No — people usually didn’t die “in the streets” (although a few did, if that’s where they had their fatal heart attack that could have been prevented with regular doctor visits and proper medication). People died at home, people died at work, and people even died in emergency rooms, which is where they often ended up with emergent conditions that could have been prevented or managed properly if they had health insurance.
Yes, we do have some clinics and charities that help those who cannot afford healthcare any other way. But not nearly enough. We also have a law that forces a hospital ER to take anyone at their doorstep and treat their emergent condition regardless of their ability to pay.
And what happens when a hospital doesn’t get paid for their services? If that happened once or twice for every thousand patients, they might be able to absorb that loss if the bill isn’t too high. However, the number of uninsured or inadequately insured people prior to the ACA was too much for any hospital to simply write off the costs.
So what did hospitals do? Some were able to get reimbursement from government funds set aside for that purpose (courtesy of taxpayers), but most of the time, they had to raise their rates for their services so they would get enough revenue from the people who COULD pay — the insured. That’s right — taxpayers and people who had insurance were paying for the health care of others.
Personally, if I’m going to have to pay for someone else’s healthcare anyway, I would just as soon pay to keep them healthy. It’s more cost-effective to keep somebody healthy than foot hospital bills for hundreds of thousands of dollars for situations that could be avoided.