What caused lack of competition? Government interference. Government started seriously meddling in healthcare in the 1970's when they started mandating companies to provide employees with health coverage. The government, through the courts, also awarded crazed malpractice suits. Both caused healthcare costs to skyrocket.
Again, the answer is what we had before the 1970's - healthcare in the open, voluntary free market. You'll get what we had before - open competition creating the BEST care for the BEST price. That needs to happen NOW. Right now many doctors are leaving their practice as we speak because they do not want to government employees. Get this out of government NOW or three month waiting lists will be the mode-o-day as in Canada and England.
As far as tort reform, I'd day forget about the feds, they'll never do it, but the states should enact sane, reasonable malpractice laws also to being down costs.
Are you sure healthcare was mandated for employers?
I worked for a outfit from 1969 through 1974 and there was no health insurance offered by the employer.
Next question...as you are surely aware, about 100 million people have no jobs. They live off government benefit checks. What is your idea in providing those people with healthcare? Emergency room visits only? And who pays their hospital bills?