Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

If the government is going to be making all the decisions there's no benefit. But I doubt we would have had Obamacare at all if he'd proposed a single-payer plan. Insurance companies, which have a lot of clout in Washington, helped push it through because they expected to make more money.

Which, quite frankly, was stupid. It was pretty clear from the outset the ACA would break the US health care system so badly single-payer is the only option going forward.

Do you think that was as clear to the sponsors of the ACA as it was to you?

If by "sponsors" you mean the political leaders, then yes. They knew they were fudging the books. They explicitly abused the GAO ten year window to make it look like there would be enough money even though the wheels were due to start coming off after seven years.

They also had enough political experience to know getting the (delayed) more unpopular parts (like cuts in payments to doctors accepting Medicare, increases to penalties for people who don't buy insurance, and extra taxes for "Cadillac plans") might be too difficult to get through when the time came. That's why they were delayed.

I suppose I can give them enough benefit of the doubt to say many of them may have believed once the system was in place they could solve the problems by closing the gap with something something.