“Nobody spends somebody else’s money as carefully as he spends his own.” — Milton Friedman
Here’s the dirty little secret Washington doesn’t want to talk about: the real problem with American healthcare isn’t a lack of money, or insurance, or government “solutions.” It’s that nothing in the system — from your doctor’s visit to your MRI to your pharmacy counter — has a price.
You can’t have a functioning market without prices. Period. Yet that’s exactly what our healthcare system has trained Americans to do — spend other people’s money through insurance plans and government programs, while having no earthly idea what anything costs.
You wouldn’t walk into a grocery store and fill your cart without prices on the shelves. But that’s what happens every single day in American medicine. The patient is blind, the doctor is bound, and the hospital CFO is the only one who knows the numbers — and he’s not telling.
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No Prices, No Competition, No Accountability
The result? Waste. Distortion. Skyrocketing costs. When consumers can’t compare prices, they can’t make rational choices — and providers have no incentive to compete.
Instead of prices, we get billing codes. Instead of competition, we get contracts. And instead of transparency, we get 14-page “explanations of benefits” that explain nothing and benefit no one.
This isn’t capitalism. It’s a bureaucratic monopoly that hides behind paperwork and pre-approvals. The middle class pays more every year for “coverage” they can’t afford to use — while the system gets fatter, slower, and less accountable.
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The PBM Black Box
And then there’s the drug industry circus — where no one, not even the doctors, knows what medications actually cost. Enter the PBMs, the pharmacy benefit managers — shadowy middlemen who decide which drugs are “preferred,” who gets the rebates, and how much everyone pays.
Almost no one outside the industry has a clue what PBMs actually do. Yet they skim billions off the top, hidden behind a maze of rebates, kickbacks, and secret pricing formulas that would make a Soviet planner blush.
They claim to “negotiate savings,” but the more they save, the higher the final price seems to go. If you set out to design a system that destroys transparency and accountability, you couldn’t do better than this.
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Why Is There a Stigma on Prices?
Here’s the strangest part: somewhere along the line, America decided that putting a price tag on healthcare was immoral.
We talk about cost as though it’s shameful — as though discussing dollars somehow cheapens compassion. But it’s precisely the refusal to talk about prices that makes care unaffordable.
There’s nothing compassionate about hiding the cost of an MRI, or forcing a family to wait for a surprise bill they can’t pay. There’s nothing noble about making doctors guess what a procedure will cost their patients.
In every other sector of the economy, price transparency is celebrated as a sign of fairness. Only in healthcare is it treated like a sin.
This moral fog benefits the bureaucrats and the middlemen — not the patients. The stigma against pricing keeps power in their hands. Because when patients start asking “How much does it cost?” they also start asking “Why?” And that’s the one question the system can’t answer.
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The Left’s Outcry: Not a Broken System — Just “Not Enough Spending”
And what’s the Democratic response to all this? Predictable as sunrise. Every failure, every distortion, every price hike — their answer is always the same: spend more.
Premiums rise? “We need more subsidies.” Hospitals close? “We need more federal funding.” Drugs too expensive? “We need another government program.”
In their world, it’s never a broken system — just an underfunded one.
That’s the fatal illusion of socialism: the belief that if only government had more control, more money, and more power, the outcomes would magically improve. Yet every dollar Washington pours into this black hole just feeds the very middlemen who created the problem.
It’s like trying to cure obesity by giving away free donuts.
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Freedom Starts with Prices
The solution isn’t more subsidies or new regulations — it’s a radical return to price and freedom. Post the prices. Make them public. Let patients and doctors deal directly, cash or card, just like every other sector of the economy.
The moment prices return, markets return. The moment markets return, competition drives costs down and quality up.
We need to bring back real capitalism in healthcare — not the bureaucratic, third-party mess that masquerades as “coverage.” Doctors should be free to post prices online. Pharmacies should compete openly. Hospitals should show what procedures actually cost — not what they bill after a six-month insurance war.
Freedom works. Always has, always will. But first, we have to rip the veil off this opaque system and admit what it is: a price-free zone run by bureaucrats, insurers, and middlemen nobody voted for and almost nobody understands.
As Friedman might say, “You don’t solve problems by throwing money at them — you solve them by restoring freedom.”
And in healthcare, freedom starts with one simple act of courage: put the prices on the table.