It is still possible to pay cash for medical services.
The risk is a catastrophic illness might wipe you our. I, for years carried a policy with a very high deductible to insure against that happening. Fortunately, I never used it.
I am now in medicare but it much better for me to pay the additional rather than carry the medi-gap insurance...
The average Joe would probably be concerned about that, but I'm not the average Joe. If it came to that due to a catastrophic mishap, I'd make sure they wouldn't find my cash or assets in 100 years ..........
"but wouldn't they come after your bank account and other assets."