Turned out when I had a big hospital bill in September that if you're a self pay they reduce the bill to approximately what I would owe if I had insurance. So two things, insurance today still leads to having a sizeable bill that hurts average Americans, and you're not really worse off not having insurance. Assuming of course that the large hospital I went to is typical.And I think it's safe to say that they also realize that when they sign the authorization to treat form that they are financially liable for 100% of the cost of the treatment as well as the fact that the days of walking out the door and stiffing the hospital with the bill are long gone.