I am old enough to remember when people who went to college paid their tuition and living expenses. That was before all the government programs (other than the GI Bill) that induced parents to think they had to foot the freight for their spawn to go to college. Those programs (and the parents) shifted the cost of college from the student to the parents which in many cases resulted in the students treating college as if it were a country club not an educational institution.
The universities could charge anything they chose, and the dumb 18-year olds would borrow it and hand it over to them.
Same with medical expenses. Those weren’t obscenely high until medical insurance was paid by the employer.