It is near-universally accepted that a perfectly competitive free market is an optimal means of distributing resources. That statement makes some assumptions:

It is near-universally accepted that a perfectly competitive free market is an optimal means of distributing resources. That statement makes some assumptions: all the parties involved have symmetrical information, equal bargaining power, and are free to choose not to participate in the market. At the point where I am experiencing a health emergency, the resources I can devote to shopping around are limited, as is the time available to choose. Also, as I am not a health professional, my ability to compare providers by the one parameter that actually matters - the likelihood of a positive outcome - is severely limited. Meanwhile, the providers will be trying their hardest to get me to choose them, and thus bombarding me with irrelevant but comprehensible and good-sounding metrics. Finally, when the alternative is life changing injury or death, I am not really free to walk away entirely from taking a deal. (I'll not even start on the perverse incentives involved in preventative medicine vs emergencies). So the free market fails me here, at the time I most need it, in several ways: * an inequality of bargaining power exists * information asymmetry exists * I am forced by circumstance to participate Without outside intervention, in such situations, we expect the costs charged to me to rise to match or exceed my ability to pay; and this is, in fact, what we actually observe when we look at the US healthcare system. In general, free markets are great; however, for some situations, like healthcare, the assumptions that make markets work in general are not true, and to the extent they are not true, some outside force needs to step in to restore balance. In countries where the government chooses to do so, largely regardless of the precise means, healthcare systems are more efficient and are more accessible to the population.