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Private or Government Health Care: Who Gets to Choose?

There may be no less appreciated industry than insurance.  We hate paying for it and hope never to use it.  If we make a claim, the company is devoted to protecting its own interest irrespective of what we want. The health insurance industry naturally yields up more than a few "Roger Moore" moments, examples of denial of benefits which, no matter the justification, look like examples of greedy corporations sacrificing helpless people.  Cigna has recently been hit over its initial denial of a liver transplant to a young leukemia patient. But there are no easy choices, and a government takeover of the medical system doesn't make the decisions any easier.  Observes Investor's Business Daily:
Any insurer, public or private, would have had to make the same tough calls that Cigna did. It's natural for patients and their families to want to try anything to save lives. It's natural for physicians to want to at least give experiments a chance. But the public can't expect to allow these desires full rein unless it is willing to pay much more — in premiums or taxes. It needs economic gatekeepers, whether or not it likes their decisions. And when it comes to the business of gatekeeping, there are really only two models. One is private insurance, which works best when many insurers vie for the consumer's business and are judged on how cost-effectively they meet the consumers' needs. A national market for health insurance, which won't happen until Congress ends the balkanized state regulation of insurance, would give the public a real choice among competitive firms. The other model is a government-run system, in which insurers are either replaced by a monopoly public payer or they are reduced to contractors given allotments of a government-run risk pool. In both models, the tough calls would still have to be made. The difference is that the first would give people a choice, and the second would not.