Set up a government insurance policy and you solve the problem of the uninsured (if the policy is inexpensive) and you get healthcare off the backs of employers (who no longer have to offer it, because there's a cheap government option out there) and you make those insurance companies now have to actually compete with something which has as it's basic goal improving the health of the people it serves.
Health insurance companies, of course, pretend they are only interested in the health of their customers, and they run advertisements which say. "We'll pay to keep you helathy," or some such nonsense. That's what they say. What they do is to refuse to pay for the colonoscopy in the 47 year old, when it might detect a cancer because they know by the time the patient actually becomes clinically apparent as a cancer victim at age 50, he will likely be with another insurance company by then and be someone else's problem.
Big bureaucracies, government or private, tend to live and die by "statistics" measurements which do not have to be meaningful, but once they are accepted, these numbers are all that counts.
Big insurance companies care about as much as the Wire's police commander Rawls cares about murders. All he wants is to be able to show the numbers of murders placed in the "Solved" column keeps getting smaller. He does not care whether the person charged with the murder is actually guilty; Rawls just cares about making that "Solved" number better.
With insurance companies the only numbers which count are the dollars of profit, not that they'll ever admit it. They cannot admit their perfectly reasonable raison d'etre which is to make as much money as possible for their stockholders becasue there is another set of values out there that all of us should care most about prolonging life and healing the sick. In reality, those are only secondary aims of the insurance companies, and when the two desires come into conflict the commercial insurance companies choose to maximize profit becasue they will be judged by their stockholders.
Anyway, that's the way it looks from the trenches, in the doctors' offices.
If a government plan brings to every American the same coverage as the Congressman gets, then there will be no need for commercial health insurance, except for things people with champagne tastes and budgets want, like cosmetic surgery or exotic but unproven therapies.
This may eventually mean the 15 million American citizens employed by health insurance companies will be looking for new jobs,which will create other headaches for the President. But by that time, there may be a new President and the problem will belong to someone else.
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