By NextBestFitRestore competition and leave prices to markets
Antitrust enforcement, ban anti-competitive contract terms, and site-neutral pay; prices still set by negotiation.
Draft decision:RejectedConfidence: medium · not yet reviewed
Too slow as the main price tool; antitrust is still chosen separately.
Review ledgerHow this path connects
This path
Restore competition and leave prices to markets
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Increase FTC funding and lower merger-review thresholds
- Ban anti-tiering and all-or-nothing contract terms
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- U.S. prices are far higher than in other countries
Antitrust enforcement, limits on anticompetitive contracts, and site-neutral payment seek lower negotiated prices while retaining market pricing. There is no price commission to lobby.
What it creates or worsens
- Takes years, or money up front, before it pays off
Competition measures work slowly, and many markets are already concentrated beyond repair.
- Solves only part of the problem
Rural areas may support only a single hospital, limiting the reach of competition measures.
Who's affected
Who gains
- People with employer coverage
- U.S. prices are far higher than in other countries: Private plans pay the highest prices, passed on through premiums.
- Taxpayers and public budgets
- U.S. prices are far higher than in other countries: Public programs pay more than peer countries too.
- People with ongoing or specialist care needs
- U.S. prices are far higher than in other countries: Antitrust enforcement, limits on anticompetitive contracts, and site-neutral payment seek lower negotiated prices while retaining market pricing. There is no price commission to lobby.
Who loses
- Hospitals and specialist groups with high private prices
- U.S. prices are far higher than in other countries: Providers with pricing power earn more per service.
- Drug and device makers
- U.S. prices are far higher than in other countries: U.S. prices are well above those in peer countries.
Where it has been tried
- FTC hospital merger cases: Successful challenges have lowered prices locally.
- North Carolina: In 2024, Novant abandoned its proposed purchase of two North Carolina hospitals after an FTC challenge and an appeals-court injunction.Sources: Federal Trade Commission (2024)
Works well with
Other paths for “U.S. prices are far higher than in other countries”
All-payer rate settingU.S. prices are far higher than in other countriesChosenCap commercial prices at a multiple of MedicareU.S. prices are far higher than in other countriesChosenGlobal budgets for hospitalsU.S. prices are far higher than in other countriesChosenFee-for-service at public fee scheduleU.S. prices are far higher than in other countriesChosenCapitation for primary care and integrated systemsU.S. prices are far higher than in other countriesChosen