My mother was a nurse for 20 years. She was extremely good at her job and worked in the ICU unit of Vanderbilt Hospital. One day she had a severe headache at home and once it subsided she sent me an email detailing five possible causes. Every item on the list was trivial except the fifth item which said "small aneurysm bleed". I, along with the rest of the family, asked her to go to the hospital but she refused because she did not want to burden the family with a $5,000+ CAT scan and hefty doctor expenses over what she insisted was a just an overreaction to a bad migraine. I assumed, because she was such a good nurse, that she knew best. I ended up moving near her soon after and had the privilege of spending many days with her and my brothers as a family until I received a phone call one night telling me she was rushed to the hospital. When I arrived at the hospital a clerk attempted to block my way to fill out insurance paperwork, I rushed by her and headed to the ICU. When I arrived to the ICU I was told the aneurysm had applied too much pressure to her brain, the doctor said there was no chance of recovery. Even in death she still helped others, her organs saved two other individuals that day. In my home upon my desk I have a photo of my mother and I, a print out of her email, an award she received for being one of the first volunteer nurses to arrive in Louisiana after Hurricane Katrina, and a big pile of bills (ambulance ride, doctor examination, bed and care costs, etc).
Yes, I would agree, most people do not go to the hospital in the USA unless they are 100% positive it is required. This prevents many early visits to the doctor. People will often wait until the very last moment to get help.