> Lack of universal healthcare in the US isn't that big a deal to the upper-class/upper-middle class people
It's not an issue for poor people either, since they have Medicaid. Or old people, who have Medicare. Or veterans who have Tricare.Health insurance is generally only an issue for middle to lower middle class.
This term seems to be reserved (with an often racist/classist connotation) for people from the global south.
Edit: I was wrong. Thanks for correcting me.
As most EU medical systems are not really geared toward private billing, if you go to a government-run medical centre for something small, it's going to be more effort for them to figure out how to bill you, so they don't.
Sometimes tourist-heavy places will definitely be set up to get you to pay, other times they just see treating actually minorly-ill tourists for low/no-cost as a cost of being a tourist-dependent area.
Sometimes the anecdotes about only having to pay 20 EUR at the hospital were really the salaried clinic doctor squeezing some EUR out of you that really should have been paid to the state.
Other times, if you go to a private-clinic doctor solo, they'll likely make you pre-pay. But if it's your local family's doctor, they may see you for free on a goodwill-basis, or fraudulently bill your local family member's plan and/or write any prescription in their name.
It was 100% free. So I definitely got free health care on a tourist visa as an American.
In reality, if the person doesn't seem to be trying to take advantage of the system, I'd not be surprised that hospital staff don't bother sorting out billing the patient.
If not, private healthcare is peanuts compared to the us (think $200/month no deductible no limit)