Useless comparisons, for the most part. The markets and competitive landscapes are different than the insurance industry in general and health insurance in particular.
Exactly why I used them. The problem with the statement you made earlier, a statement made by
many people, is a blanket "costs are too high" has absolutely no frame of reference.
Let's face it, the arguments usually start with "the insurers are making money hand over fist and still raising rates". That always gets disproven. The argument then moves on to "Costs are too high". That then begs the question "Too high compared to what?"
Compare health insurers to other insurers. Costs are higher than life companies and lower than P&C companies. Boom, that's your only valid comparison.
Compare them to B of A? Health insurers are the model of efficiency. Compare them to Amazon, they're terribly inefficient. Unfortunately, many people say "Costs are too high" while looking at other industries. Well, that's subjective based on which industry you choose.
What about Medicare/Medicaid, which is so often used? Well, apart from the fact that the "2% cost" has pretty much been disproved over the years, you also face the fact that Medicare/Medicaid is about as similar to health insurance as Ford or Amazon are.
In reality non-mutual insurers are in the game to make a profit. Some do, some don't. May of the ones that do make a profit do so on the strength of their investments and not on their underwriting results. Premiums/revenues continually increase but so do claims/benefits expenses. The absolute easiest place for an insurer to scrape out additional margins is in G&A expense. Yet somehow the industry continually lands at 15-20% expense ratio while the government (notorious for its vast inefficiencies) somehow manages to be a full order of magnitude better? I don't buy that for one second.
Health care in the US is broken, plain and simple. The quality of care received here is the global leader but so is the cost. These two items do go hand-in-hand. So long as Americans demand the
absolute best in medical care, medical providers will charge out the nose for it. At the same time Americans are constantly mandating that insurers, a not high margin industry, bear more and more of the cost for decreasingly lower (proportionally) premiums. What really needs to change here is Americans need to decide if they want the planet's best medical service and are willing to pay for it or if they want affordable day-to-day health care costs, because we can't have both.
Edited: I just re-read a couple other posts you made and the original admin costs post. I think I read the admin cost post as "Costs are too high. What can insurers do to reduce them?" when what you meant was "Costs are too high. What can be done by society to reduce them?". I agree that tort reform would lower costs some. What exactly do you mean by inter-state availability? I can't really comment on that until I know what you mean. I think the rest of what I said above, that admin costs are not exorbitant and whatnot, still applies but I do better understand the point you were initially trying to make.
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