I acknowledge I'm using anecdata and deliberately telling a story to pull at your emotions, but my cousin died suddenly at 45 of a heart attack, having been skiing and surfing just weeks prior, IE: seemingly great health. But, because he had been a (successful!) self-employed person but was in a bit of a bad time (wife cheated, divorce, sudden economic shift...) he didn't have health insurance so put off going to the doctor when he had a weird symptom a week or so before he passed.

I bring this up because in this country our health insurance is broken in every way. We absolutely should be investing in preventative medicine, because doing so would not only have found things like my cousin's situation, but it would also help us ward off both the disease and cost of more chronic illness. Instead most of us dwindle along with very limited access for decades until we either get some condition that forces us into very expensive and time-consuming care, or we end up gutting whatever life savings we might have on our last few months. So is an annual physical really all that big of a deal on the surface? No, but it's emblematic of how broken our approach is to care - to put it in IT terms, we have no monitoring/observability or metrics and we only take action after we've had an incident or breach, and even then we are generally only applying patches not dealing in RCA.

He didn't say it's not a big deal, he said checkups are relatively predictable. Those mean very different things. Moving the predictable costs behind insurance and administration artificially inflates it because there's less pressure on providers to compete.

If people weren't doing dumb things with insurance to try and socialize healthcare costs there's a good chance your friend would have been able to afford going to the doctor whether or not he was insured.