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A previous article attributed widespread airline service failures not to individual carriers but to government interventions sold as consumer protections. Through a web of intricate regulations and controls, the state restricts entry, grants shared monopoly privileges to approved carriers, and creates what Rothbard calls a state-enforced cartel. The result is an illusion of competition that allows poor service to persist without attracting better alternatives. This article examines how the same pattern protects incumbents and suppresses competition across other industries.

The banking system provides perhaps the clearest example. Entry requires a charter, regulatory approval, access to payment networks, compliance with extensive federal and state laws, and deposit insurance. The Federal Reserve supplies bank reserves, emergency credit, and the benchmark underlying prime rates, while the FDIC protects depositors from losses and reduces their incentive to distinguish between prudent and imprudent banks. Together with the discount window, this protection creates moral hazard by socializing risk and encouraging loans banks might not otherwise make. The result is an illusion of competition within a protected system that shifts the consequences of risky banking onto taxpayers and the broader economy.

Credit card pricing reveals the consequences. Banks appear to compete through branding, rewards, introductory offers, fees, and expanded credit access, yet interest rates remain remarkably high relative to the prime rate. The CFPB found that the ten largest issuers controlled 83 percent of outstanding balances and generally charged higher rates than smaller banks and credit unions. Perks and easier access create an illusion of competition that conceals the monopoly rates paid by customers who carry balances.

This restriction of competition becomes even more explicit in health care. Certificate-of-need laws allow incumbents to exercise a competitor’s veto by opposing applications to build facilities, acquire equipment, add beds, or offer new services as unnecessary. Rather than letting patients determine whether another provider is needed, the state allows existing providers to declare the market adequately served. These restrictions help explain why many communities entered the pandemic with so few ICU beds. North Carolina eye surgeon Dr. Jay Singleton, for example, remains barred from offering lower-cost surgery at his own facility while his constitutional challenge proceeds. The outrage would be deafening if the state allowed McDonald’s to veto a Burger King opening across the street by claiming that Whoppers were duplicative. Yet health care incumbents exercise precisely this power, putting Rothbard’s monopoly privilege into practice by asking the state to block entrepreneurs they might otherwise have to outperform.

Montana’s waste-removal rules extend the same competitor’s veto from hospitals to dumpsters. Parker Noland discovered that construction companies were dissatisfied with existing debris-removal services. After borrowing money to buy dumpsters and a specialized truck, he began advertising but soon received a cease-and-desist order from the Montana Public Service Commission. Continuing required a certificate of public convenience and necessity through a process that allowed existing waste companies to oppose his entry without explanation. Republic Services and Waste Connections protested his application, while other certificate holders demanded his tax returns, revenues, financial statements, and other business records. Unable to match their legal and financial resources, Noland withdrew. Rather than merely enforcing safety standards, the state empowered his prospective competitors to deny dissatisfied customers an alternative.

Professional licensing extends the same exclusionary power to entire occupations by allowing organized interests to control entry in the name of quality and public safety. Through its influence over medical education, accreditation, licensing, and professional membership, the American Medical Association helped determine who could become a physician and often applied these restrictions discriminatorily. Black physicians were excluded from many state and local medical societies, limiting their access to the national association, hospitals, and professional opportunities. Following a three-year investigation, the AMA formally apologized in 2008 for the harm inflicted on black physicians, their families, and their patients.

The AMA’s review shows that this discrimination extended beyond black physicians. Women accounted for only 2.9 percent of medical-school graduates in 1915 and remained a small minority for decades. Jewish applicants also faced blatant discrimination. In 1939, JAMA editor Morris Fishbein acknowledged that they were rejected “simply because they were Jewish” but defended the practice because Jewish physicians already represented a substantial share of the profession. Although the AMA’s apology focused on black physicians, the broader record demonstrates the danger of allowing professional organizations and incumbents to control entry. Presented as patient protections, licensing and accreditation helped create a state-enforced medical cartel that restricted the supply of physicians, raised prices, and reduced patient choice.

Control over entry and consumer choice also shapes public education, where the government acts as both financier and provider. Families must fund the system through taxes whether they use it or not, while licensing restricts who may teach, accreditation limits which institutions may compete, and political authorities determine curricula, funding, and operating standards. Parents are largely limited to their assigned public school, permitted charter schools, nearby private schools they must pay for separately, or moving to another district. Even these alternatives remain subject to state approval and regulation, while compulsory-attendance laws leave children no option to reject their poorly performing schools. Unlike a restaurant that loses revenue and eventually closes after repeatedly failing its customers, a failing public school may receive additional funding because the state restricts entry, compels attendance, and supplies it with captive customers.

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