If only there was a way to have just one of those insurance companies, maybe run as a government agency of sorts... Wait, I got one of those where I live, it's called the Ontario Health Insurance Plan. It is not amazing but it easily clears the extremely low bar of being better than the US health insurance setup.

Over in Manitoba they've got one of those for car insurance too. Amazingly, people continue driving there just the same, the government insurance plan never needs subsidies and Manitobans pay way less for insurance. Almost as if the concept of the free market being the best solution for market X needs to be tested once in a while just to be sure, and results may be surprising.

It's possible for really motivated individuals to run a government department well, if you have people of excellent character, work ethic and comp tence doing so, but there's not a load of incentive for them to be run well outside of that unlikely combination.

Well, while we're on the topic of insinuations that totally don't give away underlying biases, it's possible for really ethical individuals to run a number of competing corporations well, though there's not a load of incentive for them to steer clear of regulatory capture, cartel-like collusion and various other forms of customer-screwing behaviour.

The larger point being: there are many areas of the economy in which the free market approach is clearly better, and there are many other areas of the economy in which the free market approach is clearly deficient and a government-run agency is superior. Insurance is in neither of these convenient buckets. "Unlikely" is an opinion on a hypothetical; it is not necessary when real-world examples abound.

Any market is shaped by policy. It can be argued that the US health insurance market is not really free in significant ways and set up such that the net result is the mess we see. A government-run institution performing better than the private market is not necessarily a sign that the institution is good, it might just mean that the market is set up in a deficient way.

I mean, last time I looked, social security in France gave back 81€ for every 100€ invested. Swisslife (it was either 2018 or 2019) gave back the same year 67€ for every 100€. What's funny is that only 11€ went to shareholders that year, that mean that even w/o capitalists, sometimes public services are more efficient than private companies.

As I said a few comments above, it's possible for things to be run efficiently; there's just less of an incentive to do so.

In terms of this exact comparison - is this like for like? I don't understand it well enough to know.

I'm not insinuating anything; I'm just saying it. What do you think I was insinuating?

Too bad Manitoba guillotined its public telecom. How's Bhell treating you these days?

The risk pooling isn't the problem, its not why the industry is an unproductive leech on our society. The insane amounts of waste and bureaucracy it produces, and the price inflation it facilitates is.

(Not to mention suboptimal health outcomes arising from the perverse incentives it creates.)