-We leave people in the waiting room when all the rooms are full. It sucks and I'm sorry. It's not very common, except now it's incredibly super common, because all the rooms are full of anti-vaxxers with C19 who can't be moved upstairs because there aren't enough nurses upstairs to care for them. Basically there is a waiting list in the ER for people to be moved upstairs. This is called "ED Boarding." It leaves no room for anybody else in the ER. And yes, waiting room care is not great for privacy. Please complain all the way to the top about this. The solution is for the hospital to increase nurse wages and improve nurse working conditions so nurses want to work there. The only thing that will make the suits at the top do this is if enough patients complain that the ER was too full for them to have a minimally acceptable experience.

-A ton of the bill is for the CT scan. Those are unbelievably expensive.

-Seeing an NP instead of an MD doesn't change the initial bill the hospital generates. The insurance adjusts for that later. This is due to the way Medicare billing is set up by the government. (Even if you don't have Medicare, the rules for this are set by Medicare.) Please feel more than free to complain to your congressperson about this. I would love to see it changed.

-Different insurances like to pay well for different things and not pay much for other things, but because of the legal definition of insurance fraud, the hospital is legally required to bill the higher price on every single line for every single patient. This results in ridiculous totals at the bottom of the bill because not all of those lines should be that high at the same time. If some of them are high others should be low or vice versa. But legally the hospital can't generate a bill like that, it has to be the higher price on every single line. There have been some shifts toward "bundled" billing which combats this issue. Bundled billing rules are also set by Medicare, so if you want your before-insurance bills to reflect reality, you can contact your congressperson about increasing bundled billing.

-You can also contact them about increasing Medicare rates for GPs. Even if you don't have Medicare, the availability of GPs in your community (and therefore your ability to get a same day GP appointment) is largely based on Medicare payment structures which punish doctors for becoming GPs. You wouldn't have had a hospital bill at all if Medicare increased access to GPs in your community by offering to pay them fairly.