Medicine is losing its monopoly. The next 12-24 months could change what American healthcare looks like for decades to come. This is what's actually going on. Healthcare had the freedom to behave in a way that'd be impossible for any other business. Prices would increase every year, but the experience got worse. For comparison, if a restaurant did this, they'd be out of business in a month. Healthcare could only do it because: 1) There aren't enough doctors and their time is finite 2) The person receiving the care isn't the person directly paying for it 3) You can't opt out of healthcare so you trust it by default 4) Regulations make it extremely hard for new alternatives to compete With these four together, a customer can't leave and can't look for other options, therefore, they can't lose them so nothing has to improve. Every one of these four is falling apart: 1) Supply is expanding through AI. Doctors are still scarce, but as AI improves, their scarcity will matter less. Everyone will have a doctor in their pocket that knows everything about them and is available 24/7. 2) People are leaving the payment model because of perverse incentives. They are leaving for telemedicine, peptides, cheaper diagnostics, and they're paying with cash without waiting for approval. 3) The trust is at an all-time low. 4) Regulators can't handle hundreds of thousands of people who have decided their health is their to manage. The rules are chasing people, not vice versa. The explanation for why the current system isn't adapting could be in Shirky principle: institutions will try to preserve the problem to which they are the solution. Current healthcare system exists because you can't understand or manage your health independently. Everything inside the system depends on that staying true. So when a solution emerges that could make the problem disappear, the system wants to self-preserve so it doesn't adopt it and slows everything down. Except this time, this isn't working anymore.