I asked my Dr once why he didn't start up a Concierge Practice?  He said he would be able to have roughly 300 to 400 patients. He didn't know what he'd do with the other 5000!!!  I think free market competition is the answer. Why is it some medical procedures have gotten cheaper over the years?

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There is no free market. The norm now is for hospital systems to come into private practices and give them a choice. Either sell the practice to the University system, or lose hospital privileges. A primary care doctor without hospital privileges is dead in the water. That’s not a free market. That’s big Capital gobbling up the remnants of free enterprise.