How was healthcare done before health insurance?

Like the question says. How was healthcare done/paid for/etc before health insurance became common?
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You just had to pay. If you didn't have it, they put it on an account. Or sometimes you would work for the Dr. or trade something like chickens or something. But generally you just had to pay. If you simply could not pay anything, they had these big poor folks hospitals you could go to. Horrible treatment there for the most part, but better then no treatment at all.
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