Victor,

Your predicament is a good example of unexpected healthcare costs as the biggest take down of US middle class people. IMHO it's not an argument for the ACA, but for society/national acceptance that accident cover (if not all healthcare coverage) ought to be shared as widely as possible.

The other issue is underwriting, with few if any healthcare funding schemes practicing it. Instead they operate on Pay-As-You-Go (PAYG) models which I have been arguing is a model for ruin. NZ's Accident Compensation Scheme is a good example. Started in the 1970s, the ACC covers all costs of treatment for accident in NZ as well as income protection and compensation. It started as a pay-as-you-go scheme until in 1999 it switched to an underwriting model where enough $ has to be collected or earned to cover the entire lifetime cost of injuries that year, which can span 30 years. The underwriting delay from the 1970s proved the error of PAYG, since by 2006 the corporation posted a $5B annual loss which is a lot for the then population of 3.5M. Levies were increased to cover the shortfall with surpluses invested so that by 2013 the ACC was well on track to have more assets than liabilities by 2019, which justified levy reductions over coming years. I think I pay a few hundred $ per annum for family cover. Had it stayed as PAYG I expect it would be triple that, or probably more by now. Currently the ACC has about $10K of assets per man, woman and child in NZ- which would be equivalent to Medicare having about $3T in assets rather than a $47T deficit.

The point is not that ACC is perfect- it isn't- the point is that the longer you keep running PAYG healthcare funding schemes, the worse the eventual crisis will be. It's worse in the US because insurers make no contribution to the cost of care for the elderly which is covered by PAYG Medicare that continues to build its predictable deficit year after year, already too large to resolve by any traditional means.