> If you're the former, it works great.

I don't think that's true at all. "Insured" doesn't mean just one thing. There are many different kinds of insurance, levels of plans, etc. Most insurance companies will do their best to deny claims or push more responsibility onto the patient.

My insurance is very good, but I see a therapist weekly and my insurance only covers about 40% of the cost. I'm fortunate that ~$500/mo isn't a problem for me, but many people in the US would find that impossible.

A few months ago I went to the ER for what turned out to be gallstones, and was still on the hook for $200 of that visit. And I took a Lyft the the hospital; I don't want to think about what my out-of-pocket cost had been if I'd needed an ambulance.

Last summer I hurt my hand in a bicycle accident, and went to PT once a week for 6 weeks. I had to pay a $35 co-pay for each visit; that's $210 for a single injury.

And this is with fairly good insurance. Many, many insured Americans just have so-so insurance. From what I hear of most healthcare systems in countries that do this right, most (if not all) of this stuff would have been completely free.

> If you're the latter, it can be mediocre to BRUTAL

Yup, and in a way that's an even worse indictment, that really puts us in worse-than-third-world territory.