Even in a country with a medical payment system as terrible as the US insurance is only a factor after an emergency, not during one. A homeless bum collapsing with a heart attack outside a hospital and they'll treat him just as well as Bill Gates. Now, outside an emergency like with followups after your heart is beating again this is a huge difference and going into collections after you can't pay is Not Fun. But lets not pretend the system is worse than it is.
