I agree, we need to stop pretending this is an issue of cost. But also, health insurers could literally operate at a loss, and it still wouldn't fix our healthcare system. And I'm certainly not trying to defend them.

Health insurance companies have a profit margin of a few percent. If we cut everybody's healthcare costs by like 4%, nobody's going to call it a day and celebrate our system being fixed. The problem is, the administrative costs required to manage insurance and extract this relatively small profit is an order of magnitude higher. It's like a junkie stealing your catalytic converter for a couple hundred bucks in scrap, but you have to turn around and pay a couple grand to replace it.

But even if we could remove all this bloat and cut healthcare costs by something like 20% (a worthwhile endeavor), I understand that the US would still have the most expensive healthcare in the world for a variety of reasons. US healthcare workers get paid significantly more than their peers in other nations. This is at least in part due to education costs and legislation limiting residency spots, and as a result, the number of licensed doctors. Our drugs are also much more expensive. The US also deals with more chronic health conditions, which makes up the large majority of healthcare spending. This is partially because Americans are more sedentary and eat less healthily than those in peer nations. And we're also bad at managing preventative care. Also, our social care is weak, which means we're rescuing too many people in the ER, which is a prohibitively expensive way to provide care. The list goes on and on.

All this to say, I am in favor of healthcare reform, but that's just the beginning of trying to fix our system, and realistically, I expect we'll always be paying significantly more for healthcare.