The WHO list of essential medicines is not just over-the-counter drugs. It includes things like the chemotherapy drug cisplatin. I happened to need that for testicular cancer ~10 years ago, and the treatment cost was $50k (as "payed" by insurance). That overall seems pretty reasonable to me for the treatment I received, but definitely not something I'd expect the median American to be able to pay out of pocket.
The median American would not have to pay out of pocket, as nearly every American has health insurance (since the ACA, it is actually illegal not to have insurance).
I think it's accurate to say that the median American is insured, with only 8% of the population uninsured [1]. Although, to put that percentage in perspective, that's 26 million people and likely thousands in excess mortality relative to the insured poplulation.
I believe you're referring to the ACA's "individual mandate", which imposed a federal tax penalty for being uninsured. I won't argue whether that makes it illegal or not, but I can say that the individual madate was eliminated by the Tax Cuts and Jobs Act in 2019 [1]. There's no longer a federal tax penality for being uninsured.
This is purely anecdotal, but of that 8% (26 million), I would posit that most of those people are uninsured by choice. e.g., probably mostly young, maybe part-time workers without chronic illnesses.
