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Another important factor here is the amount of reserves that are held back from each $1 of premiums input into the system.

For a single payer system, the idea of reserves is non-sensical (similar to the farce of the 'social security trust fund' which makes zero sense from a macro economic perspective). I would make the point that reserves are a waste product of an insurance based system.

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> Another important factor here is the amount of reserves that are held back from each $1 of premiums input into the system.

You're forgetting that insurance companies invest that money.

There are times when claims payout exceeds the premiums, yet insurance companies still manage to make money because of the investments.

As always, if you think that you can do insurance better, go for it. If you're right, you get rich and drive them out of biz.

I work for an insurance company.

The company makes an operational loss, but it makes a killing in the financial market, and is thus (very) profitable.

Claims don't exceed the premiums, but it's narrow.

You would be wrong - reserves are there to pay for liabilities already incurred. Social Security is basically a Ponzi scheme without the deception. You're right about the "Social Security Trust Fund" - can you imagine a state allowing a private insurer to buy its own bonds as assets?

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