In the early 1980s the city of New York City was on the verge of being bankrupt and a lot of the hospitals and Hospital systems with in New York City ended up having to take state and federal bailouts. But those bailouts are what you have today in the form of Medicare and Medicaid it federalized a lot of what used to be local control over the medical system
I do remember a friend of mine getting a free appendetomy in the 1970s! Saved her life.