Like food, right? If people stopped selling you food you would die, so surely they can charge extortionate rates for it.

Of course, there are competitive markets for both food and insulin in the US. Quoting from a letter to the WSJ yesterday,

> Eli Lilly makes three types of insulin, which in most states you can buy over-the-counter at Wal-Mart for $24 per 1000 unit bottle. One hundred syringes cost $12. I have serious diabetes mellitus and have managed it with Lilly insulin for a decade for under $100 a month.

For some drugs there aren't competitive markets, and in some cases the government prevents competition, but both are typically temporary situations (patents, first-mover advantages) that help to get the drug on the market in the first place. An extortionate price for a drug is better than no access at all, and doubly so when it is going to give way to genuine price competition.

The difference is (1) food isn't a specialty good, you can make it yourself and (2) food is provided by the government free of charge if you can't pay and (3) subsidized by the government to a massive degree even if you can pay. If this is the kind of system you're advocating for prescription drugs, I'm all in!

(1) Food producers unilaterally refusing to sell food could be just as disruptive as drug producers refusing to sell drugs. "You can just grow it yourself" isn't a reasonable distinction -- from a practical standpoint most people can't. The reason we don't need to prohibit that behaviour is that the market works.

(2) The government doesn't grow food. Sometimes it pays for it, and sometimes it gives people money so they can pay for it, but there isn't a public option in case farmers decide not to sell us beef, because the market works. (But yeah, the government does -- and should -- help people pay for drugs they can't afford when the prices are reasonable.)

(3) Food production is subsidised, but it shouldn't be. And these subsidies have little bearing on the possibility of extortion in the market.