Mike, thanks for your input!

You are right to say that a market without competition is a sham. There are far too many barriers to competition in medical markets, including local hospital monopolies, run-away patent protection, and barriers to new technologies like telemedicine.

Although you perhaps overstate the case that there is “no” medical market now, a lot could be done to breath more life into the weak medical markets we have now. Consider, for example, the measures in a bill sponsored by Rep. Bruce Westerman (R-AR): https://freopp.org/bruce-westermans-fair-care-act-market-based-universal-coverage-74480ea70d1a

Democrats as well as Republicans should include such measures in their proposed legislation. I see no reason why most of the measures in Westerman’s bill could not be incorporated in the Buttigieg plan.

Still, there is a limit. If you really had a “pure” market for medical care, whether it was a competitive market or not (an open question what would emerge), it would inevitably become “health care for all who can afford it.” That is not what Americans want.