alt Hacker News> The laissez-faire approach to healthcare has completely failed in the US.
Why do you think we have a free market approach to healthcare? Why can I only sign-up once per year unless I have a QLE? Why can I contribute a certain amount to an HSA which is triple tax advantaged with an HDHP but I can't with a PPO? If I have an HDHP+HSA why can I also contribute pre-tax dollars to an FSA that is use-it-or-lose-it for dental or vision only but if I have a PPO I can have a limited purpose FSA that can be used for medical, dental, and vision? Why are there contribution limits? Or even more basic, why is healthcare tied to employment?
The reality is we don't have a free market when it comes to healthcare at all, we have a hampered market where over the years we have politically regulated it into the abomination it is today with some of the worst incentives possible. We can certainly have the debate of whether a free market or nationalized healthcare is best, they both have trade-offs, but it's fallacious to assume we have the former and discount it entirely thus leaving either more regulation or nationalization as the only alternatives. More regulation is almost certainly the worst possible option, we've been on that path since WW2.
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The answer to all of your questions is that if you are obscenely well off, all of these restrictions go away with enough money. Private insurance exists, or hell - just paying out of pocket. It is a free market, but only for those with enough money to pay.
The average person cannot pay. Health insurance is designed to maximize extraction of wealth from the non-wealthy, while doing just barely enough that they don't immediately get regulated away. The reason for this is greed: sure, greed drives efficiency in capitalism, but if it isn't reined in via regulation we wind up with the abomination we have today.
> More regulation is almost certainly the worst possible option, we've been on that path since WW2
We have de-regulated. In 1950, stock buybacks were illegal, the top corporate tax was 42%, and the top personal income tax was 91%. Today, companies buy back their stocks (transferring wealth to shareholders faster than dividends), top corp tax is 21%, and top income tax is 37%.
Sure, in some cases there is more regulation: factories can't dump waste into the rivers, and employers can't discriminate by race or whatever. But none of these things are the reason why healthcare has become unobtainable to many in the US.
What is the market value of your mother's morbidity and mortality? Your spouse's? Your children's? Trying to apply a market to healthcare can become macabre rather quickly.