To say my experiences with TX healthcare were VERY different than rts would be an understatement; I don't think many people walk around with appendicitis for two freaking years in places with "quality" healthcare. When I finally did get properly diagnosed and an intern removed my appendix while med students watched and I suspect the county hospital committed fraud to get paid by the state. A hospital ER can't legally refuse to treat sick people, but they can and do examine them, tell them there's nothing wrong and send them on their way with an aspirin. It's hard to do that with a compound fracture (unless they just WANT to be sued) but I recall a thread back on wotmania about a guy who came to the ER having a heart attack, was told he was fine when they found out he didn't have insurance, then died in the parking lot. Then there are the routine cases where even people WITH insurance can't get care because their insurer decides it's unnecessary (i.e. they don't want to pay for it), even when refusing treatment kills them (surprising medical research shows you need a liver to live.)

If you're obviously sick enough turning you away might prompt a costly lawsuit, you'll probably get care, but the cost may bankrupt you. Of course, you can always blow off medical debts you can't pay and there's not much creditors can do about it. A lot of people go that route, so decent people who try to responsibly pay their high healthcare costs get screwed and ACTUAL deadbeats walk away, further increasing healthcare costs already skyrocketing at an alarming rate (that's the real threat to Medicare and long term federal solvency, as you may know). It's a good system if you can afford it, but if not it gets very dicey very fast, with many people forced to weigh living on the street against living (hence the stat about medical debt causing 50% of 2008 bankruptcies, in many cases DESPITE insurance).