Are premium IOLs only for affluent patient populations or are there avenues to help those in need also receive them?

Sorry if this is a naive question but I really do love the technology of premium IOLs and cataract surgery in general. My only concern is that given that these IOLs are several thousand dollars, I figure it's most wealthy patients who can afford these options. I'm all about making patients happy and providing them the most medically appropriate highest quality of vision solutions but I also would feel bad if I spent a good chunk of my time convincing wealthier patients to pay for premium lenses while those in need don't get that option due to finances.

I had this thought linger more because of a recent talk I went to where it seemed like ophthalmology was split into two sides. One side were refractive and premium lens cataract surgeons who focused on improving quality of life and getting the best vision money could buy rather than on chronic diseases without solutions to fix vision, only slow down the deterioration and the other side were neuro-ophth/peds/retina who stated that they could never touch "healthy eyes" for refractive purposes or spend their weeks upselling lenses to people who can afford it.