What you saw was a fraud. There is nowhere in the U.S. where employers are not required to be fully insured for such accidents. Even if the person had to pay on their own, the normal process would be for the hospital to do everything possible to save the fingers. They would then write off any loss or apply to one of our many charities that help cover the costs in cases like this. One of the reasons healthcare is so expensive here for those that can pay is because we subsidize those who can't.