Posting from another thread. Below is why. Also, in your spare time look into the Heathcare systems in HK and SK (are they "pure free market" systems"? or perhaps something else...).
^This is very accurate. I will add that part of the reason we are where we are right now with lab testing has to do with the corporations, MBAs, and the "unscrupulous" (to use your word) non-laboratory based physicians often run clinical labs with skeleton crews to maximize their profits. This inhibits the ability to ramp up in times of crisis. This profit over patient mentality actually puts peoples lives at risk everyday but most of the time it goes un-nocticed....until the sh!t really hits the fan as it is right now.
Your point re: the education of physicians--well all physicians with the exception of pathologists--about laboratory testing is spot on though. The level of understanding of basic laboratory medicine by most medical specialties is analgous to what most LRCers say docs know about sports injuries and nutrition--they know almost nothing.
It is shocking because, as you accurately state, most treatment decisions in medicine are based on lab results. But basic science and--lab science specifically--have been de-emphasized in medical school curriculum for the past 20 years or so. FFS, they just decided to make the USMLE step I pass / fail--this is f@#king medical school not elementry school. The dumbing down of medical education in the US is truly appaling. Ultimately, this has resulted in a YUGE knowledge gap for most docs, marginalization and commoditization of laboratory services / practicioners, and concomitant decrease in people pursuing medical lab sceinces as a career.
This COVID-19 situation makes all of this very apparent to anyone in medicine paying attention. It is also why companies like Theranos can get a 9 billion dollar valuation and Holmes can appear in TED talks and on the cover of TIME--because the people who knew she was full of sh!t are now so marginalized in medicine that they are ignored (read Bad Blood for more details) partially because people want to make $$$ and partially because most docs don't really understand how basic labs work.
Finally, this crisis and Theranos are not the only medical laboratory atrocties being levied on the population--molecular testing in oncology is a HUGE scam right now. Listen to Vinay Prasad's podcast (UCSF Oncologist) about such topics. The FDA has been approving very, very expensive drugs based on very, very expensive tests left and right partially based on misinterpretation (or misue) of these tests and bad statistical analysis / bogus endpoints (like progression free survival rather than overall survival). See the recent JCO article about oncotype testing in prostate cancer as an example--that test costs ~$3000, has been in use for years, and they *just* figured out it doesn't work at all....but it is still on the market and be ordered ALL the time by Urologist. Heck given the male predominance on this site I wouldn't be surprised if some LRCers haven't been conned into getting this test done.
So basically, the root cause of this IS the idea that free market principles should be applied to any aspect of medicine--here it is laboratory services and tests. When one does that one gets fragmented, understaffed, poorly run labs that cannot handle a public health crisis.