The case presented by the article is of an American who can afford it, yet I would still call it legalized abuse. Just like the other cases here in the comments, none of them of Americans on the verge of bankruptcy. And either way: the real possibility of getting bankrupted by your health bills signals systemic disinterest towards the (even when poorer) tax-payers. Maybe you agree with it, state models can be different and I guess there are advantages and disadvantages to each, but at least let's call it for what it is.