It seems to me the US never outgrew it's frontier mentality. Before, if you felt too hemmed in you could always move west and get free land, get together with

It seems to me the US never outgrew it's frontier mentality. Before, if you felt too hemmed in you could always move west and get free land, get together with other locals and form a small town. Better to be the founder of your town than a random nobody in your previous town. Back in the 18th-19th centuries, medical care was primitive and sometimes dispensed by the barber. For toothaches and broken limbs, you might see a dentist or a doctor, for anything life threatening you toughed it out and died at home. We don't do that anymore of course, but it's almost as if attitudes about self sufficiency have lagged behind.