[glenra]

Price competition is mostly illegal due to the way the health industry has been successfully cartelized over the years. The usual benefit of free-market competition is that inefficient providers are allowed to go broke while better ones expand, but the field is so over-regulated that we simply don't allow that to happen. So lots of ridiculous inefficiencies persist.

In a more free market, insurance wouldn't be tied to specific states - you could buy insurance from any firm in the nation willing to provide it. Hospitals would be allowed to expand and compete and go out of business like restaurants are - there wouldn't be any "Certificate of Need" process preventing that. Doctors wouldn't be tied to specific states or nations and medical schools wouldn't have their enrollment limited via licensing rules.

In short, we have an artificial shortage of both doctors and hospitals which makes healthcare inherently expensive and low-quality compared to what it might otherwise be.

[HillRat]

>In a more free market, insurance wouldn't be tied to specific states - you could buy insurance from any firm in the nation willing to provide it.

That's an idea that sounds good but turns out to be a nightmare in practice. You would end up with a classic "race to the bottom" scenario of the sort seen in credit card regulations, corporate tax rates, and employee disability reimbursements -- eventually you would end up with a state that allows such egregiously poor insurance practices that every company would flock there to avoid more onerous regulations.

The current system is byzantine and a nightmare to deal with -- I still wake up in the middle of the night with implementation guides scrolling behind my eyelids -- but it's an improvement over a policy that would, in effect, let the payers pick and choose the least-protective regulatory structure.