Even with decent insurance, a chronic heath issue can easily result in bankruptcy or having to live paycheck to paycheck, especially if you trip up on any of the landmines like going "out of network" or having a procedure that your insurance decides they don't want to pay for. The system is set up to extract the maximum amount of money from the patient they think they can get away with. And don't even get me started on end-of-life care which is undeniably set up specifically to soak whatever savings the elderly have set aside. I think some people, maybe who are generally healthy and don't have to deal with continuously fighting with their health insurance company and hospitals, think that having health insurance is like a magical talisman that makes all your bills disappear.