Ah you don’t seem to understand the depravity of the modern American medical system. It’s not as bad in the way you think, and significantly fucked up in a different way.

If you do not have insurance, you tell them you don’t. They’ll give you a bill lower than what you’d pay as deductible if you had insurance. Or you just don’t pay…

This raises insurance premiums and reduces the quality of healthcare in a dystopian AF feedback loop.