Explainer: If you need care and you can't afford your deductible, you will have to borrow money to pay for it. Typically the healthcare provider will loan you the money. Why ? They want to get your insurance company's money. Now, by definition, the hospital is a subprime lender. Not only is the patient in a huge financial hole, across their similarly situation patients, so is the hospital. They know they won't collect however much your deductible is. And that's just for your in-network deductible, nor does it account for your family max out of pocket I don't know the % of bankruptcies this causes What I do know is that the loss of hundreds of billions of dollars for patients and hospitals, starts with the plans offered by insurance companies. They know damn well when someone picks a plan and they can't afford the deductible. And to them, it's not a bad thing. If you can't afford your deductible, the chances they pay anything from your premiums, go way way down So patients go broke or can't afford care. Hospitals have huge uncollected debt, so they make it up elsewhere And then they aggregate those amounts, among others, and use them to get payments from state and federal programs. See how all that works together ?