[Retric]

Those regional differences are hardly limited to healthcare just look at a 1,500 SF apartment in Memphis TN, vs NYC. The important bit isn’t a question of bargaining power it’s choice. Someone with a broken leg would very much like medical treatment, and had a surplus or leverage with an insurance contract to pay for it. The fact they got ripped off is no more relevant than someone paying full price for a designer handbag or whatever.

As to bankruptcy, unpaid medical bills aren’t part of the GDP. It’s a measure of output so they also exclude things like buying a house for 1 million and then selling it for 1 million.