicated that this procedure MIGHT cost up to $5000. So, I asked my insurance company (which I pay 1000 per month to for my three kids and I, in a addition to a 3500 per year deductible), what Tier 1 facility in NJ I could go to, and how much the procedure would cost.

They did not know of a facility where this procedure could be done at first. They had to 'research it'. They found a facility, but when I called, they could not perform the procedure because it called for a 'pediatric echo', which they were NOT allowed to do (mind you, it's like the same echocardiogram that you and I would receive). When I presented this information to my insurance company, they had to again, research it. I ignored it, and found it on my own after calling the heart group at one of the teaching hospitals in my state (NJ). So, I asked my insurance company how much it would cost, they refused to tell me. They indicated that they do not dictate pricing; this is the job of the provider. I noted to them that I did not believe them because I knew that they have contracted rates with all of their Tier1 and Tier 2 facilities and they knew exactly what they would reimburse for. They flatly denied that they had any knowledge of pricing and that this was the responsibility of the provider. My response was a question: so, if the provider charged you 1 MILLION DOLLARS for this procedure, you would, in fact, pay it. They indicated that they did not have any pricing knowledge whatsoever. I ended up getting a second opinion and found out the echo wasn't necessary based on follow up findings. It was one of the most frustrating examples of federally mandated RIPOFF I had ever seen. My son's health was at stake, and they simply wouldn't help me. The doctor's are literally at their mercy because they control the money and EVERYONE lets it fucking slide. It's a crime.

That sounds brutally frustrating, distressing (given your child was involved) and an epic waste of time. And that's on top of paying $1k/mo for insurance.

That is outrageous. I am happy that I left the US and that my son has access to universal healthcare in Europe. I am happy to pay 50% of my income to taxes if it guarantees that I won't have to suffer a situation like you did (and that my kids can enjoy affordable higher education).

What do Americans think of the typical European system? (Paying more taxes and receiving almost free healthcare & education)

To be perfectly frank, it would be fine with me, as I'm basically paying what amounts to a tax anyway. At least it would be explicitly stated as such, instead of this 'bait-and-switch' bullshit foisted upon us here in the US. I suspect that Obama threw down the gauntlet here with the ACA knowing full well it would modified down the road.. I believe his ultimate goal was, in fact, a single-payer system managed by the government (similar to, um, every other country in the world).. but of course couldn't call it that. It's not clear what the Republicans will do, but the 'cat is already out of the bag' as they say. If it's a tax, call it that.. we pay Social Security as a tax so we have some safety net when we're older.. nobody bitches about that (and Americans can really bitch.. just watch the news)... it's like 5%. Why not a similar tax for healthcare? Furthermore, why do we even need insurance companies? They have too much power over services and do ABSOLUTELY NOTHING with respect to our personal health. They're essentially payment clearing houses.. if we're going to privatize health, then we should mandate better price visibility of services and also better risk assessment of the ultimate receivers of the health care.. Currently, their risk assessment models are far too naive (blanket premiums with high deductibles).. Healthy people should pay less for their health care.. sick should go into higher risk pools and be paid out of the tax largesse managed by the government. Long ago, insurance companies began to amortize (health) risk through HMO's..when before that it was ostensibly pay-for-service through the doctors. They began to collect the money.. and then the service fees began to sky rocket (sounds like the US housing market, doesn't it?) Now the insurance companies know they have a huge target on their backs and are buying up all the hospitals and the private practices so now they own the 'last mile' of health care. Unfortunately it's a 45 year-old morass of legislation that no one (not even Google) wants any part of it. A good start is to mandate visibility into all services and let the consumers bitch and complain to the paymasters (their government, doctors, and insurance companies).. something will change. Until we know exactly how much things cost, we'll never be able to effectively optimize any of it.