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Competition does nothing to reduce hospital prices because in many cases it's illegal to start a competitor and either way insurance companies are footing the bill so you have no incentive to price-shop.

Competition does nothing to reduce isolated under-patent drug prices because it's not supposed to.

Competition does nothing to reduce one of a couple of specific generic drug prices like insulin and epinephrine because of some very, very stupid FDA policies that make it like they're under patent without any of the drawback of the patent actually expiring.

Competition is incredibly good at bringing down the prices of generic drugs, competing separate under-patent drugs like depression treatments, and things you do mostly pay for yourself like glasses.

Re: doctors, we don't need less-skilled doctors, we need less-debted doctors so doctors are less likely to seek high pay despite less fulfillment. We currently require a four-year degree in literally anything before you can start medical school; Ireland does not and just pads med school with a single extra year for GE, and their doctors are about as good as ours. Competition also doesn't work when it would drive your prices below cost, and medical school debt makes it effectively like that.