b) As a consumer of food, the leverage a consumer has isn’t in the form of price negotiation, but there is leverage on the side of the consumer earlier in the process, at the price-setting stage. This leverage is in the form of competition. Food suppliers know there are a virtually infinite amount of other options that a consumer can choose to meet his or her need. There’s heavy compeition even for niche or luxury foods. The marketplace itself offers some level of leverage to the consumer when it comes to everyday consumer activities. That’s not the case with health insurance.

Yes, you are – and you are at the same competitive disadvantage. Which is why professional associations and groups like the NARP can offer their members various types of insurance at lower rates than you could get as an individual: because through them you are getting a group rate.

one needs food more quickly than any restaurant or grocery store needs to sell you a policy

Since they’re not selling you insurance, I have no idea what that means. But if you’re suggesting you can negotiate a price with your local eatery or grocery, good luck to you.

Oh, and if you’re suggesting your leverage consists of being able to say “I’m going somewhere else,” that’s true – but you can do it because you have more than ample information (and time and opportunity) to comparison shop, something that is almost impossible in the case of insurance, particularly health insurance.

No. The biggest difference is that you have no buying power. You are an individual with no way to spread the risk you represent, and therefor, to be profitable on you, the insurance companies need to charge you more. More, since you need health insurance more quickly than they need to sell you a policy, you have absolutely no leverage at in the transaction.

Most, if not all, private health insurance is provided as a benefit by employers. What this effectively does is separate the purchasing agent from the end consumer. Meaning, the entity buying the insurance is concerned with completely different things than the person using the insurance. Don’t like your coverage? You can’t shop around for different insurers. You’re limited to what your employer has chosen.

Why can’t you just opt out of your employer’s plan and shop around yourself? The biggest problem with that is the difference between before- and after-tax dollars. Which makes individual coverage substantially more expensive.

Short answer?: Supply and demand doesn’t work very well when there are multiple intermediate entities between supplier and consumer.

If you wanted a market approach to health care, some of Bush’s proposal’s from early in his second term were a step in the right direction. Those proposals were also essentially DOA. The current Republican stance of “All is well!” is pretty idiotic.

Then there’s the matter of risk analysis. Other types of insurance are generally insuring things far less complex and far easier to analyze than human health.

Or, as Krugman noted this week, healthcare is not a bowl of cherries.