Here, to answer your question, the patient is treated (basic/emergency) regardless of willingness or ability to pay. Nobody is turned away to die on the pavements. Initially, all of your information and ID is taken so they know who you are and you can later be billed. Follow-up care is another story... you may die at home, or be forced to go back to the ER with out the proper follow-on care. Many uninsured in the US use the ER as their common/primary doctor, unfortunately. Healthcare has been a huge political battle here for the last decade. A giant circle jerk, really. It is a really complicated matter with various characters (Insurance companies, Big Pharma, med schools) all having a hand in maintaining margins, regardless if we have "free" or "personal paid/ private" medicine.