Something nobody else has mentioned her eis that even if a hostpital is required to provide care regardless of your insurance, in practice you’re not unlikely to get a lower standard of care if you have no insurance or even if you have insurance that’s seen as “inferior” like Medicaid.

Folks without insurance or with “lesser” insurance tende to be poorer. More likely to be seeking pain meds to use recreationally. More likely to be disabled, overweight, etc. More likely to be racially discriminated against or, if white, seen as “white trash”. So, having no insurance or inferior insurance itself may get you written off as somehow undeserving of the same level of care.

And if that’s an issue for life-threatening injuries, it’s… probably much more so an issue for more routine kinds of medical care. It’s literally not even an option to self pay in some cases. And I don’t just mean because it’s so expensive. Even if you did say “I don’t have insurance, but my bank account has $100 million in it and I can use my debit card,” you may be told you’re not allowed to self pay.

Poor people without insurance are often sent to alternative care facilities specifically for poor people without insurance. And as you might expect, those places are often very understaffed. So you can expect longer wait times and more rushed care.

Poor people without insurance also often don’t get treated early when a problem isn’t a huge deal for fear of accruing medical debt. So they’re also more likely to end up unexpectedly needing a trip to the ER because that minor infection that, had they gotten it treated a week ago, would have been taken care of with a round of antibiotics has now spread to some much more vital organ.