Variation mostly relates to the context
We are passive recipients until aware of the way we develop. You cannot fully control either.
They met new people, shared ideas, and learned new skills.
The answer is Medicare and Medicaid.
Because of the medicare and medicaid, most people believe that there's no longer a need for traditional charity for sick people for need help, because they think all already taken care of by the government. This later on become the motivation for hospitals and drugs companies to increase the price of their products/service