Squashed:

The biggest hurdle to high quality, low-cost healthcare should be a familiar one to web developers.

…or someone with slightly more than a high-school level knowledge of economics. For further reading (all are wikipedia links):

1. Economies of Scale

2. Returns to Scale

3. Diminishing Returns

4. Diseconomies of Scale

It’s that last topic that is often ignored in High School, yet has several subsections that apply. They also apply quite equally to the current system.

Regarding the post: I’m not really sure I’d call the existing insurance industry “dinosaurs,” as health insurance is almost entirely a 20th century invention. The companies in the industry are, however, large, lumbering, and inefficient, so it’s not really worth starting a metaphor debate. There’s a difference between deserving to go extinct and actual extinction. My opposition to various government health insurance proposals should never be taken as an endorsement of the current system, which has largely resulted from regulatory protection of special interests that are absolutely not in line with the common good (and the unintended consequences of other, well-intentioned regulations). I’m also not sure myself whether a scalpel or sledge hammer should be used, though there are reasons not to use a sledge hammer right now. Also, I am trying to stay out of the health insurance debate because I don’t want people to throw rocks at me.

I just re-read the top of this post and feel like I must make the claim that this isn’t intended as a dig against Squashed (nor do I think he’d take it that way, but others might, and I do try to be civil). I think Squashed actually gave a decent summary of the cumulative information in the above links, I just think it’s worth looking at the information in a more abstract context as well.