> Because for a lot of people, there is no real choice involved. If there's one hospital around for hundreds of miles, they realistically don't have the option to go to one further out when their job expects them to be available for work every single day.

Federal law requires employers to provide at least unpaid sick leave. That caps the premium a local hospital can charge over competitors at the loss of the day's wages and the travel costs, which are both dwarfed by the amount of money in medical expenses we're comparing them to for these bankruptcy-inducing procedures.

> Not to mention that requires every hospital to offer every service and to have every type of specialist for every type of disease.

Why would it require that? There are thousands of hospitals in the US. You don't need every hospital to do everything as long as there is some competition for any given thing.

And far away hospitals can provide competition even if people don't actually use them in practice. If it costs $1000 in travel and inconvenience to fly to another city for a procedure then people won't use a local hospital that tries to charge $10,000 more, so they charge only $900 more because it's all they can get away with. But that's only if there's price transparency -- if you can't find out ahead of time that it costs $10,000 more for the local hospital then people choose it anyway and there is no incentive for them to lower their prices, which is where we are now.

> You can't just walk into a hospital and choose between Name Brand MRI or Store Brand MRI. It requires a level of knowledge that most people don't have. It's knowledge I don't have! And something I'd prefer to never have to think about when I have other shit to deal with in real life.

And that option exists -- you buy an expansive low deductible insurance plan that covers everything. That necessarily comes at the cost of very high premiums, because it has to cover the cost of making you price-insensitive.

You can also buy a less expensive insurance plan that doesn't cover everything and then consider anything it doesn't cover as unavailable. That's what socialized systems generally do, because they do make people price-insensitive but still have budgetary requirements to meet. But there's no reason you can't get a private plan that does that either; just don't object when it doesn't cover everything. You pay for what you get, one way or another.

> Your analogy falls apart because the government does make mandates for cars. Things like safety features.

They also have mandates for medicine. There is a whole medical licensing system. That's independent from who pays for it.

> When you're looking for a car, you have some properties of a car which are easily understandable. When you're searching for medical assistance, most people only vaguely know what's actually wrong.

I don't see how it's different. There are plenty of subtleties when buying anything expensive that aren't readily apparent, like that car insurance can be more than the car payment, or that some models depreciate faster than others so you have to account for future resale value, or that some models have more frequent repairs, or more expensive repairs. Some people buy based on style and only later find out through experience the total cost of ownership is $40,000 higher than they expected.

It's the same thing with healthcare, but it's the same thing with healthcare either way. Regardless of who is paying, which doctor has the best patient outcomes? Which medication is more effective? What clinical trials are there for your condition? You can ask your doctor, but first you have to choose your doctor. And then, in the end, they only advise you what to do. It's still your decision and your life.