> Bullshit. There hasn't been a laissez fair in the healthcare industry in the United States in 100 years.

True. But why did health care turn away from a completely free-market approach? Why does almost every other industrialized society now support some sort of single-payer system, at least for those who cannot afford private boutique care?

The answer is simple: as a society, we do not accept the results of a truly free-market health care system. 100 years ago, it was accepted that you could become ill at any point in your life, and very possibly die. Being rich was not really a lifesaver, because many if not most major disease categories were at that time untreatable, or the treatments available were palliative at best.

Now, we live in a world where we all know fully well that with enough access, many medical situations that used to be fatal are now treatable with excellent chances of full or near-full recovery. Steve Jobs gets a liver; Dick Cheney gets a heart. My wife's uncle just died of a heart condition similar to Cheney's. Somehow, there was no transplant available for him.

In this world, most people find it unacceptable that your health outcome is directly related to your wealth and social status. The world you suggest -- where everyone simply pays out of pocket -- would be socially regressive in a way that I believe is abhorrent to most civilized people, with the glaring exception of around 50% of the US voting public.

Insurance was developed as a reasonable fair-market way to ameliorate this issue of health care access disparity. If you can afford insurance -- in the US, this typically was through getting a decent job that provided a large risk pool and could therefore negotiate reasonable premiums -- you could at least theoretically rest assured that a major medical crisis would not totally bankrupt you.

But for those outside of the pool of large employers, the insurance companies started doing bad stuff (from a customer's POV) -- dropping the sick, refusing to cover previous conditions etc. In their defense, insurers had the problem that without some sort of mandate, people could just go uninsured until they got sick. So the individual market was destined to be over-represented by older, sicker people.

If you really believe in laissez faire, free-market medicine, you (as a society) have to accept the following:

* People who treat themselves like shit for years and get sick (obesity-related diabetes is a great example) can simply drop dead if they can't afford expensive care and medication.

* If some idiot on a motorcycle without a helmet spins out and breaks their skull, and is not rich, shovel his body to the side of the road, wait for him to die, and call sanitation to remove the body

* If your parents get old and sick, and they fucked up their retirement planning, slip them some clonazepam or watch them wither away painfully over a period of months or years. Be prepared for someone in the family to quit their job and become a nurse, or let Grandma wander around until she falls down and hopefully dies on the spot.

That was basically where everyone was throughout most of history. Only difference is, now we know it can be better. But in a ruthlessly free-market society, only the rich and well-connected would ever have a chance of getting the best possible care.