The majority of patients who abuse ERs are on Medicaid and have no co-pays.
I believe that, I know a couple of gibsmedats that would use the ambulance and ER because it cost less than a taxi (in non-urgent situations).
Our ERs are closing because gibsmedats and illegals used them as the doctor’s office, and rarely paid any bills. As the state cut “charity care” reimbursement, closing the ERs (and sometimes the entire hospital) was inevitable.
I know one on Medicaid that went to the ER something like 60 times in a 10-month period.