Mark, look at your premise. Do we need commercial insurance carriers at all. Who is we? You are not asking whether you would buy a policy. You are asking whether a group of people with the power to legislate should permit other people to sell one. That is a different question, and it is the only question you ever ask. The real question is whether the state has any right to tell private individuals, and companies that are nothing but private individuals acting together, how they may trade for the things their health requires. Not whether a carrier takes enough risk to satisfy you. Whether it is any of your business, or Congress's, what two consenting parties agree to. Ask that same question of every industry and watch what the record says. The government held a monopoly on phone service for most of a century and you waited weeks for a rotary handset you were not allowed to own. It still holds one on first class mail. It licenses the utility, franchises the cable company, builds the roads, runs the schools, and keeps public libraries open in a world where the entire contents of one fit in your pocket. In every case the service froze at the moment the monopoly was granted, and in every case the one that was eventually opened to trade is now cheap and everywhere. The phone in your hand is the answer to your question. Medicine is not different. The best healthcare system in the world was built here under the principle that a man's life, his work, and his earnings are his own, and the doctor's are his. Antibiotics, anesthesia, insulin, the polio vaccine, open heart surgery. Every one arrived as a miracle for the rich and reached the working man within a generation, because nobody with a title was deciding who needed what. Then the planners took over in 1965, asking exactly your question, do we need this, do we need that, and never the question of right. Sixty years on, real spending per person is up seven times, the government pays half the bill, and you are asking whether the next thing should be allowed to exist. Insurance is a product. A man who wants to pool his risk with strangers at a price he accepts is engaged in a trade, and a carrier that takes too little risk for the premium will lose him to one that takes more, the moment the law stops telling him which plan he must buy and which doctor he may see. The carriers you despise are 72 percent government revenue because government made them so. You are describing a creature of the state and asking whether the state should finish it off. It is not your call. It is not Congress's. It belongs to the man whose body and whose money are on the table, and the entire history of this country's decline in medicine is the history of men like you deciding it was theirs.