Well, that or they die. Good luck if you're in a car accident, unconscious, wallet goes missing between the car and hospital, and nobody can confirm your identity/ability to pay.
Either I'm getting soft in my old age, or I'm becoming a bleeding heart commie, because this is my point as well.
If you're talking about turning people away from the ER because of a sniffle, I'm right there with you, whether they're insured or not. Going to the ER for stuff you shouldn't even need a doctor for is a big part of the problem, IMO.
To Firethorn's point: If you're going to implement "only paying customers" in the ER, for REAL ER cases, how will you do it? The three Bens:
Ben #1: Insured Ben is out running. Ben is hit by a bus, but is brought to the ER conscious. Ben carries nothing but a phone with him while running, and the phone went flying when the bus hit. ER asks Ben if he's insured, and he says yes. Is that good enough to get him through the door?
Ben #2: Same scenario as above, but with uninsured Ben. So if I'm at death's door, is it really tough luck, go die now? If I chose not to be insured because I'm a tightwad, or because I use the $1000/mo for the insurance on hookers and blow, then maybe I should die. What about if I'm just temporarily down on my luck? Should I still die?
Ben #3: Insured Ben is out running with no ID and hit by a bus. Insured Ben is brought to the ER unconscious. Now what? If the hospital turns away unconscious insured Ben, and Ben lives, I'm pretty sure he'd be sitting on easy street after the lawsuit. Also what if unconscious, uninsured Ben is "uninsured" because he's a bajillionaire and self-insured?
So we can keep debating about turning people away from the ER for many ailments, but I don't think in a reasonable society, that we can turn away critically injured people at the ER, say after a building is bombed, or a train derails, or if it's just a one vehicle car wreck. Or some shmuck hit by a bus.