Speaking as someone who lives in a nation with free market health care, I can tell you first hand it's an utter disaster. I am not getting better service through competition, I get shitty service essentially all the time. My access to good healthcare is entirely predicated by my ability to pay. Wealthy Americans, I'm sure, get some of the best healthcare in the world. However, most Americans are not wealthy. Many Americans are extremely poor. While any American emergency room would be required to treat me if I was in an acute healthcare situation, they would also be entitled to collect thousands of dollars from me. I in turn would not be able to declare bankruptcy due to healthcare costs, thanks to recently passed legislation in the United States. The collections agency utilized by the hospital could potentially take everything I owned from me as partial payment of my fees. A friend of mine recently lost her house this way. Luckily for me, I am among the small percentage of Americans that is insured--I pay over USD 1,000 per month for my insurance, and usually shell out anout USD 800-1,000 in copays in medication costs. (Especially since my insurance provider won't cover prescriptions that are not in the "approved list." That asthma medication that actually relieves my symptoms? Not in the "approved list," and USD 500 per vial.) My insurance also won't cover rides in the helicopter--I have to go through a different service for that. (And good thing I have helicopter insurance--my last ride would have been upwards of USD 50,000.) However, I do know others without insurance of any kind who have been denied treatment or given very shoddy care. Especially those on Medicare. In terms of preventative medicine, we are all fucked. Medicine here is a hell-infested free for all. It's terrifying.