I think choices was meant to mean things like being able to choose between competing healthcare providers.

Created and supported by big industry players that get them turned into law (and thus "government-imposed" - classic regulatory capture.

On the Mexican side of the border there are clusters of doctors, dentists, etc., offering lower cost treatment. I imagine that a large part of the decreased cost is due to reduced regulations that make it easier for small, independent providers to offer their services, which in turn results in substantial competition between the many providers to offer the lowest cost for the standard of treatment that patients want.