I can't argue with any of your points specifically, in fact I agree with most of them. I wonder if what's happening in the US though is that nearly all markets

I can't argue with any of your points specifically, in fact I agree with most of them. I wonder if what's happening in the US though is that nearly all markets with inelastic demand curves have come to be dominated by a handful of companies (duopolies). So if I need an operation that I simply must have, or health insurance or internet service, I have a couple of companies to choose from that both charge roughly the same price, which is usually quite a bit more than what I'd like to pay. The principle here is that markets with inelastic demand curves form natural monopolies: https://en.wikipedia.org/wiki/Natural_monopoly https://en.wikipedia.org/wiki/Natural_monopoly But in the US, there has been no move to break up monopolies or transfer them into the public sector as utilities (like for water and electricity) since the Reagan era: https://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780199251902.001.0001/acprof-9780199251902-chapter-6 https://www.oxfordscholarship.com/view/10.1093/acprof:oso/97... So the controversy you see in the media here about whether to have single payer healthcare, for example, stems from the fact that these natural monopolies are run by private sector corporations which have formed rackets within the government through the use of lobbying (a form of bribery). Their disinformation and smear campaigns across the major media outlets (themselves usually duopolies like CNN and Fox News) distract the populace so that basic economic principles take a back seat to political ideology. This keeps everyone divided in order to maintain the status quo of duopoly protection. If the US were to move to public healthcare, the price would fall to a rate base (a legally determined profit margin above base cost) which must be determined through regulation since the free market can't find a fair price between supplier and consumer since the price is inelastic and/or there as an information or power imbalance which makes it a non-free market: https://en.wikipedia.org/wiki/Rate_base_(utility) https://en.wikipedia.org/wiki/Rate_base_(utility) https://en.wikipedia.org/wiki/Utility_ratemaking https://en.wikipedia.org/wiki/Utility_ratemaking Looking to other countries as examples, this would lower the price to roughly 1/2 to 1/3 what it is now: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... All of this is why when I see smoking singled out on health insurance applications, I tend to see corruption rather than market efficiency. Which is outrageous, because my vote would be to move health insurance into the public sector anyway. It feels like being kicked when I'm down. I think what might be going on here is that you're thinking microeconomics while I'm thinking macroeconomics, but we can both be right.