San Francisco’s biggest health insurer, Anthem Blue Cross (and its partner Express Scripts), no longer allows its customers to buy prescription medicine at Walgreen’s California’s largest pharmacy. Why? Anthem claims it’s about price. Walgreen’s says it’s anti-competitive behavior. People like you and I could care less about this squabble between two giant companies: we just want to take the medicine our doctor says we need to stay healthy.

I now have exactly one pharmacy within a mile of my house I’m allowed to use. It’s a spooky place, so I’m going mail order. Of course Anthem and Express Scripts are right there to make it easy to order my medicine directly from them. Which I did, because what alternative do I have? Apparently anti-trust law doesn’t apply to healthcare.

Capitalism does not work to provide health care efficiently. There can be no free market in healthcare: consumers are intensely limited by geography, insurance underwriting, and medical need. Regulatory requirements make competition from upstarts nearly impossible. The US spends 50%–100% more than every other industrialized nation on health care in total and spends just as much per-capita of public funds on health care as every European nation. But we have lower life expectancy. What we’re doing now doesn’t work.