The ER vs. having a regular doctor is a big impact. It's partially why there are so many urgent care centers, but a lot of uninsured use the ER as their primary care as the ER has a duty under law (and ethics) to treat anyone who comes through the door for anything, regardless of whether they can pay or not, where a primary care physician can turn people away if they can't pay

Agree and I cannot help but think we in the US always digs this hole. I wish at the federal level we required citizens buying into health insurance with a very generous sliding scale for those at lower incomes. It reminds me of medicaid/care. Folks will not go to the doctor because of costs and then once they age or cost into assistance their condition is now permanent.