The American health care system is undergoing a market and organizational transformation analogous to the deregulation of the transportation, communication, utility, and finance industries, with price competition replacing rate controls, new entrants displacing organizational incumbents, innovation disrupting stability, and individual choice supplanting governmental oversight. These turbulent changes are generating uncertainty, hostility, and a backlash towards re-regulation. This article compares the evolution of the health care sector with the experiences of other deregulated industries, highlighting four effects that cut across all sectors. Deregulation and the rise of price competition has led everywhere to: lower costs, due to better capacity utilization and improved productivity; increased differentiation of prices and products, moving away from the one-size-fits-all patterns characteristic of regulated industries; dynamic changes in both market and organizational structures, culminating in consolidation into multi-product, geographically diversified firms; and political backlash, fueled by uncertainty, organized producer groups, and selected groups of consumers who do not benefit from the overall cost and product improvements.
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