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And whilst its generally a problem with things like telecoms, where even though there is theoretical competition, you are likely to only be served by one provider so they have a de-facto monopoly, with healthcare you also have the issue that Hospitals have to have agreements with the insurers also so if your local doesn't deal with your insurers then you're SOL as far as I can tell
branwen
This is the root of the greatest fallacy about the American Healthcare system, and Capitalism in general; you have the choice to appoint whichever 'health provider' you like within a competitive market, therefore quality must be ensured by that dynamic. Almost without fail, it's the exact opposite.