It’s was somewhat of a rhetorical question since my parents (and theirs) did the same in the 20-50s/60s.
It would be interesting to see a financial analysis done, even the case where you had to borrow money (assuming you could) to pay the doc. What would the payment with interest be compared to various insurance premium rates (especially those apparently on the way).
Dad said it was a mixture of goods, food, labor and some small amount of cash, if they had it. Docs didn’t charge interest back then. In the late-50s/60s onward, things were a lot more affluent, and it was insurance policy thru Dad’s Fortune 75 company, Allied Chemical.