health and well being

One thing about living in and working in Detroit is that you can't help gaining a deeper understanding of the inequalities in our society. The patients I work with at the hospitals here--particularly Detroit Receiving--highlight the vast gulf between the educated, resourced elite, and the underresourced underclass.
An example: For most American women, the annual exam--or at least biannual is an assumed right.  In fact when the USPSTF recommended that women really don't need quite as many pelvic and breast exams as they have been getting, there was a public uproar--despite the fact that these recommendations were based in empiric research.
Last week a 40 year old woman came into the clinic complaining of pain and irregular bleeding for the last year.  She had come to the ER twice, and been diagnosed with benign conditions and sent home.  On her third visit, someone finally took the time to sign her up for a free program that screens women for cervical cancer.  It turns out that her last visit to the doctor was 15 years ago.  She knew that she needed to come, but she didn't really have the education to know why, and she never had insurance, so she did what most people without insurance do and came to the ER when she couldn't stand it anymore.  In Michigan two groups of people qualify for medicaid--children and pregnant women. 
Turns out she had inoperable cervical cancer.  So she will have an extended course of radiation treatment and maybe chemotherapy and so forth for several years, then the odds are that she will die. 

So here's the way I see this scenario:  We as a society and as a medical profession failed to provide this woman with the basic preventative health care she needed, and so now we will end up paying many times what prevention or early treatment would have cost us to give her a treatment that has a relatively low chance of long term success and gives her all sorts of miserable side effects.