Via the terrific Interfluidity, this very important post. First, let's look at "vanilla products," in this case for financial services:

Vanilla products would be very popular, which is why they are so threatening. Financial services are an area where markets not only fail due to informational problems, but where participants are very aware of that failure. Consumers know they are at a disadvantage when transacting with banks, and do not believe that reputational constraints or internal controls offer sufficient guarantee of fair-dealing. Status quo financial services should be a classic "lemons" problem*, a no-trade equilibrium. Unfortunately, those models of no-trade equilibria don't take into account that people sometimes really need the products they cannot intelligently buy, and so tolerate large rent extractions if they must in order to transact.

Lambert here. The 30 cents of every health care dollar that goes to health insurance companies is one such rent. "Progressives" believe that such "large rent extractions" are painless, and that we should not only tolerate them, but subsidize them for people who cannot pay. Single payer advocates believe that the extraction is not painless, but pernicious, and that we should abolish it entirely. Since health care insurance reform is the administration's signature domestic initiative, most of us have had our attention focused there. If the focus had been financial reform, a similar conflict would no doubt have played out, with the Neo-Broders seeking to ameliorate and preserve rent extraction by banksters, while the left would have sought to abolish it, through proposals like making banks into regulated public utilities, and so forth.