Have you ever wondered why hospitals don’t compete on quality? Say there is a hospital in your area that has lower mortality rates, lower infections rates and lower readmissions rates than any of its competitors. In any other market, the business would be scrambling hand over foot to make sure every potential customer knows about its superiority.

But not in health care. What is true of hospitals is also true of doctors. You could be living next door to one of the best specialists in the country. But odds are the doctor will never tell you about it.

Why is that? The short answer is one I gave at the Health Affairs blog not long ago. (See here and here.) Providers who don’t compete on price typically don’t compete on quality either. And the reason we don’t see price or quality competition in health care is that normal market forces have been systematically suppressed for well over a hundred years.

But hold on. Things are about to change and I predict that they will change rapidly. Turns out, there is more to Grand Cayman Island than white sand, blue waters and the opportunity to feed squid to sting rays.