I think if you want to pick some aspect of American life that is free of government involvement, you started in the wrong place.
At the ER I was made to sign something on the way in in a state in which I couldn’t really tell what I was signing. I was given various drugs and sent through a CT scan. I had no idea what was going on. I certainly was in no position, with symptoms of a life threatening condition on top of being incapacitated to say “hey hold up, I think the Safeway has cheaper CT scans can you guys transfer me there!”
Healthcare is entirely different from buying groceries. It does not and will never operate like a typical market for typical commodity items.
A lot of medicinal procedures allow time for determining what the most cost effective offering is.
Disclaimer: I'm in favor of a preventative care system available to everyone, regardless of income.
You can never purchase local, small batch ____ than you can from large companies. That's why companies get large - they are more efficient the larger they get (to oversimplify).
Your local farmer has much less land than factory farm, and he doesn't have the state of the art equipment to harvest or store his crops. He can't justify spending so much money on equipment when he runs such a small farm.
There's also a good chance he uses "organic" as a selling feature, which means his yeild per area land is way lower than an efficient farm.
He also has to work much harder to actually sell his crop. He doesn't have large commercial deals that put his product directly onto shelves at Aldi. He has to spend half his time driving all over the place to various farmers markets to try and get people to buy his stuff.
You might think all of this is pedantic or obvious, but I think efficiency of food production is very important. Food production is a massive contributor to climate change and opting for methods than can save on land area and water usage can have big impacts.
America is the only one with this very unique problem and going further in the direction of a 'free market' won't work. Because healthcare can never be a free market. The insurers have an incentive to not give quality healthcare and give people the bare minimum while hiding details from customers and no amount of freedom would solve this. The end result is that you'd see something like ISP companies where they work together to enforce a regional monopoly and gouge people all the same.
And you can have both a public option alongside a free market.
This is a bit of a tangent, but do car dealerships have geographic monopolies in some places? I don't think I've even seen just one dealership. They always cluster around each other where I'm from - you could car shop on foot and see at least 3-4 different dealerships.
Because they see how much of the mess is the markets fault. They also see how nearly every other first world country has a working system while spending less on healtchare. In some places its private non profits subsidized and regulated by the government, in some its the government providing insurance like in Canada, in some it's really socialistic and government employs most doctors like the NHS. In each case the system works much better then the US and the US system is rightly considered a bogeyman. I'm unaware of any place that works like you've described
Think about the market's provision of grocery stores: plenty of competition. Most places they don't enjoy geographic monopolies like car dealerships do. They manage to get one of the most vital goods to a huge population spread across a huge area on time and at a great price, with local variations anticipating the specific desires of local consumers. There is no central coordinator or Department of Grocery Services. The market figures it out.
How can someone look at healthcare, with its absolutely absurd outcomes, and not understand that it is precisely because of government interference that nothing makes any sense? Costs keep rising unsustainably, which is the opposite of the way markets work. Paperwork and administrative staff balloons in proportion to patient care.
Once the state gets involved, now it becomes political. Do you think the current political climate in the US should be further embedded into healthcare? If the state controlled everything, then you'd get outcomes like red/blue states losing/gaining funding depending on the results of the most recent election. One could imagine more dystopian outcomes quite easily.