Feel free to crosspost to !AskUSA@discuss.online

There are some alternatives that are usually affiliated with a religion. CHM is one such organization. Members all pay a recurring fee like they do with insurance, and all have access to the pool for their healthcare.
I have never used one so I cant speak to the efficacy, but it seems to answer your question.

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.

Health insurance at its core is very simple. … But in the USA…

I wrote this lengthy post a few months ago about why the American health insurance system is not efficient in comparison to the auto insurance system:

So to answer your question directly, the costs for healthcare in the USA continue to spiral so far out of control that it causes distortions in the health insurance market, to everyone’s detriment. Specific issues such as open-enrollment periods, employer subsidies, and incomprehensible coverage levels all stem from – and are attempts to reduce – costs.

The auto industry has examples of “mutual insurance” companies, where the company at-large is partly or wholly owned by the policyholders (eg State Farm, Amica, Liberty Mutual USA). And that mostly achieves the objectives you’ve described for a non-profit automobile insurance pool. Sadly, this just doesn’t work in the USA for health insurance, for the aforementioned bottom-line reason.

Hospitals and doctors go through intense negotiations with insurers to come to an agreement on reimbursement rates, but the reality is that neither has sufficient actuarial data to price based on what can be borne by the market. So they just pass their costs on, whatever those may be, and insurers either accept it into their calculations, or drop the provider.

When prices for service are opaque, how can any insurance company – even the most benevolent – properly price their policies? To stay in business would require always overestimating than underestimating. The extra revenue becomes either profit or float. But this float can’t even be beneficially used or paid out, in case the next quarter has more expensive claims to pay. Which brings us full circle to opaque pricing.

In this environment, the only remaining prudent thing for a benevolent health insurance company to do is to hold huge reserves. But that is not competitive against profit-seeking insurance companies that can undercut the benevolent company, who had tied one hand behind their back. Benevolent companies rarely survive.

Because it’s not a fair market. Health insurance is a cartel market.

Let’s say you break your ankle - maybe a reasonable cost for resetting the bone would be 240$ - the hospital will set a list price somewhere like 1300$ for the operation and then Anthem/UHC/whatever will send a rep out to be like “Hey, what if, when it’s one of our people, you only charged 300$” suddenly the rep gets a bonus for getting a “good deal” the insured patient is happy to pay well below “market” price and the hospital might get a small kick back for being so generous.

In this scenario most people only ever feel the 300$ price - but uninsured people or people out of network get absolutely fucked.

Since the current system entrenches all the existing players none of the participants (except the patients who usually don’t even get to choose their insurer) want to change anything.