Caterpillar Cowboy

The bill on the floor fact does create a somewhat more competitive insurance market — through the exchanges. It’s not what I’d like to see, but given that profit margins for private insurance companies are not high, I’m not sure that competition per se is quite the problem that it’s been made out to be. The high profit margins in the industry, rather, come at the provider level — not the insurer level. The reason, for instance, that a public option benchmarked to Medicare rates would have been so powerful is because Medicare squeezes the providers.