It is far from as simple as you paint it, fx. The vast majority of the people suffering from this system are the workers, while those who continue to benifit are the bourgeoisie. Not paying for someone's care isn't what I was referring to as punishment, the punishment inherent in the system is that a retired middle-class couple who worked hard their entire lives have to go bankrupt, move in with their sons or daughters, and come out of retirement to work at some lousy supermarket just to be able to afford medicine and hospital visits, all punishment for the fact that one of them happened to have successive heart-attacks. Or, in the extreme example (albeit very numerous, unfortunately), someone has to die because their insurance wont cover the costs of their treatment, or they don't have insurance at all.

What you are expressing represents the true problem with health care in America. It isn't just an institutional problem, but a problem with the entire philosophy. It is a basic philosophy of a functioning and civilized society that taking care of the whole is equally important to taking care of the individual. In that, countries like Canada and Britain see it as a given that society should provide something as basic as health care to its citizens. Unfortunately, in America, as you express, the consumer now takes precedent over the citizen. You'd rather thousands of people die, and millions suffer, simply so that you don't suffer the horrible thought of taxes. Incidentally, like our health care system, our tax system favors unequally the rich over the middle class and poor; reform that and we can still pay for health care with actually a smaller tax burden on the middle-class.