There are private for profit hospitals which can turn away patients who do not have true emergencies. I don't believe any public supported hospitals have that policy. On the other hand, a lot of EDs do the minimum when it isn't an emergency and send the patient off to get follow up elsewhere. Without insurance, the "elsewhere" can be limited.
As far as bacterial ear infections, there is controversy whether to treat or not treat children's ear infection. I do not believe that applies equally to an adult bacterial ear infection.
With all due respect, if you could explain what you mean by "definitive care", maybe that would clear up my misunderstanding of your statement. But to imply that this is a ground rule, across the board for all ER's, is simply not correct.
Just speaking from my own experience, not trying to say this is how it is everywhere.
I would have to agree with most of what you've said in this post. Which is why I wanted to understand your definition of definitive care. I wanted to understand precisely the types of treatment you were referring to. Let us say for a moment that a pt for reason -X is brought to the ER, and using my example from earlier, it turns out to be acute appendicitis, well now this pt can not pay for the much needed operation nor the hospital stay, meds, etc. My hospital isn't a teaching hospital, but we would admit the pt, and she would be operated on. Our financial department, which has a Medicaid Unit, will try to establish temporary In-patient Medicaid to cover the costs.( they are usually successful, AFAIK) 
I'm not the authority here on emergency rooms, but as I stated before, I work in an ER, for a hospital system that I believe is the largest health system in New York. I know for a fact that at my hospital we do not refuse treatment to any patient what-so-ever. Regardless of their financial status or ability to pay. In addition to this, we also at this time do not require co-payments or other payments at time of service in the emergency room. I'm not sure, but I believe this is the policy of the hospital system, not just our facility.
Now when you come to our emergency room, you visit the triage nurse first, and then you get to speak with me. I'm responsible for registering and banding every patient that enters the ER. I don't know if it's state law or just hospital policy, but I'm not even allowed to ask any financial questions until after you visit with the triage nurse. ( I believe it is a state law, to prevent discrimination based on an individuals financial status.)
With all due respect, if you could explain what you mean by "definitive care", maybe that would clear up my misunderstanding of your statement. But to imply that this is a ground rule, across the board for all ER's, is simply not correct.
Thanks!
Are you replying to the right post???????? I said exactly what you said and certainly nothing about coming in for that bed, bath and meal that a few patients try on occasion.
There are charity, county and other public hospitals and there are private for profit ones. Some do less than others for the non-paying patients.You're certainly correct on that example. You wouldn't get chemo in an ED, however I have seen homeless people come in and be rushed to the OR, for example, acute appendicitis. Or homeless people with DVT or some other ailment have also been admitted to the hospital, for various LOS's, disregarding whether or not the patient has insurance. My point was to clarify, that to say, across the board you will not likely be treated in an ER if you don't have insurance or can't pay the bill, was incorrect. That is why I wanted to understand the poster's definition for definitive care. If your talking chemo, well then they're right. If you talking initial treatment for an injury or something else that doesn't require long term medical treatment, well, at least in my hospital system, you will be treated, admitted and operated on if necessary.