>What prevented someone from operating a for profit ride program even before Uber without a medallion?
Nothing and lots of companies do it.
Uber scaled fast while ignoring local regulations. Both parts are important. We've seen from e.g. Zenefits [1] that state regulators are powerful. Local regulators, on the other hand, are slower moving.
Previously, a disruptor might assemble a few happy customers before the regulators slammed down on them. Uber's ability and willingness to scale fast changed that. By the time the local regulators were ready to slam down, entire cities of constituents wanted and liked the service. That changed the political calculus. Uber, and consumers, won.
[1] https://venturebeat.com/2017/04/11/zenefits-fined-1-2-millio...
It's the last two paragraphs of the article.
Uber generally broke car service laws by not requiring their drivers to have the local registrations.