US health insurance is a combination healthcare purchasing agent/second opinion/fraud detection/insurance/tax collector.
A large part of a premium is a tax due to the maximum age rating factor that limits the prices old people pay to 3x or less what young people pay. It is also a tax because the insurer cannot underwrite the insureds, except on the basis of age, tobacco use, and location.
Then no health insurance would make sense?
Well, as you suggest, the regulations that cap the premiums for old people at 3x those of young people seem to blame?
At some point the consumer makes a decision that the cost of insurance doesn’t justify the benefit.
Edit: since I can’t respond to comment below due to hitting too fast posting limit:
Post ACA and pre ACA plans are completely different products due to out of pocket maximum, age rating factor caps, and inability to screen for pre existing conditions.
Hence comparing pre and post ACA health insurance prices is not meaningful.
Real catastrophic medical insurance caps how much you owe whereas the debt you accumulate from a doctor who was obligated to treat you is not capped. That debt follows you until you pay it off or declare bankruptcy like the 500,000 other Americans do each year.
To add insult to injury, we already spend $5000 per capita on our publicly funded healthcare system, which is enough to fund basic universal healthcare systems in other countries.
Let that sink in. We spend $11,000 per capita on healthcare per year. 45% is publicly funded with taxes and the other 55% is privately funded.
We’re already spending enough for TWO universal healthcare systems (for many countries), yet we have 500,000 filing for bankruptcy due to medical bills each year.
Based on what we’re spending, we can afford two systems: A socialist system that covers everyone and a private healthcare systems that provides world class treatments to anyone who can afford the insurance premiums.
Instead, we have two corrupt and dysfunctional systems, a lot of gaps, and a record number of people profiting off our dysfunction.
Well, you are spending approximately twice as much as the Brits in terms of percentage of GDP. (Comparing total healthcare expenditure, ie private plus public.)
But that doesn't mean that NHS-style healthcare is the best.
Singapore spends roughly health as much as Britain, and has no worse health outcomes. And we don't have a single payer system here.
if it's that catastropic, I imagine their income would fall drastically that year, or years. What taxes?