Not a free market

If we accept the premise that our health care sytem we have now is only marginally free-market, I would be skeptical that any effort to fully nationalize it would not be as expensive as it is today. Including the 40 million now uninsured in a nationalized system would be, in my opinion, highly catastrophic financially, which is why no politican from either party had been bold enough to come forward with such a plan. (This is aside from the fact that Americans do not like any plan that sounds like a socialized system.)

Regulations, unfortunately, are part of any free-market system, particularly in
medical care. I just cannot conceive of a fully free-market system in this field
that would work, expensive as it is to begin with, and cognizant of the fact we are not dealing here with products and commodities.

Singapore offers us a model of a nice mixture of free and regulatory markets.
The government there provides free preventive services that have been found to work, including paps, mammograms, vaccinations, just to name a few. Outside of these services, patients pay for other office visits, either to PCPs or specialists if they want to. (Some type of private insurance is now available to patients to pay for out-patient medical care.)Hospitalization and catastrophic care is provided free by the government.

Under this system, PCPs are confined to providing out-patient care, while only specialists render hospital care. It has worked quite well mainly because perverse incentives that increase costs, as they exist in our system, are eliminated both from patients and physicians.

Singapore is much smaller compared to the United States, but the idea of adopting
a similar concept sounds attractive.

(The above model, by the way, was first proposed by former AMA editor George Lundberg in his book, SEVERED TRUST.)