Council for Affordable Health Coverage President: ‘We don’t have free market healthcare…we have localized monopolies’

Joel White, president of the Council for Affordable Health Coverage, said rising healthcare costs are being driven by market consolidation and regulatory structures that have reduced competition across the U.S. healthcare system.

“We think that we have free market healthcare in the United States and we don’t,” White said on the Health Policy Podcast. “What we have is localized monopolies all over the U.S.”

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White pointed to long-term cost trends as evidence of a growing affordability gap.

“Since 2000, premiums have increased more than 300%, and wages have only gone up 100%,” he said, adding that healthcare spending could reach 40% of household income within the next decade.

He argued that consolidation among insurers, hospitals, and pharmacy benefit managers has concentrated pricing power.

“When they dominate those markets, they set the price…we don’t have any price constraints,” White said.

White also linked the structure of the Affordable Care Act to increased consolidation, saying regulatory complexity incentivized companies to scale.

“The only way you could succeed…is if you got bigger,” he said, describing a “massive increase in consolidation” following the law’s enactment.

“The answer was the Affordable Care Act, and really it was gasoline on the fire of the unaffordability problem,” White added, citing subsidy structures that he said can incentivize higher premiums.

White outlined several policy proposals, including expanding price transparency, increasing consumer choice in insurance plans, redirecting subsidies directly to individuals, and enforcing antitrust laws to break up vertically integrated healthcare companies.

“Monopolies are bad for consumers,” he said. “We need to break these guys up and get back to a free market healthcare system in America.”

White has spent decades working in health policy, including 12 years on Capitol Hill where he helped write Medicare-related legislation and contributed to the creation of health savings accounts, which are now used by tens of millions of Americans.