This really is a study on the political consequences of an underregulated free-market economy and the result of political demands for more libertarian ideals as applied. The consequence is the poor cannot afford to live.
https://slate.com/news-and-politics/2011/09/let-him-die-a-de...
>What should happen, the moderator asked hypothetically, if a healthy 30-year-old man who can afford insurance chooses not to buy it—and then becomes catastrophically ill and needs intensive care for six months? When Dr. Paul ducked, fondly recalling the good old days before Medicare and saying that we should all take responsibility for ourselves, Blitzer pressed the point. “But, Congressman, are you saying the society should just let him die?” At that point, the rabble erupted in cheers and whoops of “Yeah!”
I mean, we don't make it illegal for people to do a ton of extreme sports where they might die. I don't see much of a difference between, say, climbing Mount Everest and a healthy, wealthy person deciding to spend thousands of dollars on something other than health insurance, knowing that they might not be able to pay the piper. Both are instances of someone choosing current enjoyment and weighing it against the chance of a life-threatening outcome.
The real problem seems to be when people have no choice. Of course everyone wants to not die, and of course no one wants to pay for healthcare, but we can't have both, so we have to find a middle ground that involves preventing deaths and paying for healthcare, and it doesn't seem horribly immoral to me to allow people to make the choice to trade their future health for money now (or enjoyment, in the case of mountain climbing or sky diving or whatever). Once again, the problem lies in the lack of choice from the get go.
In my prior post, I wasn't trying to suggest that we should willy-nilly leave people to die, just that we don't live in a world of infinite resources and that I don't personally believe it's horribly immoral to let people make choices even when those choices can have terrible consequences, assuming they know the risks.
Once again, my original point was not that people should be left to die, but rather that it doesn't seem horrifically immoral, as the parent was suggesting, to believe that people should have to face the consequences of choices they knowingly make, especially where there are real costs to real people to mitigating those consequences.
I also just think it's important to acknowledge that we're explicitly not trusting people and instead deciding what is best for them, as opposed to a situation like extreme sports, where we allow people to risk their lives. I think it's a fine position to take, but I think it's slightly hypocritical to allow extreme sports, but not allow people to make their own healthcare decisions (though once again, a perfectly valid position as a matter of policy).
Vast sums of money are spent lobbying to distort the market in favor of particular companies and industries. The FDA has long been accused of preventing key drugs from coming to market that are available in other countries. The patent system alone perpetuates medication monopolies over decades for fabricated reasons, keeping cheap generics out of people's hands. The tax system heavily favors employer-run plans (for reasons rooted in the WWII era) that encourage overspending, tie coverage to your employer, and distort the market in multiple, deep ways.
Medicare and Medicaid are huge. The chart in the FEE link below puts US gov per capita expenditures at 4th in the world.
The below Vox article, which is otherwise anti-free-market, concedes that generic insulin providers seem too daunted by secondary patents and "extreme regulatory complexity," both of which obviously run counter to a free market.
This isn't to say a free-market system would be a panacea of all complaints (systems dealing in scarce resources will never be perfect to all participants), but those complaints would be much different than those about the layers of bureaucracy, high government spending, low competition, high time-to-market for drugs, breathtaking lobbying efforts, and overwhelming tax complexity we have now.
Maybe you think you'd prefer single-payer to the present regime, but to characterize the latter as "free-market" sets up a false dichotomy. (Note that it could logically still be "underregulated," as you say, despite not being free - not that I would agree.)
Drug patents: https://www.statnews.com/2019/02/11/drug-patent-protection-o...
Tax distortion: https://www.forbes.com/sites/theapothecary/2017/07/30/why-ta...
Insulin prices: https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expe...
Free market? https://fee.org/articles/the-idea-that-the-us-has-a-free-mar...
In any case, my post above was about what is (and what to properly call it), not what ought to be.
As long as private property is enforced through the threat of violence these problems are not tractable. The only solution to regulatory distortion is the complete abolition of capital.
In the case of healthcare, nationalized single-payer system gets far enough for something so critical to our existence without requiring a complete restructuring of the economy.