Strangely enough, the patients most likely to get lousy treatment are those on government "insurance,' like Medicare and Medicaid. This is because the government reimburses only 65% of the cost of the treatments. Self-pay and insured people both frequently get better treatment.
As more and more people end up on government "insurance," our healthcare system will become as poor as other countries, with many smaller clinics and hospitals being forced out of business, and those remaining open becoming more and more overcrowded and having to use cheaper labor and fewer trained personnel. Eventually, we may actually end up with "shitty filthy" places as hospitals struggle to treat more and more people on less and less money.