I don't have any opinions about what the perfect system here is, but I think it's safe to safe say that medicine does not work well as a free market. You don't get to access a free market within the confines of hospital walls when there is an emergency. Moreover, your decisions as a rational actor are impaired because you are being asked to put a price on your own life or quality of life. There is almost no way to make this business not predatory under those circumstances.