" It really comes down to cultural differences, as Kevin pointed out--most of us, at least the ones who have lived in big American cities, know better than to go to the ER of a city hospital with a health issue--it's the place to be if you've been shot, or hit by a semi, but if you're feeling a little off, you're put in the back of the line--"

That's a vicious piece of blaming-the-victim. I have lived for a couple of years in a large US city. If I had a condition like pneumonia that could kill me within, hours where the hell *else* could I go? I never encountered such a place. Maybe there's one you could go to in NYC if you had access to some secret knowledge and had a bunch of rich and influential friends, but how many *Americans* would be able to come up with a better alternative?