> Not quite how healthcare works in the US. Unless you consider having the money to cover your max out-of-pocket (between 1000-4500usd, depending on insurance plan) and copays (50-125usd) as "wealthy".

Max annual out of pocket includes copays, do you don't need to cover both separately, but 1000-4500 is not the range of out of pocket maximums. The limit for a bronze marketplace plan is $7,300 for an individual plan or $14,600 for a family plan; the average for bronze marketplace plans is about for $12,000 for a family plan. And that's for things the plan covers; there's obviously no maximum for services excluded from coverage.