Rather than moving toward a competitive world, we seem to be moving toward the opposite extreme: monopoly. Major consolidation is underway both on the provider and insurer sides of the market. And while this trend was already underway before Barack Obama became president, without doubt it is accelerating because of ObamaCare.
The graph below shows what things look like in the market for commercial insurance in major Texas cities:
Blue Cross already has 70% of the market in three of the nine largest metropolitan areas. In all of them, and for the state as a whole, more than 60% of all customers buy from only two insurers.