Health care monopoly

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The health care monopoly is a political term for a claimed reason that health care is becoming increasingly unaffordable worldwide.

The implied claim is that health care costs could be lowered by deregulating much of health care, and allowing more individuals and corporations to provide such services free from government oversight or other restrictions. These providers would still be licensed by independent oversight organizations, and patients should be made aware of provider qualifications. However, this appears to be politically impossible.

Restrictions on practicing medicine

In almost all countries, medical practitioners are trained in government-approved institutions using government-approved curricula. In the USA, it takes 8 to 12 years of post-secondary education to become a medical doctor, though in other countries it can be faster.

After graduation, these practitioners must acquire a government-approved medical license or accreditation to treat patients, and remain under government oversight throughout their careers.

The supply of medical practitioners is also limited by government-approved independent trade organizations, like the American Medical Association in the USA, which limit the number of doctors who can be trained.[1] The A.M.A. claims it only wants to serve the interest of patients by assuring the highest quality doctors are trained.

Libertarian opposition to the alleged monopoly

Libertarian opponents in the USA claim that the A.M.A and other trade organizations amount to a system of guilds or cartels that serve to artificially restrict the supply of practitioners for the benefit of members, who can then charge higher prices.[2] These opponents also claim that government oversight and control create an immense barrier to the practice of medicine through complicated and expensive regulations, that are said to add trillions of dollars in costs.[3]

In most other countries similar restrictions apply, but health care is generally less expensive in absolute terms. However, due to lower incomes and higher taxes, per-capita health care expenses as a percentage of income are usually comparable with the USA.

Political support for the alleged monopoly

In the USA, mainstream Republican politicians like Paul Ryan and John McCain are said to have supported this system because many practitioners, health care companies, and insurance companies who benefit from the arrangement are generous campaign donors. Mainstream Democratic politicians like Nancy Pelosi and Ted Kennedy are said to have supported this system because these donors also support large government-funded health care programs like Medicaid and Medicare, which primarily benefit lower-income voters.[4][5]

Most other countries have forms of socialized medicine, which are often popular and are considered politically untouchable. However, these programs are said to have many hidden costs and quality problems that voters are unaware of.[6]

Endurance of the alleged monopoly

As of the 2010s, very few efforts were being made to eliminate the healthcare monopoly in the USA or elsewhere. There was little public support for removing government regulations or reducing the power of the trade organizations, and health care costs continue to rise.

Instead, the main proposal to make health care more affordable for lower-income consumers was to expand the role of publicly funded health care or a public health insurance option, that would be partially funded by raising taxes as necessary.


  1. "The A.M.A. and the Supply of Physicians" Reuben A. Kessel (retrieved Oct 17, 2017)
  2. Shikha Dalmia (Aug 26, 2009) The Evil-Mongering Of The American Medical Association |
  3. Brett Chandrasekhar (Jun 7, 2017)
  4. David Cowles (Sep 6, 2011)
  5. CLARK C. HAVIGHURST & BARAK D. RICHMAN "The Provider Monopoly Problem in Health Care" (3/31/2011)
  6. Evan Sumortin (Jul 20, 2009)