How much state-run healthcare actually helps also depends on where you are. I was eligible for state healthcare in Arizona. I went in with a chief complaint of depression – something for which there are no easy lab tests and no guaranteed medication – and was asked by the cheerful but inattentive clerk, who was HOLDING my check-in form, whether I had come in for a diabetes screening. When I clarified, the PA they assigned me treated me with contempt. I was not allowed to change physicians, and they would not refer me to an outside psychiatrist.
I did the same thing in Massachusetts and within a week had an appointment with someone who had an actual conversation with me and was more than happy to refer me to anyone I needed. I hadn’t been here long enough to get through the insurance paperwork yet, so they referred me to an administrative service who told me exactly what I needed. As I was technically uninsured the first time I came in, I was covered under something called “Health Safety Net”, which is MA’s way of telling you they’d like you to not die in the street like a stray dog, even if you have no money.
In a lot of cases, a factor in waiting until things are desperate enough to send you to the ER is the perception, often correct, that you will be ignored unless you’ve attained the kind of crisis state that makes you willing to wait for five hours in a lobby with the sobbing, the bleeding, and the plague carriers who can’t get care anywhere else.