This is horrific, but unsurprising. Before she retired, mum used to work in population health policy. One of the things that’s pretty well-known amongst the sorts of people who make population health policy is that early intervention in health issues is the most cost effective way of providing healthcare. That is, the more accessible your primary healthcare (e.g. GP visits), the lower your overall total community healthcare costs. It’s one of those “spend a dollar now or spend a hundred later” sort of things, although in this case the analogy is more “diagnose diabetes now or lose a leg later”.

Needless to say, the US-system was always used as exactly the example not to implement: the US has notoriously greater morbidity (i.e. people living with health problems) than other first world nations, basically because people can’t afford to go to the GP. Unsurprisingly, this disparity hits poorer people harder, and poorer people of color the hardest.