Neckhammer - I haven't quite decided whether or not to disagree with you yet. Well, okay, I probably will. So I am going on personal history here, as my folks and my younger brother and I were a part of "they/them" for years and years. So I kinda feel qualified to speak.
I guess what irks me the most is you just categorized my family as quasi-abusers of a system, when in fact, my mom was never a fan of doctors and mostly was of the "what doesn't outright kill you makes you stronger" camp with physical ills. When we truly had an emergency room-worthy injury, she relented and we went, and got socked with the bill, which we paid for more than the insured/better insured as this group has/had insurance companies to either pay up or knock down the prices - and which ER visit did put us in hurtin' debt each and every time.
Emergency room visits due to bitten-through tongues and lip injuries requiring stitches (for example) happen to every class, not just the lower classes - the bill just hurt us/them the most. Today my mom says she should have taken my brother to the regular doc during his nighttime screaming fits when he had many of his childhood earaches - but she didn't, and now my adult brother has measurable hearing loss from it. THERE, access to a doc we could have afforded would have been sweet and I like to think my mom would have done it had she felt more sure of the finances. I feel that earache thing is a bona fide example of access problems causing poorer health - my younger brother could do nothing about family attitudes or finances when those earaches (which were obviously middle ear infections) happened and now he bears the permanent damage.
Now - I am the first to admit that my folks made lifelong seriously shitty decisions in their financial and work lives to absolutely precipitate us being in that situation. In my mom's case, she should have dumped a husband who did nothing but drag her down so many times that her own children (as adults) offered her airfare and short-term financial help - and our blessings.
And I wholeheartedly agree with you - education is key. I am a fan of financial education for everybody, because this poor/lower socioeconomic group needs that almost more than anything else. I base that opinion on 6 years of living in a government-subsidized housing project as I went through junior and senior high school, and we all talked, you know, and got to know each others' business. And health education. BUT - how many of us started life as Primals/Traditional eaters?? Practically none - we all here on the MDA, rich, middle class, poor alike, had to wade through our share of school-based USDA food pyramid lessons, and diet books, and health-food camps, and whatever else, to find this. I will not blame anyone for being CW still when they haven't been exposed to this yet.
And I agree with you wholeheartedly that our medical system is symptom-based - and that needs to change through better education, starting with the medical schools, whose profs need to learn how to build and maintain real health alongside being kickass surgeons and trauma docs and technology-wielders.
So, part of the problem, if you can/do categorize poor/lower socioeconomic groups as less fit and/or healthy, in my estimation, IS access. Not all - education is most of the rest. But all the classes higher up on the ladder themselves still have problems with this themselves - whom to believe, whom to go to for health education?? We all know the "trust me, I am right" noise out there is deafening when it comes to health info.
I hope you never were in that life situation where you felt you just couldn't afford the doc, NH, or felt guilt for having an injury that you knew would sink the family coffers for a while. I hated it. No easy-peasy fast answers to this, or categorizations of "them".
I have a mantra that I have spouted for years... "If I eat right, I feel right. If I feel right, I exercise right. If I exercise right, I think right. If I think right, I eat right..." Phil-SC