Before WWII, people in the U.S. bought catastrophic insurance and generally paid for their medical care out of pocket without much trouble. This kind of insurance was around $80/month or less in my state before Obamacare was implemented (it doubled after that). Before WWII, everyone simply paid for common Doctor visits and relied on their insurance for larger bills. After WWII, the US made gave employers tax incentives to provide insurance, which in hindsight was a huge mistake.