The solution to the medical question is simple—Those treated in a public facility who are unable to pay for their medical treatment are entered into a period of mandatory servitude towards the State which paid for their treatment, until such time as their bill has been paid off with labor. (For instance, they could work as a pro-bono janitorial staff in the hospital which provided their services to them, room and board paid.)
I'm starting to think we need to bring back the notion of a Debtor's Prison...