Yes, many people don't have insurance, so they go without preventative care. Then when what started out as a small problem eventually gets very bad, they go to the emergency room to get treated. This is, of course, very expensive. However, if your income is low enough, the hospital will write off a large portion or even all of your bill. However, if you have too much income, then you're stuck with paying a huge bill. This can put many people into bankruptcy. It's not uncommon (at least among my musician friends) to have fundraisers for people who got sick and couldn't pay their medical bills. Anyway, this will be changing as the new "Obamacare" phases in over the next several years.