Those who can't pay don't get their care for free. They'll be hounded by debt collectors the rest of their life, whatever credit they had will be trashed, and some will be pushed into bankruptcy. We are all paying for it.

Not when they just lie about their identity.

I don't see why you're getting down-voted. If you've got "bad" insurance that fake ID from college and memorizing 12 random digits is probably more useful when it comes to emergency care. Sad but true.

It has zero to do with problems of people who don't lie. None at all. And mojority don't. It amounts to "situation is ok, because I can point to some fraudster that is not suffering".

What exactly that has to do with someone being haunted for debt? Or is he suggesting you should fraud ER and you are suckers if you don't?

I wish I could upvote you twice to help with the other downvotes. I know of at least 3 cases so far where folks walk into ER and lie about who they are when they leave. All of the cases are because of no health insurance, but they aren't hounded by any debt collectors.

The health care system has arbitrarily chosen the "hospital" as the place where nobody can be turned away.

If your kid has a possible ear infection or broken arm, and you have insurance, you go to an urgent care clinic. If you don't have insurance, you go to a hospital. In all other respects, the care is the same.

If you go to urgent care you are seen in order of arrival. In the ER you are seen based on need. This results in very different care experiences. Also you should expect that urgent care is more familiar with the types of things people should go to urgent care for - while the ER can deal with them they may take longer.

The kid with the simple ear infection will wait longer in the ER. (Note that I added simple: if the ear infection is complex the ER may see the kid sooner, but those are cases where when Urgent care finally gets to the kid they transfer to the nearest ER)

> If you go to urgent care you are seen in order of arrival.

Most "decent" urgent care facilities will triage. That's one of the reason why you're asked why you're there on check-in (and also to ensure you're not complaining of something acutely emergent).

Will a privately operated urgent care clinic take somebody who has no insurance or means of paying?

Waiting time is a matter of how the facility is managed. If an ER is handling a lot of noncritical cases, they can set up a facility for handling those cases, which would look just like an urgent care clinic. In fact, I once had a minor injury and went to the ER, and was transferred to an urgent care clinic in the same building. I had insurance.

The health care system has also chosen the hospital as the only place that's actually open. The nearest urgent care closes at 5 … which is worse than my bank.

> Hospitals will never turn away a patient with a medical emergency

No, but if you can't pay, and you won't drop dead in the next eight hours, they will try their best to toss your ass out onto the street after prescribing you a $900 bottle of aspirin.

US health care expenses per head are on the order of 2-3 times every other country on the planet.

Wen you're that far out of alignment, something is seriously wrong.

The US could scrap Medicare and use the savings to fund European style healthcare for everyone. You still get the option to top up with private health care, which can be pricey - $150 a month for a family, but there's always a base line to fall back to.

You are correct, and there is something the US can do about high drug costs. We pass a law requiring Big Pharma to sell drugs in the US at the planet's lowest negotiated price. This will help shift R&D costs onto Europe, Canada, and Asia, because Big Pharma will of necessity spread that cost around.

> You are correct, and there is something the US can do about high drug costs. We pass a law requiring Big Pharma to sell drugs in the US at the planet's lowest negotiated price

So if a big drug company sells a drug very cheap in some poor third world country, they have to sell it for the same price in the US?

Wouldn't the most likely outcome of that be that they stop selling their drugs in poor countries?

> Wouldn't the most likely outcome of that be that they stop selling their drugs in poor countries?

And the poor countries would just make knock-offs, and sell them to other poor countries. The US as a whole would lose out because much of the US economy is based on the dubious concept of 'intellectual property'

Yes.

Why is a poor family in Appalachia less deserving of inexpensive drugs than a poor family in, say, Venezuela, or Somalia?

> You are correct, and there is something the US can do about high drug costs. We pass a law requiring Big Pharma to sell drugs in the US at the planet's lowest negotiated price. This will help shift R&D costs onto Europe, Canada, and Asia, because Big Pharma will of necessity spread that cost around.

A way less intrusive way to ensure the same end result is to allow reimporting of prescription drugs.

There was a bill to do this last year, but unfortunately it was killed in the Senate.

How is this less intrusive? I'd just reimport the hell out of drugs from the cheapest country I could find.

Instead the US is planning on cutting Medicare to pay for tax breaks for the rich. It will only get worse.