Competition is often considered a dirty word, with many critics of free market ideas emphasizing the cutthroat competition of Wall Street as an example of how competition brings out the worst in people, encourages us to cut corners, and undermines our altruistic tendencies.
Proponents of competition often talk in terms of innovation: competition spurs innovation, giving consumers options they didn’t have before. But even that defense isn’t enough for people who don’t understand the true importance of competition and innovation. Take Bernie Sanders’s derision of innovation as just a way to get lots of different deodorant on the shelves, for example.
The Problem with the Way We Think about Competition
What’s problematic about both the criticism and the common defense of competition? Both underestimate precisely why competition is so important. Competition does more than spur innovation or provide people with different kinds of deodorant. In some cases, competition provides us with the powerful freedom to decide what happens to our bodies and is the only thing that makes informed consent meaningful. This connection is particularly important in health care, but the importance of competition to human freedom applies in other areas as well.
A particularly painful and poignant case study came out of Kentucky earlier this month: after one birth center owner spent many hundreds of thousands of dollars fighting the state’s Certificate of Need process, a Kentucky Appeals Court ruled that birth centers cannot compete with hospitals for maternity patients. This decision ignored that pregnant women in Kentucky want birth centers, are demanding birth centers, and that birth centers provide higher quality and lower cost care for low-risk pregnant women than hospitals do.
The Broader Implications of Kentucky’s Ruling on Birth Centers
While this may seem like a narrow case that applies just to pregnant women in Kentucky, its implications are far broader. What this case really does is tell pregnant women in Kentucky what they are allowed to do with their bodies. It tells entrepreneurs who are providing a safe and effective service that they are not allowed to make a living helping other people. It condemns birthing women to worse outcomes, higher rates of interventions, and worse treatment than they want, expect, and demand. And cases like this happen all over the United States each day, affecting everyone from children to the elderly. Government at all levels controls the options you have access to for urgent care clinics, surgical clinics, hospitals, and other health-care providers.
So what’s the point? Competition doesn’t just allow for innovation.
Competition prevents us from being hemmed in by what other people want for us. It provides us with choices about what happens to the things we hold most dear. Without the diversity of options competition provides, freedom is literally meaningless.
Pregnant women in Kentucky have been denied the opportunity to make basic decisions about what happens to their bodies. If you think this kind of intervention only applies to pregnant women, you’re wrong. Once you peel back the layers of other kinds of government regulation, you’ll find that the government controls a lot more than you realize about what happens to your body, your livelihood, your family, and your community.
So let’s stop talking about competition as the thing that provides us with lots of different brands of deodorant. Instead, let’s start talking about competition as perhaps the most necessary component of a free society.