As someone who had shoulder replacement surgery in the USA I also agree with your statement. The whole process centered solely around health insurance and my ability to pay.
Even when at the bottom of the ski-slopes, in the resort hospital, in obvious agony, upon hearing my UK accent the nurses first words were a surly "we dont take holiday insurance, you'll have to pay and then claim it back". When I told her that I lived in the US and therefore had health insurance her mood changed, and she immediately set to work assessing my injuries.