-theres government funded coverage for poor folks, but it kinda sucks and doesnt pay for a lot of stuff
-the big, fancy pants hospitals are in the big cities, and in tons of rural places there are lots of people who cant access important services, especially anything requiring the care of a specialist
-some people have private insurance and go to the private hospitals- but in the private hospitals, they want to wring all the money they can out of their private patients, so the hospitals have started ordering unnecessary treatments and tests for these patients
-for lots of people, even if care is available, they dont have transportation- OR they have to get a caregiver to take off of work to drive them, etc., which means lost wages for both the patient and the caregiver.
-for these reasons and many others (including the desire to avoid bad news or remain in denial), many people jsut dont seek health care at all. maybe through alternative medicine which in some cases is cheaper/effective but doesnt typically help with your cancer/busted appendix/end-stage-renal-disease.
-the maternal mortality is the pits.
ostensibly these points are about the guatemalan health care system- but every one applies to the US system as well. of course there are differences in scale and the quality of top level care available and many other things beside, but it just drives home the point that our health care system is far from the best in the world- in fact, its more like that of a developing nation. not a foreign concept, but its different to see it more closeup.