This has been repeated so many times that I think people don’t understand just how small the profit margins are for health insurers. Low to middle single digit percentages. As low as 2-3% in recent years, and much lower than the average S&P 500 corporation.
There are also non-profit insurance companies out there. Their rates are not appreciably different, as you’d expect after seeing how low the profit margins are in for-profit insurers.
I also think people don’t realize that countries with nationalized health care also deny procedures, have pre-approval processes, require step therapy, and will not authorize procedures they don’t believe to be medically necessary or to have enough evidence. There is no health care system in the world which will simply approve and pay for every request.
So while health insurer profit margins are convenient bogeyman, if you deleted their profits entirely from the system it wouldn’t move the needle on costs. It also wouldn’t open the floodgates for approving everything, because no health care system will allow unlimited services. The amount of excess and unnecessary care would be astronomically expensive. I do agree that we need a more robust system in place for ensuring that incorrect denials don’t happen, but health insurance profit margins are barely a blip on the overall cost of health care in the United States.
It’s a combination of high prices for services, American’s unusually high utilization of health care services, and very high rates of drug prescribing that mostly contribute to the cost. I think most Americans would be surprised to discover that a lot of nations with nationalized health care would also be restrictive in their access to many services and prescription drugs. For as much as we talk about insurance companies denying claims, Americans still get far more services and prescriptions than most of their counterparts in other countries.