>>Finally, Michael C made a very good point about most insurance being for cover for catastrophe, whereas health insurance is expected to include routine care.

To expand on that - health insurance is expected to cover everything *without regard to cost*
The patients only care about out of pocket costs
Doctors and hospitals are certainly not under daily pressure to contain costs.

Oh, sure, there are rules and schemes in place about cost control.
Just look at how crazy medical bills and insurance payments are.

The rules and schemes are just part of a rigged game.
If there were actual cost pressures on medical care, then every hospital would not look like a marble palace.