I don't believe Pelosi is actually confused.
Rich people get better treatment because they have money, obviously, but I'm also pretty sure insurance companies have large lists of starred "important people" to make sure that nobody with influence ever deals with the bullshit that normal humans do. The bluechecks of hospitalization. No one who has had a standard interaction with our medical system - even with "good' insurance, even one which went relatively well by the standards of these things - could not want to burn it all down.
