That makes a lot of sense to me--Doesn't Madge mention something about how maybe her mom could get proper medical treatment in the Capitol but they haven't been authorized? (It is entirely possible that I picked this up from somewhere and it's not actually canon...). Presumably the level of care would increase as you went from "who cares" outliers through the middle districts (where more skilled labor is less replaceable) and would be pretty good in Two (at the very least for Peacekeepers).

And I definitely think the train crews aren't allowed to interact much with district citizens, leaving presumably very loyal Peacekeepers as the only non-Capitol people to actually spend much time in other districts and return home afterwards.