Health insurance companies have become useless bureaucracies set up to complicate a transaction. They are not competing with each other on price or service. They don't have to. They have the country carved up into regions, and there's usually only one or two options available per region.
Doctor's offices have to hire people to interface with the insurance agencies. Their entire job is to persistently hound the insurance companies to get them to pay off claims. An inefficiency (overly restrictive acceptance criteria for claims) gets turned into a job.
And on the other side, there are people who work for insurance agencies whose jobs it is to find ways to avoid paying for claims.
And then health care providers negotiate privately with these agencies to charge absurd fees for things. Seen an ER visit bill lately?
So the prices we pay for insurance go up, but there's nowhere else for us to go; it's expensive-ass insurance or be uninsured.
Conservatives think that the free market will fix the health care cost-benefits problem. And it might, in a way that I can't currently imagine. But the current system, with medical prices rising every year because of the lack of competition, is simply a drain on our economy.
Insurance is an easy thing to provide when you're providing it for lots and lots of people. You simply observe the average amount of money people pay for health care in a free market, and charge slightly above that. You're guaranteed (to a 99.99% level) to make nearly the exact profit you set out to make. Law of large numbers, right?
But you can be undercut by someone else who's willing to make less of a profit. So you differentiate yourself. You think, why not just own a bunch of good doctors? Then we could have our patients go to doctors we choose who set rates we decide. Those rates will be lower, so we can charge less.
Now the insurance companies own the doctors and people have to effectively choose which company's doctors they want to use. But they don't really get to choose, because in the meantime congress made it so companies can give health insurance as a non-taxed benefit, so people get whatever insurance the company they work for has. So now you've got a market where the consumer has absolutely no say in where the product he has comes from.
There is no consumer benefit to the health insurance company system. There are massive drawbacks. There is no meaningful competition. Most regions are monopolies.
But insurance is necessary for health care. It is unreasonable to ask people to save enough money to cover an expensive medical procedure. And it is unreasonable to ask people to not require expensive medical procedures. Insurance is a good thing when properly used. It is a tool to allow people to pool risk, so the occasional devastating disaster can be averted. This benefits everyone; can you really say that it's a good thing that someone goes bankrupt because they had a treatable medical condition?
So we need some form of insurance. The only thing is, I don't see how the free market can provide this insurance without denying agency to the true free-market participants in healthcare: the patients and the doctors. The free market simply doesn't work for necessary insurance for an inelastic good.
With that in mind, I've reluctantly concluded that the best solution is single-payer healthcare. I don't trust the government to do it well. I think it may lead to less innovation. But honestly I don't see how they could make the on-the-ground medical situation for most of the US population worse than it is now: fearful that you'll get some injury or disease because it will bankrupt you.
