re: All things considered, why is the Federal government involved at all in health insurance ?

Because the Democrat party has always been after more power and control of your life. They've been after healthcare for a while, and given the opportunity, they rammed it through without any consideration. As usual, the ends justify the means for "progressives." They always claim it is to help the poor and afflicted and for the betterment of society as a whole, but they know that is complete bullshite. It's the same con ruthless dictators and oligarchies has been running for centuries.