Health care is special
Health care services are in a special category of "services". Unlike almost all other services in our "free market" economy, most health care services (just like police and fire services) are necessary for all residents-often a matter of life and death.
Incredibly, we treat most health care services as if they were optional for some residents. The extreme costs, the multiple inefficiencies, and the shameful injustice of our current health care system are the guaranteed results of treating heath care services as optional for some residents.
As a civilized nation, we would never tolerate a system where police or fire services were treated as optional for some residents. To understand how utterly absurd our private health care system is, imagine life in America if we treated police and fire services the way we now treat most health care services.
If police and fire services were optional for some
Instead of groups pooling their resources and providing everyone with police and fire services, where each dollar spent provides a dollar's worth of services (minus the cost to administer payments), imagine introducing a middleman-police and fire insurance companies.
Like our current health care system, about 30% of every dollar we spend wouldn't provide any police or fire services whatsoever, but instead would go to other insurance company expenses.
Aside from administrative costs to pay for services, insurance companies would pay billions to shareholders as profits, plus spend billions more for advertising, lobbying Congress, huge executive salaries, and paying a large staff whose main job would be to find ways to shift costs to purchasers and providers and to maximize profits by minimizing services.
Like our current health care system, maximizing profits would mean charging the highest possible premiums (money in) while spending as little as possible on actual police and fire services (money out). This is simply smart business.
Insurance companies would compete to enroll residents likely to require the least police or fire services, while trying to avoid residents likely to require the most police or fire services. Like our current health care system, this would guarantee that residents who need these services the most would be the least likely to get them (this is simply smart business).
Those residents unfortunate enough to need services "too often" would be denied, dropped, or charged unaffordable premiums. Those who live in "dangerous" (low profit) areas would simply be denied police or fire services due to "pre-existing conditions" (this is simply smart business).
Insurance companies would have great profit incentives to find myriad ways to deny services or to shift costs because any money spent providing actual services comes right out of their profits. Like our current health care system, this would guarantee millions of residents would have no police or fire services at all (this is simply smart business).
In a civilized society, most health care services are no more optional than police and fire services. It's patently absurd to put a middleman (whose profit incentives are plainly against the interests of the American people) between us and our health care providers.