Is that because of the distoration insurance causes, though? We don't have to buy cars through intermediaries and they aren't ridiculously jacked up. We don't buy groceries through intermediaries and they aren't ridiculously jacked up. I think part of the reason medical costs have gone nuts, and to a degree education costs, too, is because people are separated from actually paying them. Most people don't pay for their medical costs, they pay for their medical insurance, or rather just a part of it. People don't care what things cost, they care if it's covered by insurance or not. Your premise seems to be that without insurance you'd be paying 3x as much. Maybe competition would drive the price down to what the insurance companies pay.