It's preposterous to imagine the A&E triage personnel trying to ascertain exactly how an injury occurred and whether it amounted to self-inflicted negligence, and then proceeding to discover whether the patient had the means to pay. You can envisage the conversation;- "Well, we can give you a Paracetamol, but we refuse to set your broken leg. That'll be £2 please!" Here in UK, anyone and everyone who needs medical care, whether emergency or not, gets it. And no-one is asked to pay on a culpability basis. Habitual self-inflicted harm should be addressed with therapy, counselling and medication if required.