Here's a sad example of "reluctance to pay". My childhood friend, best man and ski pal lived in Edinburgh. He made a lot of money and had all the toys. Lovely house, expensive cars and a beautiful yacht. He had not been feeling well for about a year and was being treated by a NHS doctor.
He was 56 when died of a heart attack. No heart condition was diagnosed prior to his death.
Had he shelled out for a better private doctor I'm pretty sure his heart condition would have been diagnosed. Of course, even if it had, he might still have succumbed.