The Case for Free-Market Healthcare

Anthony Galli
8 min readMay 16, 2022

The US has a mostly socialist healthcare system.

The government accounts for over 65% of U.S. healthcare spending and the 35% that is “private” is highly distorted by regulations. Here are some of those regulations…

  • Employer-based health insurance mandate for companies with over 50 full-time workers and tax penalties for individuals who try to self-insure. Your healthcare shouldn’t be dependent upon and decided by your employer.
  • Medical licenses. I’m a strong supporter of credentialing, but they shouldn’t be required by law to practice medicine. There’s always a chance one gets an incompetent doctor, but consumer empowerment via reviews, reports, ratings, and when appropriate lawsuits is better at mitigating risk than limiting the number of people who can enter the field, ostensibly to protect the consumer, but in reality to protect the seller. America has the highest-paid doctors in the world because the American Medical Association has successfully mandated a doctor shortage.
  • The average cost of a medical malpractice claim has increased by more than 50% since 2009, but the true cost isn’t so much in the claims themselves, but in what’s called “defensive medicine” whereby doctors will over-test-and-over-treat to avoid any potential lawsuit. We need to reduce malpractice claims, which can be done via tort reform and patients’ compensation (similar to workers’ compensation).
  • Certificate-of-Need: New hospitals are prohibited from opening without the approval of existing hospitals. This has made the hospital industry into a cartel. Hospital spending is a third of overall healthcare spending.
  • Customers are prohibited from buying health insurance across state lines.
  • Customers are prohibited from buying prescription drugs from overseas.
  • The FDA doesn’t trust individuals to do their own cost-benefit analysis so they prohibit medical products from entering the market until they give their approval. Big Pharma has successfully lobbied to increase the average cost of drug approval to $3 billion and a 10-year wait time. The FDA may sound good in theory, but its politicization of medicine has led to more corruption and its general risk-aversion has cost untold lives (an eight-year delay in the