Yeah, in Canada check-ups or physicals may not always be covered since they may not be "medically necessary" procedures, so I know some people don't go to get them done. It depends on the province.

I imagine P&E, if they do use doctors, use walk-in clinics or the emerg wing as "John/Jane Does", like that case in the pilot with Philip and the man he was working with.

The EMTALA wasn't law at the time, so Directorate S agents probably had a list of hospitals which would not turn away patients for lack of funds for treatment.