If every time you took an ambulance you were forced to sign over 80% of your wealth or be left to die in the streets in a 'voluntary exchange', that would be exploitation.
The difference between that and slumlords is simply a matter of degree.
Desperation is the route to profit in both cases. Truly voluntary exchanges without gaping chasms of systemic inequality do not provide opportunities for sustained profit.
>If every time you took an ambulance you were forced to sign over 80% of your wealth or be left to die in the streets in a 'voluntary exchange', that would be exploitation.
What is wrong with this scenario? If there were no ambulance service I automatically choose "Die" (which is, apart from matters of inheritance, always the wrong choice), but if there is the ambulance service I can buy my life for the relatively meagre price of 80% of my wealth, then having neither children nor wife I would take that deal ten times out of ten.
All prices, everywhere, are limited in some way by the cost of a torches-and-pitchforks mob to storm the chateau.
I'd pay the price on the spot, because I like not being dead. But afterward, I think I'd try to rob that guy to get my 80% back, and maybe some of the 80% from some other people. That's not a "thank you so much, you're my hero" price. That's a "better watch your back" price.
When too many people start to see you as a parasite upon their community rather than a foundation pillar for it, they will certainly reduce their rate of cooperation with you, and some may retaliate. You may have to acquire a taste for other people's spit in your restaurant food, for instance. And worst of all, you may motivate someone to launch a business in direct competition with yours.
Then, if your choice is 80% to the dirty exploiter or waiting a few more minutes for a Medic-Uber to pick you up take you to the hospital, you would almost have to be gushing blood from a major artery to accept the former.
I don't see the false dilemma, I think you're hinting at a third choice where the ambulance company charges a price that is not extortionate, but if that was part of the hypothetical then, sure, I would have chosen to get my emergency care from the company that charges less (but it's not, the GP postulated that all ambulance companies charge 80%).
Either way it's not exploitation, even if there's a company that charges prices that always bankrupt their patients, I still choose broke over dead, and if I wanted to choose dead I can do that too.
I get the point in your scenario. The simple matter of "degree" in this case might be simple but it is very big. First of all, i would say that your scenario is unrealistic. It is made up and it would never happen in actual real life. First of all, what psychopaths would leave a dying man, woman or child like that? Also, how would these ambulances get customers? Thirdly, who would sign up for their ambulance service? Yes, if we accept your premise of a society where this psychopath ambulance service has a monopoly and everyone is forced to use it, then sure, it is exploitation. But on the other hand, someone with authority has therefore sanctioned this psychopath monopoly ambulance service. Where did this authority get this mandate? Democracy? If you want to argue that this scenario would happen on the free market, i would like to see your arguments to why this ambulance service would still have customers.
If you control the premise of the arguments, it is easy to "win".
The largest fortune in the Roman empire was amassed in almost exactly the same manner (Marcus Linnus Crassus - he ran a fire service).
Desperation is a rich source of profit. Neoclassical economics, instead of analyzing this sordid detail, masks it with assumptions.
That's why you view it as an unrealistic scenario despite the massive amount of historical precedent. Under econ 101 models (perfectly equal wealth; perfectly competitive market) it is an unrealistic scenario.
The difference between that and slumlords is simply a matter of degree.
Desperation is the route to profit in both cases. Truly voluntary exchanges without gaping chasms of systemic inequality do not provide opportunities for sustained profit.