That's not the point I was trying to make. In America, the coverage provided by Medicaid, Medicare, and private plans under ACA rules, will determine whether t

That's not the point I was trying to make. In America, the coverage provided by Medicaid, Medicare, and private plans under ACA rules, will determine whether to approve or deny a treatment plan based on a number of criteria, which are largely based on a balance between the cost of the treatment versus its likelihood of resulting in additional QALYs (Quality-Adjusted Life Years) for the patient. An expensive treatment that's unlikely to help, or even a less-expensive treatment for somebody who's already 90 years old, is likely to be approved. Thus, there are potential treatments that the government will deny. You're right that in America, emergency acute care is going to be provided in any case. This was true before ACA, and in this context may be seen as one way that the American system, as defective as it might be, is still better in many ways than is commonly admitted. (Source: my wife's job used to be Medicare reimbursement, and now centers on "DSH" payments to hospitals, which is essentially reimbursing hospitals for bad debts from indigent care and stuff like we're discussing in this sub-thread)