There are economic reasons why size matters. For example, Singapore is small enough that you can get to any hospital from anywhere. In many areas of the US, t

There are economic reasons why size matters. For example, Singapore is small enough that you can get to any hospital from anywhere. In many areas of the US, there are fewer accessible healthcare providers. (For example, less dense regions, or urban areas in which all the competing hospitals have merged.) Perhaps this doesn't matter if you want to set broad price controls or nationalize the entire industry. But under Obamacare, it has made insurers' lives more difficult.