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

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Some of the Republicans don't want to for political and personal reasons. That is true. However, the Democrats knew it would be nearly impossible to repeal and forced it on us all for ideological reasons.

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They didn't go nearly far enough, quite frankly. There are only two ways to reduce costs -- single payer or globally free market. Both would create leverage over costs.

What we had before Obamacare wasn't a free market at all, but rather a state-by-state oligarchy. In a free market, I'd be able to get pharmaceuticals from Canada, dental surgery from Mexico, all covered by an insurance company in India. What we had before was nothing less than a state-by-state oligarchy that limited competition among several health insurance providers.

Obamacare is screwed up, its true. But ideological? No. Obamacare was a detente -- a mutual agreement between insurance companies (who traded additional risk for additional revenue) and the federal government (which erroneously believed it had the political will to reform the system).