I believe you're confused about how insurance companies affect health costs, there. When you look at a health bill, it does appear that the insurance company is keeping rates low by refusing to pay part of the billed amount, but what allowed those billed amounts to skyrocket in the first place? At one point, most people in this country could afford a doctor (who would make a house call) when they needed it. Then insurance plans came around and became widespread, and because some company was obligated to pay for the health care instead of the patient, prices shot upwards. Also, people began seeing the doctor for more trivial issues, because they "didn't have to pay for it," it was all "covered by insurance." This has, over time, lead us to the present time, where we have some of the most expensive health care in the world. An overnight hospital stay for dehydration in Mexico cost me $274, complete with IV fluids, anti-nausea/anti-vomiting drugs, my own private room with air conditioning, TV, and attached bathroom/shower, and breakfast. In the US, you could probably expect to add a couple 0's to that number, and I almost certainly would've been in a shared room, without the ability to control the temperature to my liking, with a bathroom further down the hall than I could walk on my own. In Mexico, I had to pay cash when I left. Here in the US, I would have paid more in deductible.