Getting well in America can bankrupt you. A Texan man has a heart attack – and good medical insurance – and still finds himself on the hook for $109,000 in medical bills. Another man in Florida owed $3,400 for a CT scan, after his insurance company paid its part. And a woman who had surgery for back pain was billed more than $17,000(!) for a urine test that her insurance company refused to pay (outrageous).

A recent survey of American adults by the University of Chicago shows that this situation is actually the norm. 57 percent of those surveyed have been surprised by a medical bill they thought would be paid for by their insurance companies.

The survey shows that 53 percent of those surveyed were surprised by a bill for a physician’s service, and 51 percent got an unexpected bill for a laboratory test. Hospital and health care facility charges surprised 43 percent of respondents, and 35 percent reported getting unexpected bills. Most of these bills arrive with no explanation.

The survey shows that some of the unexpected bills arise because doctors or hospitals where patients are treated don’t participate in the patients’ insurance networks. Patients expect their insurance to cover more than it actually does. They blame the insurance companies but in fact doctors or hospitals may not have joined the insurance companies’ networks. Patients are unaware of this and it hugely increases costs.

An earlier survey conducted in 2015 by Consumers Union found about a third of people got an unexpected medical bill after their insurers paid less than expected. Which raises the question: what should a health service be for? To enrich a small number of medics and pharmaceutical CEOs, or to offer a healthy, happy life for ordinary people. (Edited part-version of a piece by NPR and Kaiser Health News).

If you have good health insurance in America you are very lucky. People criticise the British National Health, and it is true that you have wait for non-urgent attention, such as hip or knee operations, where the delay tends to force people (who can do so) to join a private health insurance scheme. But if you are seriously sick the NHS does a superb job, even in relatively remote country districts. All this despite the efforts of ideologues to shrink the service until the pips squeak. Why are they doing this? The answer is ideological – they want to hand over the NHS to the very American health organisations that are profiteering, as above, in America. The right-wing politicians pushing privatisation already have taxpayer-subsidised private arrangements, so they’re alright, which what matters (ahem!).