Here's the relevant chart: https://i.imgur.com/s97bp9R.jpg
"Health-Care Paradox Threatens to Add to Japan’s Debt Problems"
"Japanese seniors, who enjoy the world’s longest life expectancy, pay as little as 110 yen ($1) out of pocket for specialist appointments. While these visits may help prevent expensive-to-treat diseases, they’re becoming unaffordable in a country where almost 1 in 7 people is 75 years or older, and annual health-care expenditure grew at a pace 40 times faster than the economy from 2000 to 2016."
https://www.bloomberg.com/news/articles/2018-12-13/health-ca...
Japan's healthcare system doing so well given current stresses is a testimony to it's strength.
In the UK we pay nothing. I think this article is biased by American thinking.
I sort of imagine conversations going like:
Doctor A: You might have this other nasty thing, but I'd have to send you to doctor B to check. Doctor B will cost you a hundred bugs. Patient: I don't have a spare $100 Doctor A: we'll just hope it isn't that then. Me: WTF?
So what happens when you go to the ER? Obviously if it's a true emergency they'll save your life and try to bill you later, but then what?
Would it ever make sense to deliberately stop paying your premiums? If you can pay "out-of-pocket" for medical expenses, you might be better off saving your premium money until you need medical care that's actually more expensive than the back premiums. That creates an adverse selection problem (assuming that enough of your prospective customers are devious enough to try this). Even if you can't pay out-of-pocket, you could just stop going to the doctor until something serious happened.