@silas it was originally freedom of choice. traditional american values involve a lot of small actors doing many things and you having to rely on personal responsibility to make good decisions.
basically, the state isn't your dad.
unfortunately over the years a lot of that choice has been shut down with regulations (many of which are captured) and weird modernity like people expecting the state or their boss to provide for them. in old america you just demanded money from your job, and you sought things like healthcare from friendly societies or other programs.
And I mean that in the sense of yes. Being safe if you lose your job or become chronically ill. Freedom when you needed a big surgery and couldn't work for 3 months and then lose your job and can't pay for your house.
What annoys me more is that in a way I get it. Yes I prefer knowing yes things can go bad but not super bad. But I see the point. It's still dumb. Like how some people still apparently have to pay thousands of dollars for giving birth. After insurance. That is stupid. But I get it
America seems like "fuck the others or get fucked". It's not that much of what I call a modern society. Because it's not set up in the way to lift everyone at once up on a base level. So, its like yea "Freedom" to have to go to work because you used your 4 sick days of the year. But also freedom to tell your boss to go fuck himself and fuck off. The same day. Which you really can't do here. Neither with a job or something like a rented house.
but apparently a nontrivial amount of people got their healthcare through some equivalent of an independent union, and since the unions had no state interference you were pretty much free to start one whenever, so they were subject to market forces to offer good deals to their members.
there were also a lot more medical schools back then, and a lot more lines of research open, so that too pressured costs down.
the downside is metaregulation fails sometimes. if you don't join a club that checks people on your behalf, its much easier to employ a total quack, but the upside is there are a lot more practitioners and the good ones are more able to route around bad actors, so its pretty much up to you to figure out what cancer doctor you want (or have someone deal with it for you)
of course this is also when you could get doctors to come to your house, people had a family doc who did so, and pharmacies weren't medical shackles where you have to constantly beg continued permission to have drugs you need to live (you just, go buy them. the scrip is a doctors *opinion*, and that's why they are historically called opinions.)
@silas as an upside your membership with the union is your own, so you don't lose your healthcare with your job and other bizzare things the daddy state policies create.
for example even having a benefits package is WW2 state interference. they banned raising wages, so companies started relying on giving out bonuses, and then the government came back again and said hey those benefits are now gonna be mandatory, even though they shouldn't exist in the first place and your company's sole concern is actually getting you paid (while you hire someone else who's sole job is keeping you alive.)