Insurance is something that you pay for because, in theory, it protects you against greater losses.  In other words, the product insurance companies offer that is theoretically worth their profits is insurance against financial calamity.  Given the number of people who buy healthcare insurance and still end up in bankruptcy over healthcare costs, it's pretty clear that the insurance is more or less worthless since it does not insure you from bankruptcy (which is the entire point of insurance).  Then there is the stupidity of tying your insurance to your job.  As James Kwak pointed out at Baseline Scenario, most people do not actually have health insurance, even those who think they do because they pay a company for it.

So why pay a company to provide you with a worthless service that will only last as long as your job lasts when you can ban together with your fellow citizens and get it cheaper from your government (also freeing up the capital wasted on health insurance parasites to go to more economically important activities, like say building businesses in your community instead of continuing to pay to outsource call centers to Asia)?  

Things began to change after the introduction of federally supported "managed care" in the early 70s. Managed care made it possible for insurers to profit from the DENIAL of care -- and that invited, for the first time, the interest and participation of both for-profit insurers and the financial markets. Gradually, health insurance become almost entirely for profit (and the tax laws changed too). Now this huge for profit industry, that wouldn't exist without the HMO act of 1973, is so financially and politically powerful that it is dictating the terms for all future government "reform" of the system.

Ironic, isn't it?

Again, what value do they add? Medicare pays for care with vastly lower overhead. What does the 30 percent give patients?

I've long felt the administration has done a poor job explaining that its health-care bill is an incremental, centrist compromise that resembles nothing so much as the Republican health-care bills proposed in the 1990s.

Ezra:

But the fact of it is that this bill represents an enormous leftward shift for American social policy.

I spent 2008 enlightening Republican women that their birth control pills were now considered an abortifactent(and you'd be amazed a how many didn't know). Since I didn't have to canvas for Obama and all and I had decided that I would not activiely oppose him. I will have no problem in 2010 enlightening Democratic women as the depth of the Democrats betrayal on their reproductive choice.

While the Democrats and Republicans play games I look at the end sum game. I will not care that you passed a health care bill unless that bills value exceeds its negatives(hint: we won't qualify for the exchanges, we barely miss the excise tax, and we are a 2 female household which means paying more for our services(even though I know that my daughter will likely earn less than my sons). Short of the fact my soon to be 18 year old will get an additional 7 years of coverage and I will never need to worry that the fact that a derm saw a mole on my daughter she thought warranted consideration will never mean she never has to worry that she will outright be denied-you notice I didn't say the bill meant she'd get affordable care- the takeaway is more bad then good. That doesn't bode well for your side. Particularly since I will NOT be saying this time I around I will sit on the sideline and let others weigh things.