What are deductibles?
Say you are very healthy and don't need a lot of office calls or healthcare you can choose a higher deductible from $100 on up say $1000 and so on.
The higher the deductible the less your insurance premium will be.
If you are sickly you can buy insurance with zero deductible that covers everything from tests to surgery but it is very pricey.
After 65 you are eligible for Medicare that automatically pays 80% of your medical bill and you are responsible for the other 20% so you buy a supplimental plan that covers the other 20% which is where the deductibles come in.
Plans run around $125 a month depending on how much of a deductible you choose.
Poor people and people on disability get Medicaid too which picks up that other 20% automatically so in essence they are covered 100%.
The employer of most people pays 80% for the workers healthcare.
It's up to the employee to get a supplemental plan to cover what the employer does not.
And like Dirk said, most people don't pay their medical bills because they were not self inflicted so the courts won't make you pay for something that is not your fault.
So the hospital does not waste their time suing you.
The hospitals pad such bill outrageously and use them for a write off for a tax loss.