The "weird libertarian strategy" came about through 20th-century gatekeeping by the AMA to prevent mutual aid societies and unions from paying for medical services, and it makes actual libertarians furious: https://reason.com/2020/04/05/how-doctors-broke-health-care/

In general, the US has a problem where it pretends to love free markets, but when you look under the hood there's horrific regulatory capture and crony capitalism.