It’s time to start buying health care like everything else.
Imagine walking into a grocery store where there are no price tags, and instead of paying the cashier, your bank, your employer, and the government secretly negotiate what you owe weeks later. Sounds insane? That’s exactly how health care works in America today.
Unlike typical markets, patients have no direct influence on medical costs. Prices are set through hidden negotiations between providers, insurers, employers, and government programs, all vying for their share. This results in inflated costs—like a $0.50 dose of Tylenol costing $15 in a hospital, not due to superior quality but because patients are shielded from real costs.
The system isn’t merely inefficient, it’s structurally misaligned with consumer interests. And no amount of tweaking the Affordable Care Act or Medicaid expansion will fix it. In my 2018 article, I explored how third-party payers, hidden pricing, and restrictive insurer-hospital contracts create a runaway cost spiral. That crisis has only worsened, but new tools—artificial intelligence, blockchain technology, and decentralization—can end the medical monopoly and finally let Americans buy healthcare like they buy everything else. .
What Buying Healthcare Should Look Like
Traditional insurance pools risk and makes opaque decisions about coverage, premiums and reimbursements. A blockchain-driven system could replace this with smart contracts that execute automatically at pre-agreed prices, eliminating pre-approvals or confusing co-pays. Imagine car insurance instantly covering a tire change when a mechanic logs it on a blockchain—no middleman needed.
In everyday life, you know prices upfront, choosing based on cost, quality, and convenience. That’s how free markets work.
Healthcare should work the same.
With blockchain-based platforms, every clinic, doctor, lab, or holistic provider could list their services with transparent, verifiable pricing, like Amazon or Airbnb for medicine. Patients could compare providers, read reviews, schedule, and pay directly using crypto-backed health tokens or blockchain-based Health Savings Accounts. That means you, not your employer or the government, control how your health dollars are spent.
AI as Your Healthcare Assistant
An AI-powered health assistant, running securely on your phone or encrypted cloud, could guide your health care journey: recommending providers based on symptoms, budget, and location; analyzing wearable data and medical history to catch issues early; suggesting nutrition, lifestyle, or alternative remedies; and negotiating or bundling services.
This isn’t sci-fi. These tools already exist—but their widespread adoption is hindered by entrenched challenges within the legacy healthcare system, which fosters dependency rather than informed consumers.
Ending the Medical Monopoly
Blockchain and AI-driven decentralization dismantle the medical cartel.
Insurance would cover only catastrophic events—not routine care. Hospitals would lose monopoly pricing power, competing like restaurants or gyms. Pharmaceutical markups would collapse as AI-recommended generics and open competition undercut inflated brands. Doctors could leave bloated hospital systems for independent practices, serving patients directly. Third-party payers would become obsolete as prices are transparent, care is direct, and consumers are in charge.
It’s a radical return to the obvious: Let people shop for health care the way they shop for everything else.
What About the Poor, the Sick, and the Elderly?
Critics argue that the poor, sick, or elderly might struggle with decentralized systems due to limited digital access or tech literacy. Yet, smartphone adoption proves otherwise: in 2011, only 11% of Americans aged 65+ owned smartphones; by 2023, 76% did.
In 2021, 27% of adults earning under $30,000 used smartphones as their sole internet access, up from 12% in 2013.
Instead of funneling billions to insurers, health tokens or wallets could be issued to low-income Americans, letting them choose care—whether acupuncture, therapy, or surgery. By gamifying health, tokens could reward healthy behaviors, and then Medicaid becomes a health wallet booster, not a trap.
User-friendly design, local awareness campaigns, robust security, and community support would ensure empowerment and inclusion for vulnerable groups, making decentralized platforms intuitive, like smartphones. With the right support, what once seemed out of reach becomes second nature.
Reclaiming Health Through Prevention
AI-powered assistants and decentralized platforms don’t just treat illness—they prevent it. By promoting nutrition, movement, sleep, and stress reduction, connecting users with holistic practitioners and rewarding health improvements—like reduced inflammation or better sleep—they prevent illness with incentives.
In 2022, Cleveland Clinic reported 85% user satisfaction with AI chatbots for scheduling and reminders. Mayo Clinic used AI to cut hospital readmissions by 30%. A 2023 JAMA study found an Amazon Alexa–based system reduced insulin dosage optimization time from 56 to 15 days, improving adherence by 32%.
This isn’t just good medicine. It’s good economics. Preventing disease is cheaper than managing it, aligning incentives with patient outcomes in a free market.
Decentralize or Decay
Economist, Milton Friedman, warned us decades ago of the dangers of not reducing the role of third-party payment systems. Today, we’re living that nightmare: inflated prices, disempowered patients, and a system that treats people like billing codes rather than human beings.
We can rebuild healthcare as a transparent, consumer-driven ecosystem where prices are clear, providers are chosen freely, and innovation thrives.
Blockchain makes it trustworthy. AI makes it personal. And decentralization makes it unstoppable.
The revolution is here. It’s time to start buying health care like everything else.
Nicholas DeSimone
Nicholas DeSimone is a PR Associate with Young Voices. He holds a B.A. in PPE from the University of Pennsylvania and has worked with free market think tanks including Reason Foundation, Independent Institute and the Grassroot Institute of Hawaii. His work has appeared in the Washington Examiner, The Daily Caller, and Foundation for Economic Education. You can follow him on X at @nickyd8181.
