Want better health care for North Carolina? The Mercatus Center at George Mason University offers three prescriptions for all 50 states in a new report.

Well before the advent of the Affordable Care Act (ACA), the US health care system lacked many of the basic elements of consumer choice, price transparency, and efficiency enjoyed by consumers in other industries. The ACA, unfortunately, did not change this.

Most health care transactions take place without any reference to prices. Indeed, a large share of hospitals cannot even tell patients the price of a standard procedure.1 The market is hamstrung by a third-partypayer model that divorces the consumer from choice. Moreover, it is limited by a patchwork of constraints that favor risk-averse insiders over innovative disruptors who might transform the system to the consumers’ benefit.2 The result is a system that lacks the sort of dynamic competition that permits other industries to discover innovative ways to improve quality, reduce prices, and enhance the user experience.3

In this paper we discuss three ways that states can benefit patients by making their health care markets more competitive: they can abolish certificate-of-need laws, liberalize scope-of-practice regulations, and remove barriers to telemedicine.

Regular readers in this forum know about efforts to scrap certificate-of-need requirements. As the Mercatus researchers show, North Carolina is among the states that could benefit from scope-of-practice and telemedicine reform as well.