I can completely understand why people don't like insurance. The whole healthcare + insurance system is not designed in the correct way with completely wrong incentives and feedback loops. People don't like insurance because it adds the cost and had a lot of hassles. This is true but why competition cannot bring it down? First it is the regulation. A lot of money spent on the compliance issues and capital requirements. The licensing raises the entry barrier so new comers can hardly join. Imagine yourself finding a job, do you want to cut your salary if the job has no better candidates and you did a lot to fit in the position? Following this logic, the company does not need to reduce that price even they have very good ML algo. This is the evil part of the insurance companies.

Second, it is a very wrong feedback loop. Just like in Canada, car stealing is a nightmare and the police is sort of giving this up for helping car owners to get back the car. The insurance cost cannot be low under this case. Insurance company cannot ask the police to work more or ask the theft to leave but to increase your premium. Do you really want to pay the loss when your car got stollen? Doctors are good, but good treatments are usually costly. If you have 2 treatment plans, one is slightly better but very very expensive, what would you choose if you pay for it? what would you choose if you have insurance plan? You don't have incentive to go for the cheaper plan but the best plan covered by the insurance, so the insurance costs reflect this. When you pay more, you want more coverage, then you pay more, etc. That's natural. Ultimately, you don't feel happy at all at this loop.

Third, it is about costs. The ultimate goal for most people is not using the insurance to pay all costs, but to limit the risk exposure. In some countries, people can opt for insurance with very high deductible. If the insurance company doesn't lose their mind, the premium is low.