Starting Oct. 1, 2014, the law will signify the beginning of the end of the health insurance industry as we know it. My former CEO at Cigna said at a leadership retreat that what kept him up at night was the fear that big health insurance corporations might someday be viewed as unnecessary middlemen, that their “value proposition” would come under scrutiny and found to be wanting – that insurance companies would be, to use his term, “dis-intermediated.” - Mitchell Tsai

One of the things apparent right off the bat is that some of the best deals will be offered by non-profit health insurers, including the brand new co-op plans that will be available in about half the states. These plans will be lean and mean. They won’t have the enormous overhead costs of the big for-profit insurance corporations. - Mitchell Tsai

If you’re wondering why Aetna, Cigna, Humana and UnitedHealth Group, four of the biggest for-profits, are not planning to participate in many of the marketplaces, it’s because they know they cannot be competitive and still satisfy the profit expectations of their shareholders. - Mitchell Tsai

Tinfoil - Given the ~$2 trillion US "medical care" market, all the rich people in that industry will probably fight tooth & nail for keep healthcare the way it is,... and delay ObamaCare as long as possible. .... the "healthcare right for all" is big ball of different issues (e.g. clean water & air & organic healthy food for all are probably good "rights" also ... IMO people have no "rights", but we agree/disagree as a society to certain mutual behaviors, and those change as societies evolve/devolve). - Mitchell Tsai

I agree that insurance companies are often unnecessary middlemen that inflate costs. Still, I don't view medical care as a right, and I don't see government healthcare as an improvement. Most nations with centralized healthcare also have a private market with better and faster care. Unless the private market is severely hampered or outlawed, the same will happen in the U.S. I view Obamacare as just a way to remove the stigma of welfare healthcare, just like EBT cards for food or section 8 for housing. I see no reason to mainstream welfare in any way. - Todd

@todd30 quote "Most nations with centralized healthcare also have a private market with better and faster care." -- the problem with this "private extension" is that it tries to swallow public service, sucking out precious resources which it didn't create, leaving it with hard, problematic load. You know, "privatizing profit, socializing cost". - piikummitus

In the nations that I'm thinking of, the private providers are a reaction to poor or failing public providers. I'm no fan of the insurance companies, and I agree that they have created a mess, but we already have government medicine at the state and local levels, which is a bigger mess. Our government refuses to even define who is or isn't a citizen, and eligible for benefits. Do you really think that same government can manage healthcare? - Todd

@todd30 I guess you don't realize we are in different countries, or better say on different continents. And hence our problems are different - US has let it happen, while we didn't yet. Our needs are different. - piikummitus

@A.T. -- I just assumed that you are an American, sine the topic is the U.S. healthcare system. I'm not sure what your position is. - Todd