Private health insurance in a country that has a robust public option is an entirely different thing because that baseline level of care means that the private

Private health insurance in a country that has a robust public option is an entirely different thing because that baseline level of care means that the private providers have to offer something substantial above and beyond the baseline to justify their continued existence. People with medical needs can choose to tell them all where to stick it and still live without going in to debt. Most insured individuals in America don't choose their health insurance provider, they just get it from their employer where they might have a choice of plans. The closest thing to an actual competitive insurance market we have is that provided by the ACA, and though that act did many good things the disappointment of the marketplace has been well documented.