Medicare is a monopoly: a central-planning bureaucracy grafted onto American health care. It exercises a stranglehold on the health care of all Americans over 65, and on the medical practices of almost all physicians. Medicare decides what is legitimate and what is not: which prices may be charged and which services may be rendered.

Persuasion has become a kind of force. The more the advertiser knows about what consumers want, and the more desires the product and packaging seek to fulfill, the more coercive the force.

Medicare is immune from the competitive pressures that force private insurers to pay attention to what patients and doctors want.

Virginia Postrel Quotes