Adam Smith and other distinguished economists became acutely aware of the shortcomings of economic competition. It creates a society that rewards people for seeking their own best advantage, rather than looking out for one another, and will only be beneficial if there are conditions that prevent people from taking advantage of one another. Beneficial competition requires there to be many independent buyers and sellers who can enter and exit the market easily, good cheap or free information about the qualities and prices of what is being bought, and full use of this information. If these and related requirements are not met, then competition can be damaging to individuals or to the community. This happens because the easy ways to win are not by coming up with something new and better, but by colluding, fixing prices, skimping on services or quality, deceiving customers, and other tricks of sharp sellers.
Competition seems so foreign to health care.
In commercial life, the law of the land is caveat emptor , let the buyer beware . In health care, the law of the land is confidat emptor , let the buyer trust . Patients go to doctors because when they are hurting, scared or anxious they want an expert they can trust to put their interests first. Markets here are a paradigm misfit. No other nation with an advanced health care system has embraced competition, and no other nation has turned its services over to investors seeking profits.