Health care is no different than any other service. If you are able to increase the availability as well as lower the price it helps everyone. Including the poor.
There are plenty of products where the market drives prices down, but doesn't make them free or available to everyone, and in most cases that's just fine. Some people and some societies take the view that in some way or another, things like food, shelter, and yes, at least basic health care ought to be available to everyone, even if it is not profitable. That's "social engineering".
Healthcare prices have come way down in the past two decades, the issue is that nobody wants 1990 level care, which could be administered at a fraction of the price of delivering all of the latest advancements.
The "healthcare costs are rising" meme is false. It's like saying "the price of supercomputers is rising". In non-inflation-adjusted dollars, the top-end supercomputer from IBM costs more than the top-end supercomputer from IBM cost 10 years ago, but the price per unit of computation has gone way down.
Healthcare prices have done the same thing, but everyone wants the best possible at all times.
(I want this too, but at least I try to appreciate that what I'm getting today is significantly better than 10 years ago)
Unlike other industries, getting service is often a literal life or death issue, you have to pay or you might die; morally this makes health care very different from other industries.
An entire sub-industry has popped up around coding claims correctly because doctors have figured out what they can and can't get paid for, the effect being the insurance companies now basically dictate treatments rather than the doctor. Frankly it's extremely fucked up and it's caused entirely by companies seeing the most profit.
So, given that health care is one of the most fundamental individual needs, profit most definitely should be the goal.
But health care is not the most fundamental need -- that would be food. I find it puzzling that people don't apply the same arguement to this need. Why not say that profit shouldn't be the goal of the food industry? And that supermarkets are immoral for making a profit at the expense of hungry people? Well, because it's clearly nonsense, of course.
But I wonder if it would seem like nonsense if we lived in a world where there was no free market in food supply. We might worry that greedy corporations would only be interested in serving expensive foods to rich people.
Of course people don't apply the same argument to food, food isn't scarce for most of us and few have problems acquiring it and the ability to produce it can't be easily collected in the hands of a few, anyone can grow their own food.
Anyone cannot operate on themselves and perform some life saving operation, and while those who can certainly deserve to be compensated greatly for that ability they walk a fine moral line knowing their product, or the refusal to provide it, will directly kill people. Doctors are much more like firemen and policeman that businessman. Society has certain expectations of them serving the greater good of the community and helping people when they're in need.
The free market is not the cure for every ill and seeking profit is not, and should not be the goal of every job. Greed is not some inherently good moral trait.
When this situation gets distorted through monopoly or other forms of regulations it is generally speaking bad for everyone.
Greed is good. My greed is good for you and your greed is good for me. This is the most fundamental philosophy of entrepreneurship albeit said using a word most people through years of indoctrination think is bad.
This is also why I don't like the term social entrepreneurship. Any entrepreneurship that isn't kept a live through some sort of corruption or force is good for society as a whole.
Name me one real monopoly that isn't enforced through "social engineering". A free market may have ocasional dominant market leaders like IBM and MS in their time and Google today. None of them are or were monopolies as better technologies and startups will always (lets repeat that word ALWAYS) come around as long as they are allowed.
True monopolies like the telecoms monopolies in many countries are not outcomes of free markets, but rather more or less corrupt deals between governments and a little group of businesses. Most often the monopoly is argued as a way to protect the consumer.
The free market works wonderfully in many different places in the world and in many different aspects of our daily life. Banking, telecoms and health care are not examples of this as they are heavily regulated. Most of us readers of hacker news are doing what we are doing because of the wonders of the free market.
If not we would be marching fists held up high to Washington demanding the creation of the National Department of Internet Services, to give us lifelong employment. Yet we aren't doing that. The free market works great even though our chosen field has been hit by many different bubbles and failures. The market has picked right up with no real government interference (except for financial and gaming fields) and will continue to improve.
Spare me the old marxist marching chants (I should know what they sound like as I used to be one).
Your view that the free market works wonderfully if left alone is simply naive. The real world is simply more complex than that.
In fact, your belief that there even is such a thing as a free market is naive and ignores the very real fact that corruption is inevitable and businesses seek out regulation to protect themselves from competitors destroying the very free market they so claim to love. Any truly free market is simply a temporary state of existence destined to die as soon as corruption takes hold, which it always does.
As a programmer you should know that extremely complex systems like the world can not ever be managed by a small group of super clever beings.
This has been the fallacy of each and every of "I'm smart you're not, I'll run things" philosophies originally invented by Plato and perfected by Marx.
The world is a complex system managed by 6 billion autonomous beings. Together these 6 billion autonomous beings for an extremely smart mega intelligence. While you, I and our "leaders" may be smarter than the vast majority of these individuals. Together though is another story.
I agree with your point about corruption as long as we assume the presence of a regulating entity. Corruption is essentially the markets way of calculating a price on overcoming social engineering.
But without regulators in the first place it would not exist and would simply be just other transaction between two or more parties.
Your statement:
"food isn't scarce for most of us and few have problems acquiring it and the ability to produce it can't be easily collected in the hands of a few, anyone can grow their own food"
is directly contradicted by the millions who starved to death when food production was collectivised under various profit-hating communist regimes.
That may serve as a counter example, but it doesn't contradict what I said. America is not Russia and just because it went down that way for them does not mean that's how it'll play out for us. Knowing some history is one thing, trying to predict the future from it is another.
You seem to be hung up on extremes, that's not the real world. If I say the free market isn't the solution to every problem it doesn't imply I think it's the solution to no problem and suddenly I'm a communist.
A problem with society having "certain expectations" of doctors - or anyone else - is that extra expectations (above "do a job so that trading with you helps the world") are a disincentive from getting into that profession.
All that said, I suspect that a purely free-market healthcare system would be worse for the very poor than a socialist one like England (unless the culture had a particularly enthusiastic charitable ethic. Maybe that would develop? Does government charity crowd out private charity?).
I guess the 99 cent hamburger must also be part of my delusion, then.
Profit is the creation of value. If there's no profit, then there's no value added.
Profit works great for food, shelter, clothes, heat, and most every basic human need.
I think what really messes up the healthcare market is that the more that technology progresses, the more sophisticated and expensive treatments we discover. The cost and effectiveness of treatments are both soaring, yet people whose means are not rising as fast feel entitled to the best health care no matter what. I think as technology advances, things will only get more distorted until we realize that everyone should only get what they pay for (or what their insurance that is correctly priced by the market will cover and pay for.)
I hope you mean profit in the non monetary sense then. ie profit meaning to increase someones standard of living?
Charitable workers don't make any money and I'd say they add alot of value to other peoples lives.
For the exceptions, use exception handling also known as charities such as non profit hospitals and health centers who already donate health care to the poor.
The increased efficiency and lower cost of a non regulated approach would benefit all and make it easier and cheaper to provide good care to everyone.
Baloney. This is a belief, not a fact.
You know, there actually have been some highly intelligent and thoughtful libertarian thinkers, far from whatever fantasy you may have.
Such as financial products? I think we have enough evidence right now that people are not mature enough for a totally free market.