Insurance company profits are already capped by law. I don’t think your ideal insurance company can possibly be that much better for the customer than the already-available options are.

The companies must spend at least 80 cents of every dollar they collect in premiums from small businesses and individuals on health care, and 85 cents per dollar for large employers. The remaining 15 to 20 percent is all they are allowed under the Affordable Care Act to spend on administrative costs like overhead and marketing and to keep as profit. Any additional revenues are to be returned to consumers in the form of rebates.

Note that the remaining 15 to 20 percent has to cover all the costs of actually running the company. It isn’t just profit.

Furthermore, insurance companies do have to compete with each other on price. Denying a lot of claims helps them offer cheaper policies. Employers who provide insurance want the cheapest policy that their employees will tolerate and healthy people want the cheapest policy that they expect to protect them from sudden, catastrophic expenses. (I’m relatively young and healthy and I have never even seriously considered picking a policy other than the cheapest one whenever I had a choice.)

In this context, if your business plan is to spend more money per customer than the existing insurance companies do, and your target market is people unhappy with their current insurance companies (these people probably have expensive problems) then you’re not going to do too well…

Obama tried and the entire Republican party started talking about gulags

A public system specifically would mean it’s run by the government. So that would need to be created by the government. Which means you’d need all relevant voting systems to vote in favour of it, which isn’t likely… especially given the last presidential election.

I imagine the biggest challenge of creating a non-profit health insurance thing is one of two things.

Firstly, anyone who has that much money would probably rather open a charity.

Secondly, people actually DO commit fraudulent claims, or try to claim things that they don’t need or that the health insurance company decided that they won’t cover. If the company doesn’t try to filter these out, it’d be losing more money than it expected to…and it’d go out of business.

Another factor is that being in the insurance business is already a losing model if you want to do good in the world. Hospitals will charge jacked up rates because they don’t have to worry about what a person can pay. They try to extract as much as they can out of the big insurance corporation, since the patient doesn’t care what the insurance company has to pay. So this non-profit insurance company would be paying as much as any other insurance company, more than any patient would be paying, and so it’d be losing money even just paying out all of its valid and covered claims, let alone the fake and unnecessary ones.

So, maybe you want to partner with the hospitals because, why should you pay as much as the evil companies, right?

Well, that sounds great from a consumer sense. But from a business perspective, that’d be suicide for the hospital – why would any other insurance company do business with that hospital if they’re giving one company discounts unfairly?

Or…maybe they do give discounts. But then they make less money and can’t pay the doctors as much (who can leave for work elsewhere), or buy the newest equipment, etc.

But if they do want to give discounts and just charge the company what things actually cost…at that point, you might as well be a charity.

And even then, you still need to budget for validating the claims that come in, because how do you choose who gets covered, and within that group, who gets priority?

American capitalists are really, really good at cracking down on any civil attempt at unionising and/or improving society at the cost of the ultra rich.

You could recite the extensive history of violence, but honestly the greatest achievement is in the propaganda. Solidarity seems to be commonly understood - by all classes - as having to take the bill for somebody even poorer than yourself, and nobody seems to be comfortable with the idea that they might themselves one day benefit.

Americans can’t have good things before they start fighting back. Read up on union history. Organize. Educate. Teach people what solidarity is and what the Battle of Blair Mountain was. Learn what was taken away from you, and help others understand as well. Begin locally.

Either that, or keep watching the fascists take over day by day, as they have been doing for decades.

It’s incredibly simple. Complacency. Greed takes root, nobody cares enough, and greed takes further and further root. The US has constructed its society into one where it is entirely normalised for someone to see a homeless person, and say “they earned it”.

Healthcare–and, by extension, everything else–will only change, when the people work to make that change. Simple as. As of now, corporations make change instead. Perhaps, what’s transpiring proves a turning point, but I’m not willing to believe that yet.