Mike, let me answer for John and his wife in my role as a podiatrist.  Most studies find foot care for diabetics to be cost effective, preventing expensive amputations among other things and decreasing the death rate.  Therefore, a lack of insurance in this case  (forgetting the human costs to the family and simply looking at money for only one of the many problems for diabetics) is indeed penny-wise and pound-foolish.  John is quite correct in that socialized medicine for preventative early care appears to decrease costs and increase health.  You, on the other hand, bring a callous edge to a sensitive conversation.  As always, John doesn't really need my help, but your ignorance demands a response.