For me, to be "market driven", you have to have easy entry on the supply side and not have huge amounts of mandated care on the demand side.

The US has all sorts of constraints on the supply side and a lot of the demand side is treated under various mandates.

Without easy entry on the supply side, there can't really be a market response to changes in demand, hence not really market driven.

When care is provided to comply with government mandates and incentives rather than because it can be priced above cost, not a market driven transaction.