When the market doesn't provide

In case you missed it, Paul Krugman had a nice, concise explanation of why health care doesn't really function as a market. In brief, most of us don't really need health care until we do, at which point it becomes insanely expensive, more so than more people can afford. As Krugman writes,

This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care.

The whole thing is worth a read. I would also add that the ideal of a competitive market of health insurers pretty much never obtains in reality. In most areas and for most companies, there is really only one health insurer from which to choose (although there may be a choice of plans). It's pretty close to a monopoly situation.