> No body goes to the doctor because they want to.

I routinely go to specialists for things I don't need to, because I make enough money that it's better than waiting for the issue to go away on its own.

Now imagine expanding that to the entire country, when they don't have skin in the game.

Their health would improve?

Imagine it doesn’t go away on its own, it’s something serious and you caught it early.

For working class people , the skin in the game is having to miss a day of work, etc. Theirs still an opportunity cost