Healthcare activist Donna Smith of the California Nurses Association asks in a recent essay: of what value is private health insurance? The answer is, none. Private insurance by itself doesn’t provide the medical care. It certainly doesn’t make our care cheaper. It turns something valuable – our health – into a commodity. It’s simply a racket.

And yet we keep the idea of private health insurance around, despite the fact that the insurance companies keep ripping us off. Just last week, the California Department of Managed Care fined seven of the state’s largest insurers $5 million for not paying doctors and hospitals fairly. The companies included the usual suspects in corporate healthcare malfeasance: Anthem Blue Cross, Blue Shield, United/PacifiCare, Kaiser, HealthNet, Cigna and Aetna.

Meanwhile, California employers have seen costs for health insurance increase almost by half over the last six years. For the majority of Californians who get their insurance through their job, that means taking on more of the financial burden by forgoing higher wages, or seeing their employers drop their coverage altogether. Workers continue to pay more for less coverage.

So why as a society do we allow this product to exist when it doesn’t give us much of anything in return?