Healthcare costs (what I assume you mean by prices) are the least market-driven items in the US economy. And as much as the medical community would have you believe, the primary driver of costs are labor costs. If we had twice the number of doctors, PRNs, PAs, and nurses, their annual income would drop dramatically. But since they're constrained by a guild system, it's not going to happen.
> If we had twice the number of doctors, PRNs, PAs, and nurses, their annual income would drop dramatically.
Yes, but the parent is saying that the middlemen will still charge the patients the same and pocket the difference. The patients have already shown what they are willing to pay. There is no reason to charge them less, even if your labor costs are now lower.
Theoretically competition will eventually squeeze the middleman, but it's not exactly straightforward to build a hospital on every street corner like you can a restaurant. There is somewhat of a natural monopoly there. Maybe less so for basic clinic care, but where the infrastructure needs are complex...
You sound like ESR ranting about how Apple was doomed by Android back when the iPhone came out. He would rant and rant every time about how there was no conceivable way that Apple could survive. Somehow, Apple has managed to survive by the skin of it's teeth.../s
I don't think there's anything to back up your last sentence. In my small city, there's at least four convenience store chains, and many of them use the owner's name as part of the street (advertised) name. There's also a lot of small convenience stores that are single owner, many serving immigrant communities.
It’s a reference as to why people go to McDonald’s even though a local one off burger place is very likely better — expectations. Particularly when traveling outside your known regular places.
It does not mean that McDonald’s replaced all restaurants, nor that they are better, but it does mean that when you go to one you know exactly what you are going to get vs the uncertainty of the unknown competitor.
It’s why suburbia all looks the same.
And for that matter, it’s happening in cities that pride themselves on not having things like McDonald’s. There is cool kids Blue Bottle coffee in SF, and LA, etc. Whole Foods used to be only in hip places and now it anywhere trying to be hip (don’t worry, Erehwon is here to soak up hipsters cash).
Back in the 80's you still needed to have multiple stores. Otherwise your overhead from back office and maintenance stuff would just eat up too much profits. Once you hit three stores, you could start to make serious money if you ran a tight ship.
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