Even in a pure unadulterated market economy that doesn't publicly fund healthcare you would expect to be able to protect yourself from high-impact low-likelihood events by means of an insurance. I find it hard to describe the US healthcare situation as anything other than a market failure

> I find it hard to describe the US healthcare situation as anything other than a market failure

The market is just reacting to the regulatory environment and all the political patches and shortcuts of same done to appease voters over the last 100 years. Fix that and the market will sort itself out.

I was shooting heroin and reading “The Fountainhead” in the front seat of my privately owned police cruiser when a call came in. I put a quarter in the radio to activate it. It was the chief.

“Bad news, detective. We got a situation.”

“What? Is the mayor trying to ban trans fats again?”

“Worse. Somebody just stole four hundred and forty-seven million dollars’ worth of bitcoins.”

The heroin needle practically fell out of my arm.

Basically the US has mixed the worst aspects of for profit healthcare with the worst aspects of socialized healthcare. It underperforms while still costing obscene amounts of money.

Probably, but that isn't really something I say anything about in what I wrote. Instead, what I wrote is basically a terminology quibble with the use capitalism instead of market economy.

I don't think your statement is true absolutely, I think it's very possible to have pure market economies that are quite well-functioning, i.e. not monopolies etc., where many people are very rich but with some people being really poor, even to the point of not being able to afford healthcare or healthcare insurance, so I don't think it's guaranteed to be true, though I think it's mostly true.

> Communist distribution principles can coexist with ill-functioning market systems such as things which have degenerated into actual capitalism, whereas the socialist distribution principle can't.

You won't have to worry about distributing advanced cancer medications when they don't exist in the Communist version, because they weren't discovered. You can't fulfil a need with a drug you never risked a giant amount of funding and effort to discover.

I’m the farthest thing from a communist, but what makes you think public funding cannot be given to drug research?

It can be, but who decides what to work on? Capitalism puts risk and reward off to the side, to be done by experts. Why take the risk if you have no reward, and, conversely, why give someone a load of money to allocate if there's no risk for them if it fails?

the problem is your framing of the problem, not the questions you posed. it seems to me like you’re assuming that the only metrics for risk and reward are profit and cost. let me put it this way: do you find there to be any intrinsic value to the invention of antibiotics, or is such a development only worth the money that it can make for its inventor / discoverer? do you think that the cost of developing such technologies is worth it even if it does not gain any material income?

Let’s also imagine the other side of the equation. Can you not imagine any penalty or cost other than bankruptcy? Let’s say you are forced to allocate $1 million per year to research. is the only cost function you can imagine based on the risk of default?

I would say your problem is the framing :) You're assuming an outcome because you know antibiotics work. What is the incentive to spend $10m on research for a particular drug? It's not "because we know it ends up in a cure for X", because we haven't done the research yet. It's "because we think this will reach enough people to be useful and we'll commit a lot to this thing vs lots of other options."

You literally have the communist distribution principle for education at the primary level in the US, and it's a stabilizing element that allows you to stabilize your system despite having one of the harshest market economies in the world.

So I don't understand how your comment really relates to mine. My comment is basically me quibbling about terminology with the terms capitalism and market economy.

"the accumulation of capital by some to the exclusion of others"

This allows decentralised decision making for large grained resource allocation - for example should we build a factory for shoes, or for toothbrushes? - and is a good thing, as central planning has been demonstrated to not work if applied to the whole economy. (the converse, no central planning to any of the economy, has also been demonstrated to not work!)

However that accumulation can be (and nowadays usually is) orchestrated by a corporate entity, which in an ideal world would be almost entirely beneficially owned by retirees on an equitable basis.

What has gone wrong, is that the benefits of productivity enhancements (since 1970?) have flowed to capital more so than to workers - which not least prevents them from forming capital themselves (savings/pensions), hence rising wealth inequality.

Maybe, and you really believe that, then you do believe in capitalism as Louis Blanc defined it, even though he invented it as a way to characterize something which he regarded as bad.

But this kind of thing, i.e. capital accumulation by some to the exclusion of others, is, I think, objectively problematic in that it's not really compatible with free markets since capital ownership will be barrier to entry once capital has in fact been accumulated by some to the exclusion of others.

I agree that it is decentralized though, but sort of like how feudalism is decentralized.

My point is that socially beneficial capital intensive projects require, well, a large lump of capital. This can be organised by the state (command economy), or through allowing private accumulation of capital - but here I do include corporations, and indeed financing through loans. It would be quite possible for individuals to have much the same wealth (perhaps modulo time to retirement?), and to be pooling it as share owners of said corporations. This would still be a capitalist system - but a fairer one maybe!