Reasons are historic and idelogical. A free market is considered sort of a religion here. In other words we don't usually evaluate and consider things based on their own merit (what is the best way to provide healthcare, what is the best way to fix infrastructure, like bridges, etc), but rather how will this make free market happy. We treat it as sort of a deity and if we don't abide by its likes we'll be severely punished.
The healthcare "market" is anything but free. From insurance companies, negotiated prices, all the way down to the AMA limiting the supply of doctors and all the other things they do to keep prices high. It seems the only thing free about it is the freedom to get screwed over.
So in those terms, I'm not sure what sort of diety it is that we're worshipping.
Are you arguing that 'negotiated prices' are not part of a free market? I mean, sure, negotiated prices are a way to hide information, but as far as I can tell, the less regulated a market is, the more "negotiation" is involved in pricing.
Frankly, it's one of the larger reasons why I don't want to be in business for myself. As a consumer? At least outside of healthcare, most of the prices are set, more or less, the way commodities are. There are laws saying that when I get to the cash register, I'm entitled to the lowest marked price in the store. Hell, even with things like cars, which are notorious for ripping off consumers, you are paying at most like 20% more than your neighbor. If you are buying, say, bandwidth, or nearly anything else sold to businesses? It is completely normal for the initial quote to be 200%-400% more than what you end up paying after negotiation.
Now, how much does this have to do with it being a business, and thus having the expectation that you have professionals on hand to do the money-dance, and how much of this is that there's a lot less regulation in the business sphere than in the consumer space? I don't know. I don't think it has as much to do with the cost of the goods involved as you think; I think the biggest contract I signed was around a third of a million bucks for a five year lease; Well under twice what someone doing what I do, only as a worker would pay for rent in my area. Most of my contracts were in 'mid-priced car' range, and still there was a tremendous difference between initial quote, and what I was actually expected to pay.
If you want a market make it transparent not "free". Patients have no chance participating in the US health care market because they have insufficient information.
And it's impossible to get "sufficient information" or negotiate anything when you're being loaded into an ambulance. The whole idea of negotiating healthcare at the personal level is patently absurd.
