Selection effects. The poor and elderly are likely to be on Medicare and other public programs. If you can't afford healthcare and get it for free of course you'll be happy

It's like my charcoal Weber. I found it on the side of the road. Its dirty, dinged, and the wheels are falling off. But it was free and I can grill on it, so I'm extremely happy with it

On the other hand if I paid for a Weber and got that, I'd be pissed.