After the ACA: Freeing the Market for Health Care

Abstract

I survey the supply, demand, and market for health care and health insurance. I conclude that a much less regulated system is possible, and necessary. Cost control and technology improvement must come from disruptive competition from new suppliers, as it has in airlines, retail, internet, and other successful industries. People must direct their expenditures at the margin, and feel the benefits and costs of their decisions. Individual, portable, guaranteed renewable insurance can then emerge, addressing the pathologies of today’s insurance markets. I discuss how current law and regulations rather than fundamental market failures are the main reasons a healthy market does not emerge, and why a regulatory approach must fail. I address common objections to market-based health care and insurance.