There's also a profit motive in food production, should we move to single-payer for that (hint: this means breadlines)? There's also a profit motive in housing; single-payer? Mobile phones? Internet access? Entertainment?
This is such a shallow argument. Healthcare is a service unlike any commodity or service you've mentioned. Healthcare demand is unpredictable on an individual level, and it grow on an individual level over time when it isn't met. That is to say you get sicker if you go untreated. If I skip a meal today, I don't need extra meals tomorrow. If I sleep on the street tonight, I don't need two houses tomorrow. This is to say that any random individual can be struck ill (demanding healthcare) at any time, to an unknown cost that snowballs the longer they go untreated. It's a thing unto itself and metaphors don't work well.
Furthermore, there's an enormous information asymmetry in healthcare, so it's hard for it to function as a market.
Because we already have "free" healthcare in the form of emergency rooms, this is ultimately a conversation about how to best allocate health spending. Emergency care is the absolute most expensive form of non end of life care, so we should focus on minimizing that send. There's a well known path for doing so, regular check ups, vaccinations, preventative care, and chronic disease management. All of which cost money now, but reduce future expenditure. And if we already pay for sick broke people in the emergency room, why not optimize the expenditure of those tax dollars by shifting it to more effective health interventions?
If your concern is cost basis, and "allocating health spending well", then why are we subsidizing preventative care?
You yourself admit that end of life care is incredibly expensive. Why are we pushing people to live longer, when it incurs a much much greater cost to keep people alive? Why not just let them die young?
In part, this is a huge reason (the other reason is pregnancy cost) why pre-ACA healthcare prices were much much cheaper for <30 men than women - most things that seriously hurt men under 30 just completely off them, and dead boys don't incur major medical cost.
I think most people disagree with you darwinian notions of societal priorities. And you still aren't addressing that pre-ACA we still spent the same dollars, just on the backend through emergency room spending, and medical debt defaults. Basically all research points to outcome focused medicine and preventive care being critical to controlling costs, anything else just shifts the spend around.
I don't believe in those 'darwinian' notion of societal priorities, I'm just pointing out that those are baked into your priorities. If reducing cost is the priority, the machine (government/society) will churn out a solution that reflects the priorities it is programmed with.
I don't know about your characterization that "Basically all research..."
Oh if only it were that easy. The competition in those other markets is much stronger and has proven to be reasonably efficient.
Healthcare is different because consumers often don't know what anything ought to cost, rarely in a position to shop around, and will never be able to afford some big ticket items without insurance regardless.
And the economic consequences are non-obvious. For example, many conditions are much cheaper to treat if caught early; if access to a doctor has an inconvenient cost attached, overall costs go up. The ability to see a doctor for cheap – ideally free – is the most effective way to lower the risk of expensive procedures in the future.
It's all about choice. We have huge choice when it comes to food - I can live on noodles if my circumstances go downhill. Entertainment I can forgo, and I can live with my old mobile phone.
But if I get pregnant or cancer, I have no choice - I have to get treatment or die.
If you get cancer, chances are you get treatment and die.
I've been through chemo and radiation once, if I ever am told I need to do it again, to scrape and cling to another few months of life, I'm going to laugh in their faces, put my affairs in order, go on a hell of a vacation, and Old Yeller myself.
Markets work well for those things, they don't for healthcare, that we're here is proof of that. There's a good reason civilized nations have socialized medicine, it's the best solution to the problem. Markets are not the correct solution for every problem.
