With the amount of error we have (see malpractice suits) as it is, I'm not convinced that what we have right now is actually yielding better overall results than a free market would with actual price signals.
Reason being that medical care quality is usually not a binary matter—with outcomes of either total success or total failure. Usually it's a broad continuum, and yet mediocre doctors are presently extremely difficult to differentiate from superb doctors because of the lack of price signals.
Malpractice suits would still exist in a free market, of course. And if care lead to death, there would be lawsuits. But in a majority of cases, bad care would lead to non-death but non-ideal resolution. That's where price signals will flourish.
Ironically, I see the current situation as an all-or-nothing where I want more nuance. We currently treat all doctors as essentially similar because they have all completed the same rigorous training and certification process, and we few other measures to use. (Some above-market review systems notwithstanding.)
Finally, don't be certain that doing away with regulation would lead to certifications evaporating. It more likely would mean variation in certification. A less politically-entrenched alternative to the AMA perhaps. (Of course, I'm also not necessarily bowled over by certification. I put no stock in computer programming certifications.)
> And of course the typical libertarian response is "tough luck" or "work harder".
While true, this shouldn't be dismissed cavalierly. We tend to speak without as much political thought as the right and left—saying apparently heartless things like "work harder." But what we mean in practice is that there would be more emphatic pressure on individuals to work to solve their own life situations first and only in extreme cases leverage safety nets.
We have a situation today where half of the country uses some form of government assistance. That's not what safety nets should be for. But outside of "character" or other intangibles, there's no incentive to avoid the safety nets—in fact there's every incentive to use them, lest you be a sucker. Only suckers pay for things.
When I had an electric car, I momentarily reeled at the $5,000 federal government incentive because it goes against my every belief. But, come on. Who is going to pass on such a sweet kick-back? I took the money. We all do.
Yes, it's utterly impossible for a libertarian paradise to provide a 50% safety net. But we feel we have such a large safety net because it's a venus fly trap, not because it is necessary to have a 50% safety net as a first principle.
Furthermore, many libertarians are amenable to a basic income, and with a basic income and a free market for health care and health insurance, it's almost a foregone conclusion that a great deal of competition would angle for that demand.
> Compromise shouldn't be such a dirty word in today's political discussions, it's a sad state of affairs
The trouble with compromise is what I said earlier. We're willing to allow central planners to build within a free market, to create a voluntary consortium of participants supporting one another through centrally-planned distribution of resources. But reverse the tables and we're absolutely never permitted the same freedom. Central-planning is not voluntary; it a piece of totalitarianism.
So compromising with central planners means totally conceding. Either they plan for you or you plan for you. I prefer planning for me, difficulties and all.