If you look at the top of the bill, it seems like this person didn't ever get health insurance and the last minute applied for medicare in the hopes of getting covered. They probably are low enough income to get covered under Obamacare but probably thought they we never get sick.

In other nations, universal health care is actually cheaper for the state per capita than our system in the US.

Source: http://www-tc.pbs.org/prod-media/newshour/photos/2012/10/02/...

The US actually has higher per capita spending on healthcare and pharmaceuticals than any other OECD nation and public expenditure is only higher in the Netherlands and Norway.

Source: http://www.compareyourcountry.org/health?cr=oecd&cr1=oecd&lg...

It's not a middle man, it's that insurance companies only cover so many things, so they bill everything and collect what the insurance company covers. To keep up the charade uninsured get bills like this, which they then take to some hospital board to get reduced to something 2-3X what an insurance company would pay.

I got the impression that the person wasn't insured.

Having glanced over some of the ( 14000+ ) comments, I haven't found any that would suggest otherwise. I really wish someone would clarify this.

This isn't the bill that an insured would get though. I believe the maximum deductible under Obamacare is ~$6000.