You prefer your "for profit" HMO deciding what kind of health care you receive?
Bob show me where the Constitution "vaguely hints" at what type of road you should have, what type of fire dept we should have?
For profit means you have to be efficient to survive the competition. Of course, the competition was eliminated in 1966.
Before Medicare you could pay for your doctor's visit out of pocket.
Roads, fire depts., etc. fall under States Rights, but of course if you need funds from the feds for your road, some bureaucrat in DC decides how that road will be designed.