How exactly would you like the federal government to "open up" this almost unregulated industry? The feds didn't set up those monopolies anymore than any other in history: Private insurance companies did it in what may not be called collusion but definitely is. And, yes, when you have regional monopolies with gentlemens agreements not to poach each others cash cows, introducing ANY competition is more competitive, by definition. Again, that's why the insurance lobbies that manipulated so much of this bill tried to insert an amendment that would guarantee they continued to use Palins "death panels" as they have for decades, because it holds down their costs, but prevent any federal program from doing the same. Why does private insurance care whether a system in which they're not involved limits costs or not? Maybe because they don't think they can compete with it...?

And, yes, the DEMOCRATIC solution to a problem is always to let the voters run it rather than a private institution, and yes, that's socialism. The only questions are 1) do you believe in democracy and 2) can it be done without trampling inviolable civil rights? The answer to the latter question is "yes" but the answer to the other you'll have to decide for yourself.