The federal government's reliance on market solutions to improve quality and access and reduce costs has not been successful. The main reason for this is that the healthcare industry is not a free market. There are many factors that prevent it from functioning like a free market, such as the fact that people cannot shop around for healthcare services, there is no transparency in pricing, and providers have significant market power. As a result, the healthcare industry has seen little innovation and has been slow to adopt new technologies. Additionally, costs have continued to rise, while quality and access have remained poor