There is a good post over at the Incidential Economist that discusses games that companies can play with drug patents. I think that this highlights one of the issues that we always neglect -- modern economic systems are based in a system of regulations. In the absence of regulations we would not have patent protection and these games would be more difficult to play. But a complete absence of rules (anarchy) isn't usually a very economically profitable equilibrium.
Once you have a government (with laws and soldiers), you are really just picking your poison. Hyper-free market approaches have the same issues as communism does, only in reverse. Communism removes private property, which weakens those parts of society that work best in private markets where ownership incentives productivity and long term care of the resource (think subsistence farming).
In the same sense, Randianism removes public goods, resulting in other problems (like the failure to have an educated workforce, a strong military, or a system of roads). Health care seems to be one of those areas where treating it as a public good seems to lower costs no clear drop in outcomes.
So I think the authors of the above post are correct to doubt that free markets will improve health care anymore than communism improved agriculture. The right tool for the right job should be the goal.
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