I also note for the record that much of my own context on the discussion arises from observation of my father's professional career. He spent virtually his entire working life in the nonprofit health insurance field, beginning in the 1950s as a claims clerk for a smaller Blue Shield plan. By the time he retired in the 1990s, the company had become a great deal larger, and his final big project as a senior executive and general counsel was coordinating its evolution into a group of affiliated Blue Cross & Blue Shield plans covering most of four western states. As you might expect, I am therefore easily irritated by those who rail indiscriminately against Evil Insurance Companies; by the standards of many such commentators, I am obviously the Spawn of Evil and thus irredeemably tainted.
However, as e_moon60 points out in an excellent recent post, the foregoing is not itself a point of civil discourse; it's an emotional response. And as it happens, a different post from kateelliott crystallizes for me what one of the key issues actually is.
It's this: people can tell you without too much difficulty what they've spent on health insurance and/or medical care in a given year, and frame that figure as a dollar amount (call it $xxx for simplicity's sake, recognizing that there are often more digits than that in the real figure). But in order to accurately frame the the economic context, we need a second number. We need to know $yyy, where $yyy is the value of the resources received for that expenditure.
( This leads to two distinct levels of complication. )