I’m not sure if “difficulty accessing healthcare” captures the whole problem. Even if you live next door to a hospital, you still don’t know how much it will cost you if you check yourself in. Sure, there is some theoretical maximum out of pocket, but are you certain that the hospital is in network with your insurance? Are you sure that every provider you will see and every test or scan you have done will be treated as in network?

I once had a doctor order a test at a hospital that he assured me was in network. The hospital got pre-authorization from my insurance company for me to have the test done. I had the test done. My insurance company then denied me any benefit because they said afterward that I went out of network … and there are millions of stories like mine.

Not to mention that even if you manage to stay in network, lots of people cannot afford even the max out of pocket that creeps up faster than inflation every year.

I have had some family members decide that they will just accept that they are going to die in an emergency situation because “if it’s my time, it’s my time” and they don’t want their life savings to get vacuumed up by some hospital administrators. This is not merely theoretical… one person in my life is dead now who probably would have lived if he had felt comfortable seeking medical care.