If you're a techie, you are likely capable enough to learn and use a static-site gen and host your blog on Github Pages, Vercel, Surge, Netlify, etc. If you're a techie, you probably also care enough to not inundate your readers with a crapton of intrusive trackers and weird browser hacks/overrides that Medium employs.

If you don't want to use an SSG, or if you're not a techie, you can use or self-host: https://write.as/, https://bearblog.dev/, https://rwtxt.com/public, https://the-federation.info/plume

The downside of the above options is that they are nowhere near as prominent and thus don't provide the same level of discoverability as Medium -- in which case, if you're really hurting for cash and are trying to make a career of writing, maybe it is in your best interest to stick to platforms like Medium, despite how intrusive and reader-unfriendly they are.

EDIT: I am hesitant to recommend https://dev.to/ because I have this sinking feeling that it will eventually become like Medium. Also, semi-related, but Dev.to uses endless scroll, which I think is very bad for readers (also it makes it impossible to click links in the footer).