It's not.

ER - life or death (if you can drive yourself, it's probably not an emergency)

Urgent Care - you have the flu, and your PCP isn't available; minor emergencies (but you can still drive yourself)

PCP - flu, check-ups, whatever

The balance billing and OON charges are separate issues from over-use of the ER.

Your simplistic description shows that you don't even know what you're talking about! The ER is for far more than life or death. A broken bone -- no matter how minor -- is a perfectly reasonable reason to visit the ER. Urgent care may work just as well, but there are many reasons why urgent care might not be a great option for people in their circumstances.

ER is definitely not appropriate for a small cut requiring only a band-aid.

Sure. I never said otherwise. There’s obviously some judgement, and some areas won’t have an option. Bit to claim it’s too confusing to figure out (as the prior post suggested) is completely hyperbolic as well.

If the system was honest, then the ER would send people to the right place instead of charging them an arm and a leg for basically nothing.