poor people are quite literally expected to shorten their lives, and worsen their quality of living instead of asking for help to alleviate their pain and suffering.
it’s considered a grave social more breach when you go to the ER or see a doctor for something you’re pretty sure wont kill you immediately.
everything poor people do to maintain their health is seen as frivolous extravagance by the upper classes
no one rejects welfare more than the impoverished, who are so embarrassed to be seen as needing extra help they would rather suffer.
a starkly different attitude is held by the rich, especially when taxes are involved.