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>You get fucked when you don't have insurance, because you can't participate in this process

This is not accurate. Cash payers just have to go through the administrative part themselves, cobbling together charity and self-negotiation, eventually landing on a payment plan that doesn't get reported to credit agencies.

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So the medical industry is based on intentionally giving ridiculous bills that no one can pay and waiting for people to haggle them down in hopes of not having their finances crushed?

Yes, this is accurate. There is no expectation, from anyone, that a person with a $1.1m medical bill will pay that. There's a specific group of people called Medical Bill Advocates that help people navigate the medical billing system.

As well, people don't really go bankrupt from medical costs that often. Hospitalizations cause about 4% of bankruptcies among nonelderly adults. Among uninsured, this rate is about 6%. They mostly go bankrupt because they lose their jobs and income [0].

[0]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/

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