If one wishes to have these sorts of resources on offer - and it's not a bad idea because, at the least, these places act as first-line triage centers for emergency rooms, diverting those people who do not need emergency help but who would have gone there in the first place - but rather than making them "free" - TINSTAAFL - set it up so that people can either pay at the time of service, or not pay immediately, be sent a bill, and if the bill is unpaid by the end of the year, that information should be reported to the IRS - on a 1099 form, just like so many other items of information - and the unpaid amount added as an additional tax. Given that most people end up being in a refund position when they file their returns - the withholding system was intentionally designed to overwithhold - that refund would cover some or all of the unpaid balance; any remaining balance could be subjected to a means test - based on the information in that same tax return - and partially or wholly waived. That way we achieve some measure of compromise between free markets and welfarism, and require people to have as much skin in the game as they can afford while still providing basic care - i.e., nothing like MRIs or the like, or fancy therapies or medications - without leaving poor people to rot in the gutters - or, more to the point, clog up emergency rooms - solely for lack of resources to immediately pay the bill.