If we end up having a government insurance plan, somebody has to mind the shop, and even if not, the states are having a terrible time anyway with the big monster, even though some think it is working, well ask any citizen or physician what they think, and you might get a different answer.
If for no other reason, companies need to try to operate closer to the same standards in each state, which now varies quite a bit. BD 
WASHINGTON (AP) — President Barack Obama's congressional allies want to create a powerful insurance commissioner to oversee medical plans nationwide. State regulators say it would duplicate what they do without better protecting consumers. Conservatives bemoan the big government mentality.
The issue could flare as lawmakers push to meet an ambitious schedule for votes on health care legislation before their August vacation.
Like the notion of a government insurance plan to compete with private companies, designating a single official appointed by the president to oversee the market goes to the heart of the federal role.
When adding those two to the mix, five federal agencies would be involved with health insurance regulation, joining the departments of Health and Human Services, Labor and the Treasury.
Proponents of having a federal commissioner say a national health insurance purchasing pool needs a regulator at the federal level. "If we're going to have a national insurance exchange, you can't have it run by 50 regulators in the states," said Vaughan.
The Associated Press: Need for federal insurance czar is questioned
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