They’d rather have you die than have to pay out of network. The scenario in the OP worked out perfectly here for them: pt got care, they didn’t pay for it, physician gets labeled as the bad guy, patient will think twice before going to the ER again.
Behind the scenes the physician group almost certainly reached out to the insurance provider to negotiate rates, I’m betting they asked for average market rates or less, then got told to pound sand by the insurance company because the scenario above is much better for them. Screw their clients’/patients’ needs.
I agree the system is broken. Patients get hosed. Universal healthcare, anyone??