Last week I responded to an argument that we ought to open Medicare to all and let it compete with the private sector health insurance. One of my responses was that since the government gets to run Medicare and regulate private health insurance, it was a bit like letting a referee both officiate and play in a game.
You can get a good glimpse of this by looking at Medicare Part C, which was supposed to let private insurance companies offer health savings account-type policies to seniors (called medical savings accounts (MSAs) under Medicare). However, Part C was weighed down by so many regulations that virtually no private insurance plans bothered.
Apparently the Centers for Medicare and Medicaid Services (CMS) decided to revamp the application process. Under "Downloads" on the CMS website, there are nine different links for "useful information" and memos before you get to the applications.