In the US, it depends a lot on where you live, and how much you depend on services like Medicaid.
In times when we have had neither insurance nor medicaid, it's no big deal. Nobody harasses us for not having a pediatrician.
When we've been signed up with Medicaid (administered through the state, so it may vary a lot from state to state), we get absolutely snowed under with vaguely threatening letters in the mail, reminding us to take the kids to the pediatrician, the dentist, etc, to get them vaccinated, and also not to give them crack, or forget to feed them, etc etc etc. We found, after a while, that these could be safely ignored. But again, might be different in other states. It is impossible to get off their mailing list, even when you no longer qualify for the services.
I don't know how that'd play out with proper health insurance, as we've never been able to afford that.
Re: Emily Oster says 'Let's forgive and forget'
In times when we have had neither insurance nor medicaid, it's no big deal. Nobody harasses us for not having a pediatrician.
When we've been signed up with Medicaid (administered through the state, so it may vary a lot from state to state), we get absolutely snowed under with vaguely threatening letters in the mail, reminding us to take the kids to the pediatrician, the dentist, etc, to get them vaccinated, and also not to give them crack, or forget to feed them, etc etc etc. We found, after a while, that these could be safely ignored. But again, might be different in other states. It is impossible to get off their mailing list, even when you no longer qualify for the services.
I don't know how that'd play out with proper health insurance, as we've never been able to afford that.