Living in Sac, we are not remotely in the same league as what is described in OP. Sutter may have outsized market power, but you can definitely get care at a to

Living in Sac, we are not remotely in the same league as what is described in OP. Sutter may have outsized market power, but you can definitely get care at a ton of different providers in the area, on e.g. the open market CA insurance plans. I know this because I did it. Definitely can't speak to the ambulance thing, we've been lucky enough to avoid those at least, if not the ER.