Prices, more and more, are negotiated between very few providers and customers. It's like there are 3 fruit stands and 3 buyers of fruit, and those three buyer

Prices, more and more, are negotiated between very few providers and customers. It's like there are 3 fruit stands and 3 buyers of fruit, and those three buyers of fruit are willing to buy huge quantities of fruit (provide a hospital business with lots of patients) as long as the fruit stand meets their price demands. The fruit stand can take it our leave it. If they leave it, they lose out on 1/3 of their potential sales. They go through this kind of negotiation with each of the three fruit sellers every so often. This is far from an ideal free market.