Can Health Regulation Move Beyond Markets?

In March 2019, the Patient Protection and Affordable Care Act (ACA) celebrated its ninth anniversary. When President Barack H. Obama signed the ACA into law, few people could have imagined that Democrats would now be debating whether “Medicare for all” should be a centerpiece of their 2020 policy goals. This debate is evidence of the beginning kernels of a major conceptual shift in health policy and, in turn, health law and regulation. One of the most defining features of the last half-century has been looking to markets to solve health care’s greatest woes—relatively high spending and disappointing nationwide outcomes compared to other developed countries. For instance, the United States spends more on health care per capita than any other Organization for Economic Co-operation and Development (OECD) countries, and yet it has lower life expectancy and higher infant mortality than many of them. Market choice now pervades all corners of health care. You…

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