The Cure for Healthcare Costs? Competition

I spent last month on Capitol Hill, talking to members of Congress, and the hot topic was healthcare legislation, specifically federal subsidies tied to the Affordable Care Act. Our system is broken because incentives are misaligned, consumers are disconnected from cost and value, and competition has been steadily squeezed out. These dynamics aren't ideological; they're structural.

Every sector of the economy that embraces competition delivers lower prices, higher quality, and fast innovation. Sectors that suppress competition through regulation, monopoly, or protected incumbents see the opposite: higher costs, weaker accountability, and slower improvement.

Healthcare is no exception.

Healthcare doesn't need more regulation. It needs real competition.

That starts with empowering Americans to be true healthcare consumers—people who care about cost as much as quality and convenience. Benefit designs should reward patients for choosing high-value care based on price, quality, and convenience, rather than shielding them from cost. High-deductible, high-copay plans paired with generously funded Health Savings Accounts are a practical first step.

Consumers must also be able to shop. Today's transparency rules fall far short. Any provider offering healthcare services should be required to publish clear, upfront price tags in a format that the average American can actually understand.

Congress should actively promote provider competition. State certificate-of-need laws, physician non-competes, the moratorium on physician hospital ownership, and ongoing hospital consolidation are all anticompetitive.
The federal government should use the power of the purse to unwind these barriers.

Current healthcare incumbents shouldn't be driving this process. They've had decades to fix the system. If they were going to, they already would have.
Where competition exists, quality rises, and prices fall. Where competition is suppressed, costs explode. Healthcare is Exhibit A. Until healthcare is forced to compete like every other industry, exchange premiums will continue to spiral, and taxpayers will keep paying the bill. Subsidies can hide costs, but only competition can lower them.