I am sitting outside the Emergency Room at a major hospital in the Bronx, smoking a cigarette, taking a breather. Yes, that's right, taking a breather. Inside is a scene that would make a sadist proud. The lights are harsh and bright. The thin curtains that give the illusion of "rooms" are spaced three and a half feet apart, barely wide enough to fit a thin hospital bed. Most are stuffed with two.  To get to them, you need to wade through floating pallets of other beds, stacked three deep in front of the "rooms" and filled with mostly silent, mostly elderly patients.  
When I first walked in, I strolled right past the reception area. There is a large sign, but with the beds stacked everywhere, milling doctors; nurses; and family members, and monitors beeping like an old-style department store on steroids, I missed it and walked right past the desk while looking intently for it.  
A small family is clustered around an elderly man a few beds away. The man is bleeding profusely, and his wife and daughters are clearly worried. They try to find a nurse, a doctor: anyone really, but there is no one available or approachable. Finally a nurse comes over.  She notes that the man is scheduled for an MRI., assures his wife and daughters that everything is fine, and convinces the daughters that they can go home. Their mother refuses to leave her husband's side.  
Fifteen minutes later, on the way to be tested, the man is dead and his wife's screams of misery cut through the beeping drone. 
Health Care for the poor: It is one thirty in the morning, and right now I'm finding it hard to be proud to be an American. This is not compassionite conservatism, this is a tragedy, and a travesty. 
There are thousands of Emergency Rooms in America, and they are assuredly not all like this one. I remember, years ago, showing up at an Emergency Room in wealthy Westchester County, in the middle of the night. There was a small sign on an otherwise empty reception desk. It said, "Ring Bell for Service". 
But for the poor, and especially the elderly poor, this hospital scene in the Bronx is more the rule than the exception. The rest of the hospital is state-of-the-art, fueled by insurance dollars and grant money, but the Emergency Room is a packed, nightmarish place. Triage rooms and cots give the impression of battlefield medicine, but there are no war heroes here, not of this war anyway: only the unglamerous urban poor.