Actually, if you go to the emergency room here, they have to treat you no matter what, whether you can pay, whether you have insurance, or whether you don't. After they treat you, if you survive, then they ask for payment. If you can't pay, then it goes to collections - if the bill is big enough and you can't pay it, you end up going into bankruptcy (over half of all bankruptcies in this country are due to medical bills). In the mean time, the hospital and/or the government has to cover the cost of your emergency room visit (indigent care funds, etc.). However, if you want to go to a doctors office to get preventative treatment or checkups, you have to pay first, and if you can't pay, you don't get treatment. What this means is that people who don't have insurance get no preventative care, they wait until it is really really bad and then go to the emergency room. This is the worst of all possible worlds because the treatment in the emergency room will cost easily 10 or 20 times as much as if they had gone to a regular doctor visit, and the taxpayer ends up picking up the tab anyway. The whole point of the current reform is to make regular, preventative treatment accessible and affordable to reduce overall spending on health care. But see, this is long and drawn out and complicated. Rather than taking the time to comprehend these issues, the republicans would rather go around telling everyone that Obama is a "socialist" and a "communist". ooooooh scary.