Bottom line is that if you're middle class and don't have health insurance, a serious accident could bankrupt you. The system was designed with the idea that you don't exist, and would never actually pay the rack rates that hospitals charge.
Planet Money had some good coverage of the joke that is medical billing a couple of years ago:
I don't understand why an uninsured patient who pays out of pocket can not dispute the charges and prove that the price has been fraudulently inflated due to "cost shifting".
Actually you simply offer to pay whatever they would have gotten from the insurance company -- they are likely to get even less if they sue you into bankruptcy.
Planet Money had some good coverage of the joke that is medical billing a couple of years ago:
http://www.npr.org/blogs/money/2010/07/06/128338526/ex-ambul...
http://www.npr.org/blogs/money/2010/07/01/128243987/medical-...
http://www.npr.org/blogs/money/2009/11/podcast_paying_doctor...
http://www.npr.org/blogs/money/2009/08/the_wild_wild_west_of...