People who can't afford to go to the doctor just go to the ER instead, since the ER legally has to treat them. Pretty much everyone has access to medical services, just not in the best of ways.
Too bad they're financially screwed afterwards.
Generally speaking, these people are financially screwed anyway. My point is that they don't pay and there's nothing the hospitals can do about it
Or they're just flat out denied coverage due to some condition they have or have previously had before.