Dennis, I don't exactly know how it would work with you as a foreigner. I can almost guarantee you wouldn't have had that gigantic debt, you would've worked out a payment plan and gotten the cost down negotiating with the hospital. In most cases the hospital is just happy getting something for the service, I've heard of people getting the bill down to 1/100th of the initial cost, paying amounts like $20 a month.
As a citizen the insurance landscape is quite complicated. Most people have their insurance tied to their employer - your employer negotiates as a group with the insurance company to provide plans for the employees. All employers are required to provide their full-time employees with an insurance option. It might suck, but it's offered. My current plan costs $130 a month and a doctor's visit costs $35. My plan kinda sucks because I have a $2000 deductible. So if I need to get any bloodwork or imaging like an MRI, I have to pay the full price until I hit $2000, and then my plan kicks in and pays 80% of the cost, a scheme called "coinsurance". If I need more work done after that, my plan's "out of pocket" maximum is $4500, so after I hit $4500 in medical bills for the year everything is covered 100%. But basic stuff like doctors visits are always just $35 and you don't need to hit that $2000 deductible for them.
If you work part time or are self employed, you buy your own plan through the "marketplace". I did this for the past year as a contract worker. You put in your income and it suggest you some plans, and if you are low income you get tax credits that make the plans really affordable. My income was rather low last year so I was paying $45 a month and only had a $250 deductible, and after the deductible everything would be covered 100%, no coinsurance nonsense. I'm not eligible for this plan anymore because my employer offers me a plan, and if you are offered a plan by your employer you aren't eligible for any tax credits.
Very low income people are in a government sponsored plan called "Medicaid" where they pay pretty much nothing for their insurance. Everyone age 65 and older is in a government healthcare plan called "Medicare", which everybody pays into throughout their life through taxes automatically deducted from their paycheck. This is the plan most similar to what you guys have.
There are definite trade-offs between the American and most European systems. If you're in a high paying job or work for government you likely have an incredible insurance plan through your employer. My dad was a state govt worker and paid nothing for his insurance and everything is covered 100% for life. Salaries are also generally much higher here that can offset much of the cost. But if you're in a low-paying, low skill, or entry level job where your insurance plan is probably worse and higher cost, it's definitely more comfortable as a European.
« Last edited by steelersrock01 on Jun 11th 2022 »