HCR Update from Mark Sanna: People can only handle so much complexity. And few things in life seem more complex than the American health-care system. How complex? A new paper suggests that even those who have health insurance have a poor understanding of their coverage. Researchers commissioned two surveys of covered Americans and found that only 14% could explain all four key health insurance concepts: deductible, copay, coinsurance and out-of-pocket maximum. Only 11%, given all the necessary information, could calculate the cost of a four-day hospital stay to within $1,000.