It's this way for everyone I know, except for medicaid recipients.

You are healthy and not self-employed, I take it.

Do you have insurance? I fail to she how being healthy and not self-employed affects the scenario as described (present card, get treated, recieve a bill).

If you are not self-employed in the US, typically your employer provides insurance coverage, most of which is pretty decent. If you are healthy, it doesn't really matter either way; unless you are involved in a serious accident or something, your interactions with the health system are infrequent and relatively simple.

I have, among other things, asthma. I'm a 1099 contractor; I buy my own health insurance. Prior to the ACA, which people keep threatening to revoke, I could not buy insurance that covered my asthma. I tried. I shopped around a lot. The same company that provided complete coverage at a previous employer had a pre-existing condition rider on the same policy.

After the ACA, my policy now covers my pre-existing condition (Yay!), but I'm paying $750 or so per month for it. If I could not afford $750/month, my options would be considerably narrowed. (And that's before the prescriptions for my pre-existing condition.)

Yes, I go in, I get treated. But my situation demands a pretty hefty bill anyway, or potentially a very large bill. Possibly enough to make me consider not going to get treatment.

I’m sorry you have a chronic illness. Do you understand that this is not about insurance, but about your ability to share the cost of your illness with society?

Plus, $750 per month is not that expensive for healthcare (unfortunately). My wife was paying $600 per month under the ACA and was completely healthy.

Another point is that the people with lower incomes qualify for subsidies under the ACA.

Youve skipped the step for obtaining a card in the first place. Something which is trivial here in Canada (easier than a drivers license, and free).

Also theres none of this in-network vs out of network chaos. Emergency care always covered, doesnt matter where you go.

It feels like youre trying not to understand how a public option could be better.

"It feels like youre trying not to understand how a public option could be better."

This statement assumes a public option (which varies wildly depending on the one) is better.

The parent comment wasn't about a public option or getting a card. It was a complaint that recieving care at a provider is extremely complicated. At that stage of the process, that claim is incorrect.

That bill can be for an amount that varies wildly based on your insurance, the doctor, who helps the doctor, what lab they send things too, and a large number of other options. If things work out well, your bill could be for $30. If you don't remember to ask the right questions, the bill could be $30,000.

Insurance companies have web portals that you can comparison shop for providers.

However, if your in-network doctor sends your bloodwork out to a lab that is not in-network, you're now paying a lot more.

Or (until recently), you go in for surgery where the surgeon is covered, but then get billed for an out-of-network doctor that consulted without anyone asking you.

One of the recent situations that I've heard about are nurse practitioners and doctors at your doctor's practice, contracted by your in-network doctor. The person who comes into the room to ask you what you're there about may not be in-network even though the ostensible doctor-in-charge is.

I haven't seen that lab issue. I suppose that could be an issue in specific circumstances.

How am I supposed to do that in the back of an ambulance?

You can't. You should select a plan that covers you at all the local hospitals. If you look it up before hand you can usually specify which hospital you want to go to from memory. I do this not just for the network, but also for quality.

What if you're injured while visiting a different city?

Then you should do research before going or accept that it is an unlikely scenario. This is what people do when travelling, especially internationally. You can also select a plan with the most extensive network to reduce the likelihood.

>In the current system you walk in and hand them your card (insurance, Medicare, medicaid, etc) and they treat you. You get mailed a bill later.

I'm glad we now agree that the current system in the USA is in no way like this.