His Medicare reform plan is NOT based on free market principles. It calls for the use of taxpayers' money to subsidize "government-approved" insurance companies. (Therefore, the lobbyists will influence the lawmakers which insurance companies will win and which will lose.)
Whereas the health-care oligopolies (such as the hospital & drug companies) benefit from limited competition. The overly stringent licensing laws, together with corporate friendly regulations and patent protections ... have the effect to thwart competition and maximize profits.
Paul Ryan is not a trust buster like Teddy Roosevelt. He, (like Obama and Romney) advocate government subsidized insurance to feed the appetite of the "too big to fail" hospital industry.
If Ryan were truly for free markets, he would deregulate health-care. (This would increase competition and break up the monopolies.) Patent laws would be loosened. Importation of drugs from Canada would be allowed. Insurance would be optional -- and not subsidized.
Let charitable foundations, religious groups, wealthy donors, etc. -- be the ones who play a bigger role in our local communities. This is far better than the corporatist models espoused by Ryan, Romney and Obama.