I have a GI friend and colleague who makes most of his living sticking tubes down people’s esophagi and up their behinds.
He told me that he recently took on a 1 day/week job at a Medicaid clinic to keep busy in this economy, and to do some low-fee work for the benefit of the community.
After four months of it, he was frustrated. He told me that over half of the scheduled patients do not keep their office appointments, and 2/3 do not show up for their scope appointments.
He is quitting that experiment (leaving them without any GI person), and told me “No wonder these people are on Medicaid. If they cannot at least treat their doctors’ time with respect, how can they hope to function in the normal world? It almost seems like they just do whatever they feel like doing. I end up just sitting there, like a chump while I pay my malpractice insurance bills to cover the work.”
I told him what he had already learned. The poor often do not have good health stats because they do not take care of themselves, and are often stuck in bad circumstances because they do not function reliably or behave respectfully in the world.