In a recent conversation with Becker’s ASC Review, I shared a simple but often overlooked truth: America doesn’t have a healthcare spending problem — it has a competition problem.

For years, we’ve tried to make healthcare more affordable by subsidizing insurance premiums and expanding coverage. While well-intentioned, those approaches don’t address the real issue — the underlying cost of care. In fact, when prices remain opaque and competition is limited, subsidies often mask inefficiencies and allow costs to continue rising.

Healthcare is no different from any other sector of the economy: competition drives down costs and improves quality. Yet consolidation among hospitals and health systems, combined with anti-competitive structures, has reduced patient choice and weakened the market forces that naturally keep prices in check. If left unaddressed, this trajectory risks pushing the U.S. toward a two-tiered system where access and quality depend on who can afford it.

The path forward isn’t more complexity — it’s restoring real choice. Patients need transparent, understandable pricing and meaningful options among providers. When consumers can compare value and providers are incentivized to compete on outcomes, efficiency, and experience, the system begins to work as it should.

Lowering healthcare costs doesn’t require reinventing the wheel. It requires bringing competition back into healthcare — and letting it do what it’s always done best.