I commented below, but seriously, WHY does NOBODY appear to understand this?! The reason ER bills (and hospital bills in general) are so high, is because so many uninsured go there because it is the one and only place they can get medical care. Primary care doctors can and do refuse to treat the uninsured. ERs have no choice in the matter; they have to treat anybody who shows up. Also, conditions that have finally gotten bad enough to warrant a visit to the ER are generally much more difficult to treat than if those conditions had been caught at an annual checkup, which of course most uninsured simply cannot afford out-of-pocket. Since hospitals end up with so many delinquent accounts from poor patients, they overcharge the insured (who aren’t paying out of pocket and therefore don’t generally have much reason to complain) to make up the difference. The people who REALLY get screwed are those who have no insurance but still have the means to pay—even if it takes many years to settle a debt that the hospitals would likely be the first to admit is disproportionately high. If we had universal heathcare this would never happen to anybody, ever. And those who wish to do so, would be still be able to to buy private coverage on top of their government coverage, just as they can in so many other nations. So don’t get outraged. It’s not about greedy hospitals. Unless you support either single payer or the ridiculous mandate to subsidize private insurers through the ACA, this is just the way it’s gonna be.