You are confusing “access” with “affordability”. If Medicare/Medicaid/VA won’t pay for something, that doesn’t mean the patient has no “access” to it. It means the outrageous prices will create backlash against the pharma companies and drive prices lower. Just as any free market is supposed to do.
Having a third party like an insurance company or government paying the bill has wrecked the “free market” that requires a direct relationship between the seller and the consumer to function properly.
I’m not understanding your final point. Are you saying there should not be health insurance?