The U.S. health care system does not meet the perimeters of a free or market-based system. In a free or market-based system, the price of health services is an established agreement between providers and patients. A free market is an economic system that allows the price of products to be determined by unrestricted competition in the market. Under a market-based system, prices are determined by supply and demand and the government has little control over production or trade. It is interesting align health care with the terms free market or market-based systems. In the United States, the federal government accounts for over fifty percent of health care spending. The health care industry in the United States is heavily regulated by the federal government in an effort to improve access to patient care for all Americans while also preventing fraud, waste, and abuse of such a limited resource. Another very important reason that that health care industry is not a free market is due to third-party payer system. The U.S. health system is a free market for voluntary health services that are non-essential to good health. Competition in the market give an indication that the health system has the potential to be a free or market-based system. The U.S. health care system does not operate under the free market concept for basic, preventive, emergency, and routine health care needs. The U.S. health system operate as a free market in regards to health services such as plastic surgery, Lasik corrective eye surgery, dental care, and any other cosmetic type of health care. The quality of outcome for these health services are readily available to consumers and the price of these health services are agreed on by the consumer and the provider. Recent changes in health care law, the Affordable Care Act did stimulate free market by providing subsidized health insurance and denying the opportunity for health insurance companies to deny coverage based on pre-existing health conditions. Another important way that the ACA stimulated free market is by increasing competition in the health insurance market. For the first time in history, consumers were able to shop around for a health plan at competitive prices. In 2013, the rates of health care were examined in 36 states by Peter Gosselin, a senior health policy analyst Bloomberg Government, the results suggested that the health exchange reduced health insurance premiums by one-third due to competition in the market and the large number of insurers operating in the market (Wagstaff, 2013). The U.S. health system primarily operates under a third-party payer system where consumer health care is paid for by employers, health insurance companies, or the government. The fact that the U.S. health system primarily utilizes a third-party payer system means that consumers are more often than not, completely blind to the true cost of health care services. In fact, health care is one commodity in the economy that consumers pay for without the benefit of truly knowing the outcome or if their efforts would prove worth the cost. Yes, health care is a commodity because the cost and distribution of it is controlled by third-party payers with some government oversight. How is it possible to conceive that the U.S. health system operates under a free market when third-party payers intermediates all transactions and contracts on behalf of consumers?
