we don't have single payer system that disciplines the free market in every other developed country

I don't believe it. Medicare doesn't discipline the free market now. Why should it if expanded? The providers would just play politics with it, as they do now. The Atlantic Monthly solution - doing away with insurance except for catastrophic events - is much, much better.

Medicare doesn't discipline the free market, it deletes it. The problem is that in the United States, NO ONE is responsible for medical costs. Not patients, who don't pay for them and often don't ever think that they "pay" for their insurance (although they do - rising medical costs are the main reason that "real wages" have stagnated since the 1990's).

American health insurance, with its "systems" and restrictions on competition both at the insurance level and the provider level as a result of past legislation (including Medicare), basically prevents providers from competing on price.

American medical care is a government enforced provider cartel. Monopoly prices charged to the end user, with every special interest along the way (including the government) siphoning off some of the money.

Oh, the experiences I've had during the final days of my brothers' life!

Shuttling between hospitals via ambulances and helicopters. During one ambulance transfer, his attendant convinced him to buy a supplemental health insurance policy for $300 cash. I refused to provide the money as Brother was days from death.

Seven stents implanted implanted during final stages of life.

Three MRIs performed in a 36 hour period at three different hospitals.

After it was determined to cease life support, I walked into intensive care and found a dialysis team preparing to perform kidney dialysis on him. I stopped the procedure.

When he was removed from life support, he was transferred to a general room. It took him three days to expire. On the second day during this period I was told that he had to be moved to a nursing home via attended ambulance. After a heated argument with his case doctor I drove 100 miles to prepare him for transfer the following day. While at home that night, I received a call that my brother had died...alone.

Many times, I would observe various doctors eating lunch together in the hospital cafeteria. Then, as a group, I would later observe them in my brothers room. They would walk in and look at my brother and walk out. I correlated names and dates that reflected billing for consultation fees.

In summation expensive medical equipment fees were addressed in the initial topic. In my estimation, the system is rotten to the core and the entire industry is scratching for its' cut of the pie.

An interesting side effect of these obscene medical costs is the rise of "medical tourism." (I have three tourism websites and I have recently added one for medical tourism, so I've gotten into it.) US patients traveling south or overseas can save big on major medical procedures and have enough left over for a recovery vacation in Costa Rica, India or wherever. And now the insurers are picking up on it.

The four largest commercial U.S. health insurers — with enrollments totaling nearly 100 million people — have either launched pilot programs offering overseas travel or explored it. Several smaller insurers and brokers also have introduced travel options for hundreds of employers around the country.

Overseas care can lead to price breaks of more than $40,000, not counting travel costs, for procedures like knee replacement surgery or heart bypasses. Insurers, or employers who provide their own insurance, can save between 50% and 90% on major medical claims, said Jonathan Edelheit, president of the Florida-based Medical Tourism Association. A lower cost of living and lower prices for medical supplies and drugs help drive down care costs overseas compared to American providers.

In the Libertarian's "perfect market" pipe-dreams, an oversupply should drive down costs of individual services. But that's not what happen

Fair market value = willing buyer, willing seller, both having knowledge of all relevant facts and neither being under compunction to buy or sell.

When you are a patient who is sick or even dying and you want desperately to get well, and your doctor says you need a CAT Scan, this does not fit the fair market definition, you would pay anything for it and you are trusting your doctor with the "knowledge" part.

We have now spent months and months claiming that the cause of our health care woes is rapacious insurance companies when it turns out that the real culprits are the people who actually generate all the expenses in the first place.