In addition to what everyone else said, property damage is a big part of it as well.

Let's say you run into a building and knock out a load bearing wall. Or plough through a business or government office. It's not impossible to rack up a couple million in damages if you crash bad enough.

Real answer: in most other countries you can be punitively sued, ex: if a person wants to recoup the emotional damages from being crippled. You can also, depending on the country, be made to cover the cost of services provided by the medical system if you were found to be at fault (I don't know how often that happens for an individual vs. a large company, but that's how the rates were explained to me by a UK colleague)

Even in countries with universal health care surgeries aren't typically free. They are just paid by a public health insurance. That health insurance will pay at first but it will try to get it's money back from you if you injured somebody.

Repair costs for two vehicles outside the US is probably just as expensive as a doctor's visit for a single person inside the US.

##ItsAScam

Third party liability for my policy is a few million last time I checked, if you somehow cause a heavy truck to crash or damage a piece of infrastructure you can run into those figures pretty fast.

Health insurance companies are lobbying the shit out of both parties. Car insurance companies would love universal healthcare. It would drop their outlays which would increase their profits.

I DETEST both-sides-ism, but yeah actually in this case, both sides are being bribed and blocking true progress, just the paid off Democrats have been doing it more quietly by slow playing and avoiding real single payer solutions when the party actually has power.

In reasonable countries they do exactly that. The health insurance ensures that your victim gets the required treatment. But they also ensure, that in the end the damages you caused aren't paid for by the public.