Soaring prices in healthcare are increasingly blocking Americans from accessing the care they need. Doubling hospital prices , rising insurance premiums, tripling deductibles, and unsustainable out-of-pocket costs are eating up our paychecks, threatening our living standards , and saddling many of us with debt we cannot manage .

We have a moral duty to find a solution that enables all people to access necessary healthcare while still maintaining our degree of quality that runs circles around what Europeans have . Currently, our prices of care prohibit such a solution.

Some insist that America’s price of care culprit is the free market system with its runaway market forces that jack up patient prices and prevent universal access to care.

But we don’t actually have a freely functioning market in healthcare. We have a rigged one — hog-tied by anti-competitive and backward government regulations that keep our system from operating under the simple forces of supply, demand, and competition. Competition causes one provider to try to do it better and more affordably than the next guy. That’s a good thing for patients, and it’s exactly what our system is missing.

A free-functioning market with healthy regulation would reduce the prices to levels affordable to most people while maintaining our high quality of care. This would enable Medicare and Medicaid to focus on smaller, still-in-need populations — providing better care than what they currently can.

This is not to say the healthcare system doesn’t need some market-guiding laws. Every industry does, whether they be worker protections or monopoly prevention. But in healthcare, we have developed a canon of anti-market regulations that significantly drive up the price of care by blocking innovative competition and supply. Some of these market riggings are monopoly loopholes, residency capitation, Certificate of Need (CON) laws, a too-strict scope of practice laws, prohibitive state boundary laws on providers and insurance, tax breaks that favor the wealthy, price-hiking pharmaceutical regulations, medical school squeezing, and so many more. Let’s examine two examples more carefully: the COPA monopoly loophole and CON laws.

COPA stands for Certificate of Public Advantage , a process in which hospitals can sidestep standard anti-monopoly law and oversight by applying to their state government for permission to merge. If granted the ability to merge, the consolidated hospital system submits itself to direct oversight by its state health department and attorneys, forever — which is supposed to prevent them from acting as a monopoly. But this supervision often is insufficient since it straps state health department resources , and there are ways to get out from under it. This then creates a monopoly free of meaningful state oversight and federal antitrust enforcement .

According to a paper by the Federal Trade Commission (FTC), our anti-monopoly watchdog, this loophole in normal antitrust laws most often creates a regional monopoly that no longer answers to FTC oversight and pushes insurance companies (and subsequently patients) to accept much higher prices — to the tune of a 20% to 38% increase. Additionally, the FTC reports hospital consolidation creates job lock, lowers worker wages by 4%-6.8%, and removes important incentives for maintaining quality.

Thankfully, the FTC is currently urging states to remove their COPA allowances.

Our second regulation quagmire that drives up patient prices and reduces the accessibility of care is Certificate of Need laws . Most states have varying degrees of CON laws that require medical providers to apply for permission and pay fees ranging from $200 to $300,000 just to be allowed to expand their services or renovate existing ones — such as starting a surgery center, buying another MRI machine, or even adding one more hospital bed. In this sometimes yearslong application process, the state asks the provider’s regional competition whether this new or updated service is necessary. This is like asking Walmart whether or not your uncle should be allowed to open a hardware store or if your neighbor can sell clothes. It’s insane.

Reforming just these two anti-market regulations would increase the number of providers in the market, remove practice prohibitions that keep existing providers from, well, providing, and work against monopoly pricing resulting from ever-increasing hospital consolidation. The FTC says that competition incentivizes lower prices, improves quality, and provides better patient access to treatment — we desperately need that.

To provide high-quality care that everyone can access, we need an affordable, free-market healthcare system within the financial reach of most people, coupled with government aid to those who need extra financing help. Revision of harmful regulations is one part of much-needed comprehensive, pro-market reform that is necessary to create better accountability, affordability, and accessibility — all of which are essential for empowering all people to maneuver through a high-quality, affordable system to get the care they need. Now that’s universal care.