No, common sense says people and companies will chose providers with best coverage at lowest price. Insurance companies does have huge incentive to lower the premiums. I think the article is simply not well researched. The guy thinks of insurance company as middlemen who negotiates for him. That’s true only to an extent because insurance company does have to build a network. If they miss out on big players like NYU then their lower premiums are pointless. The most flexibility customers want is to chose any doctor they want. Hospitals have taken advantage of this since long and negotiatons are not simple for insurance company to build their network. Medicare is different beast.

Yeah, but when you're locked in to only choosing whichever your company provides you there's not much opportunity to switch, so there's really nothing you can do.

Exactly.

> No, common sense says people and companies will chose providers with best coverage at lowest price.

This is basically the argument Comcast uses to justify their de facto monopoly. In Comcast's case, their "competition" doesn't even exist on the same scale (which is hardly competition).

If the market were really a "free market" there would be viable options between insurance companies for the insured. Sure you can pick your doctor, and to some extent your plan, but does your company offer you multiple choices for where your health benefits come from?

I would add: 3) Rising medical prices make it harder for people to justify going under-insured.