It's lacking because they aren't paying for an on-call or easily accessible doctor; or for the staff to be able to respond sufficiently quickly to an emergency

It's lacking because they aren't paying for an on-call or easily accessible doctor; or for the staff to be able to respond sufficiently quickly to an emergency where they would be able to see the concern and then get a doctor there quickly. In both cases, part of the solution is to pay more / have better employees (that you get, in part, by paying more). That's why I argue it's "reducing costs". It's a banal and boring explanation; but, most evil is.