Um, not the millions of us who have been self-insured (the self-employed, for example) or uninsured.
Since we spent over a decade in that situation, I became very aware of how completely uncomprehending people who had always had some kind of standard plan through an employer were.
When I see someone say they have a “high” deductible, and it turns out to be $1,500-2,500 or the like, I laugh. We used to have a deductible of $15,000 per person per year. Even recently, under a good corporate health plan, we had to have a deductible of $5k in order to be allowed to have an HSA. At least they have changed things so that it is no longer “use it or lose it” annually. That was ridiculous.
H is extremely adept at managing this stuff and negotiating with providers. He’s had years of practice. 
One thing which many people don’t realize is that if you have a lot of medical expenses that would exhaust your HSA, for example, you can arrange monthly payment plans with virtually any provider to stretch out the cost over time so that you can continue to cover it with your HSA.
Last month Cigna called me to inform me that my scheduled CT scans were through an out-of-network provider, and that although we had fulfilled the in-network deductible and out of pocket, we had not fulfilled the out of network out of pocket, only the deductible. So they said the provider could charge us for the difference between what they would pay and what we were billed, and they had no control over it. They were actually very helpful in helping me get set up quickly with another local radiology provider. I was grateful, especially as it would like not have cost THEM any money. (Ironically, the OON radiology provider was with my oncologist’s practice! Go figure.) It would never have occured to me to question this in advance.