Of course he’s self-insured. What insurance carrier would accept him, with all of his pre-existing medical conditions?: drug addition, intractable pain, cervical spine damage, cardiac problems, smoking, goodness knows what else. And even if they did, why should he pay? Why not just write a check for any procedure, if you have the money? That’s what everybody used to do. It’s only been in the last half-century or so, when medicine has been more complex and thus terribly expensive, that we’ve started to use insurance. But even if, God forbid, Rush needed a heart transplant, he could pay cash for it.
Our care would be remarkably less expensive today if more people did what we did just a couple of decades ago, not 50 years ago. That is, major medical. You pay cash for all the small stuff, even the medium stuff, and insurance is cheap beause it only covers the catastrophe. You know, the heart “big one” or the cancer, etc.
Meanwhile, the “hit by a bus” example has always been breath takingly ignorant - if that happens, the bus’s auto insurance pays the medical.