Health Insurance: Stop The Profits
- Brian
- 5 days ago
- 5 min read
Article Type: Opinion
Disclaimer: This article contains a mixture of facts, supported by 3rd party references, and the constructive opinions of the author. These are meant to be done in a thought-provoking and non-confrontational way. If you disagree, that’s okay, just be kind in your responses.
Opinion
If you turn on any news channel, or read a news article, you'll probably be confronted with at least one story about today's complicated and difficult landscape around health care and health insurance. For many decades this has been a charged topic across the political divide and business world combined. Businesses are faced with complex and costly plans where they must pass on significant costs to their employees. Employees are faced with a challenging network of multiple insurance companies, interactions with health care units, such as hospitals and doctors offices, very often to be left with frustrations, added debts, and unknowns. Good intentions from long ago seem to have evolved into what I can only describe as organized chaos.
More recently, events took a dystopian turn when Luigi Mangione murdered United Health CEO Brian Thompson. His motives ultimately stemmed from a lack of help that the insurance giant could have provided in the way of approving payments.
All of this is why I believe it is time that we all turn health care, and specifically health insurance, on its head and migrate it to . . . non-profits. Yes, I said it. Health Insurance agencies/companies should be legally required to transform into non-profits that are tasked solely with the care and aid of everyone who is insured.
You may be thinking, "shouldn't the government do that?" or "isn't that a step toward socialism?" or "aren't there already government sponsored programs?" or many other things. All are correct, however, remember that the United States has an enormous infrastucture surrounding insurance. Making a slow transformation to a non-profit while allowing those companies to continue to exist may help protect jobs and lessen the immediate impacts versus a total disruption of moving everything to be socialized medicine.
If you, or anyone you know, has ever had to deal with more than just a basic doctor's checkup, you probably can at least appreciate the initial thought.
A Complicated History
Insurance in the United States developed alongside industrialization, initially focusing on property and life insurance rather than health. In the 19th century, medical care was relatively inexpensive and often delivered at home, so Americans relied on mutual aid societies, unions, and fraternal organizations to help cover lost wages during illness. As hospitals modernized in the early 20th century and medical technology advanced, healthcare costs rose, creating demand for insurance that covered medical services rather than income replacement.
Modern health insurance emerged during the Great Depression with the creation of prepaid hospital plans that became Blue Cross, followed by physician-focused Blue Shield plans. These nonprofit models stabilized hospitals and made costs more predictable for patients. World War II then permanently reshaped the system: wage controls pushed employers to offer health insurance as a benefit, and favorable tax treatment entrenched employer-sponsored coverage as the dominant way Americans received health insurance.
Government involvement expanded in the 1960s with Medicare and Medicaid, extending coverage to seniors and low-income populations while stopping short of universal healthcare. Since then, rising costs and system complexity have driven continual reform efforts, from managed care to the Affordable Care Act of 2010. The result is a uniquely American health insurance system—built incrementally, shaped by economic and political compromises, and defined by a mix of private coverage and public programs.
A More Complex Today
Even with the Affordable Care Act in place in conjunction with Medicare and Medicaid, navigating a complex web of insurance companies, varying plans, and networks is frustrating and time-consuming.
Health insurance in the United States has become a costly and confusing landscape for millions of Americans. Over the past decade, premiums, deductibles, and out-of-pocket costs have climbed faster than worker wages, squeezing both employees and employers. Many employers now shift more of the financial burden to their workers, cutting benefits or freezing employer contributions to keep overall labor costs down. This trend leaves employees facing steep monthly premiums and high deductibles before meaningful coverage begins, contributing to medical debt and deferred care for those trying to balance healthcare with rent, food, and other essentials.
For self-employed individuals and small business owners, the situation is even more challenging. Without the leverage of large employer groups, they often encounter higher premiums and fewer plan options, with limited ability to negotiate or spread risk across thousands of employees. Subsidies help some who purchase coverage through the Affordable Care Act (ACA) marketplaces, but many middle-income people fall into a gap where available plans remain unaffordable, especially as marketplace premiums jump significantly for 2026 in many states. This dynamic leaves freelancers, gig workers, and small-company employees wrestling with a difficult choice: pay high costs for coverage or risk being uninsured and vulnerable to catastrophic medical bills.
Another glaring complexity is the stark difference in what the uninsured pay compared with insured patients and insurance companies. Uninsured individuals are often billed at “list price” rates for medical services — rates that can be many times the actual cost — because they lack negotiated contracts insurers use to discount care. Meanwhile, even those with insurance may face claim denials, burdensome prior authorization hurdles, and surprise bills, making it difficult to get needed care covered despite having a policy. This situation undermines the promise of insurance and can leave people scrambling to appeal coverage decisions at the very moment they need care most.
Amid these stresses on families and individuals, the financial performance of health insurers has drawn scrutiny. In 2024, the seven largest publicly traded U.S. health insurance companies collectively reported record profits of about $71.3 billion, highlighting a disconnect between industry financial success and widespread public frustration over costs and access to care. Critics argue that insurers’ abilities to raise premiums and manage costs sit alongside delays and denials of care, intensifying strain on patients and providers.
At the same time, many hospitals are struggling financially. Rising operational costs, inadequate reimbursements from Medicare and Medicaid, and shifting care patterns have put persistent pressure on hospital budgets — particularly for smaller and rural facilities. Some hospitals face narrow margins or losses even as they serve growing numbers of complex and low-income patients. This financial squeeze contrasts sharply with headlines about insurance industry profits and raises broader questions about how the U.S. healthcare system distributes financial risk and rewards among payers, providers, and patients.
Let's Simplify Without Total Disruption
I believe that if we transformed the landscape of insurance companies in the United States to be non-profits it would be less disruptive than creating a full socialized medical system like is available in Europe and other places. A second step down the road could then be to transform to socialized medicine by utilizing what works in other countries, what works in the United States, and merging them to create the best system in the world.
In addition, if we transform these companies into non-profit organizations, we can also simultaneously lower costs by eliminating not only those profits but also by limiting executive compensation. A law could easily be passed to ensure that no person at any health insurance company can make more than $1MM/year all-in (base + bonus).
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