> In my state the wait is under 8 minutes for ER care. So, I can't relate.

That statement doesn't match actual data about ER wait times, for example [1], [2], [3]. It seems anecdotal (one lucky visit) at best, and just made up at worst. As the father of three with multiple ER visits of varying severity in my own set of anecdotes, 8 minutes seems extremely unlikely unless you required resuscitation, or the ER had no other patients.

While a hospital employee (health care professional) may talk to you within a few minutes to ascertain your condition and severity, and insurance/payment method, that doesn't equal time to get care, nor does it mean you will leave the ER with satisfactory treatment, referral to a clinic, or medications. Because American hospitals very often don't have diagnostic equipment, or only want to use it when absolutely necessary (and payment looks likely), you may get "treated" with pain killers and antibiotics and referred to a diagnostic clinic for further tests, scans, etc. Those clinics do not treat anyone who walks in, they require payment in advance of treatment, so they create a chokepoint on people receiving actual needed care.

One relative waiting over six months for a non-emergency MRI in Oregon. Another has waited for over three months for her insurer to "approve" diagnostic imaging for a foot surgery her (required by insurance) primary care provider already prescribed. That kind of thing happens in other countries too, but I have walked in to hospitals in Taiwan, Thailand, and Malaysia and received immediate care, including diagnostic imaging, at prices a fraction of what I've paid for the same thing in the USA.

Without getting into the possible reasons, health care in the US consistently (during most of my lifetime anyway) ranks very high for cost, very high for corruption and profiteering, and increasingly worse in terms of outcomes. And the US has a large and growing population of uninsured and underinsured citizens, even compared to other countries with similar demographics and immigration (Canada, Australia).

> our life expectancy is on par with countries that have a tenth of the immigration rate and a lesser poverty rate

Actually the US ranks rather poorly in terms of life expectancy, even compared to countries with similar immigration rates and poverty [4]. You can slice the numbers all kinds of ways, and interpret them according to your own biases, of course. But given that the USA stands as the richest country and the biggest spender on health care per capita, by wide margins, one has to wonder why it ranks below, for example, Thailand and Panama on at least some measures of medical outcomes and life expectancy.

As you seem to allude to, the truly indigent and uninsured may receive some minimal care faster, and for free, compared to the working class or middle class people who appear to have the means to pay. Hospitals and the US health care system at large factor treating the uninsured as a cost of business, passed on to those who can pay-- similar to how Americans who pay for car insurance subsidize those who don't. As a middle-class person with some form of insurance (often useless or inadequate, but that's a different topic) I know my first interaction at a hospital or emergency room will amount to establishing how I will pay, the wallet-dectomy.

America also leads the world in medical debt [5], the aftermath of inadequate insurance and inflated costs for treatment and medications. Medical debt usually ranks at the top of the list of reasons for personal bankruptcy in the US.

[1] https://worldpopulationreview.com/state-rankings/er-wait-tim...

[2] https://www.beckershospitalreview.com/rankings-and-ratings/e...

[3] https://www.statista.com/statistics/1475298/average-wait-tim...

[4] https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...

[5] https://en.wikipedia.org/wiki/Medical_debt