Competition and supply are good things, and as we've said before, health care needs more of both. Innovations along those lines could mean interstate licensing of doctors to ensure wider access and lower prices for Missouri patients. It could mean making sure innovative primary care practices are able to practice medicine without undue government interference. It could mean reimagining the Medicaid program into one that breaks the network limitations of the current program and empowers patients. Indeed, competition and supply are good things for customers and patients—patients, of course, being customers by another name.

That's why news broken by Samantha Liss at the St. Louis Post-Dispatch should be very welcome to patients in Missouri and elsewhere, as it appears the market for at least some pharmacy services is about to grow:

Throughout the past year, and without much fanfare, Amazon.com Inc. has gained approval to become a wholesale distributor from a number of state pharmaceutical boards, according to a review of public records….

According to a review of records by the St. Louis Post-Dispatch, Amazon has received approval for wholesale pharmacy licenses in at least 12 states, including Nevada, Arizona, North Dakota, Louisiana, Alabama, New Jersey, Michigan, Connecticut, Idaho, New Hampshire, Oregon and Tennessee.

An application is currently pending in the state of Maine.

An Amazon spokesperson told the Post-Dispatch via email that the company does not comment on "rumors and speculation."

It's a little complicated, but one of the big questions surrounding the Post-Dispatch report is the ultimate aim of the Amazon filings—that is, whether Amazon wants to open up a pharmacy benefits management business only, or whether a soup-to-nuts model is also in the tech giant's future. Does Amazon want to be Express Scripts? Does it want to be Walgreens? Or does it want to be both? I would welcome all of the above, actually, and I suspect millions of Amazon customers would feel likewise.

And despite the failure of our Federal representatives to actually do what they said and repeal Obamacare, there is still reason to be optimistic about the trajectory of care in this country. Along with the reform initiatives above, tech innovations like 3D printing of prosthetics, and much more, the potential entry of Amazon into the pharmaceutical space reiterates that the future of health care as some government product remains anything but assured. After all, people are markets, and markets are powerful things.