Comment by scottjg

i have no doubt that other countries have some problems in their healthcare systems too, but i think you are downplaying a few key points:

1) united healthcare made 90 billion dollars gross profit in the last 12mo, and that's only one health insurance company. claiming that it's not a great business at a 2-3% profit margin ignores the scale of money involved, and ignores that the customer for health insurance is truly captive.

2) you're right that america has very high prices in healthcare. doesn't it seem bad that private insurance companies are incentivized to make things cost as much as possible so they can skim that 2-3% off the top? insurance companies negotiate and set prices for services and pharmaceuticals. they now own the pharmacy benefit management companies that would normally be incentivized to negotiate for lower prices.

i would expect in a public health care system that rejects procedures, they would follow consistent guidelines and rules. american health insurance companies will arbitrarily reject a percentage of procedures that they know they should be accepting in order to keep their profit margin in the right range.

i think it's hard for me to see the argument that health insurance companies are a net-positive or even net-neutral party in the united states. i don't think it's a coincidence that we have some of the highest prices and some of the worst outcomes.