Patents and licenses, both forms of government granted monopolies, are the primary reason capitalism goes bad. A true free market would vastly reduce prices across the board especially in areas like medical care where supply has been strictly limited for decades.
Monopolies don't need to be granted by someone, they're innate to a system that targets endless growth and centralization. Governments, despite being partially corrupted by undue influence that lets monopolism seep back into our society, are the only entities standing in between full monopolization and the world we live in now. In the total absence of a government, the wealthiest entities would repeatedly buy out smaller competitors and use their near-endless power to inhibit any new players from joining the scene (if not legally, then militarily). At that level of wealth, there is nothing that would be able to hold them back from further growth. The biggest company would become a de facto totalitarian government after a certain point.
If you had an urgent emergency that had to be treated now, your nearest hospital in free-market-land might as well charge you a million dollars. If there's any sort of urgency that prevents you from going elsewhere, what are you gonna do? Die?
"Government granted monopolies", as you call them, are the logical endpoint of a "free market". It always devolves into this, as capital accumulates into fewer and fewer hands until some people are able to wrangle the state into doing their bidding.
