As someone else here noted, someone probably has to connect patients with health care providers. The huge problem comes when that administration is done as a for-profit business that must, by the very nature of the thing, somehow extract billions of dollars from the process.

Sure, they could make things "profitable" by encouraging efficiency, but that only goes so far, and nothing is ever far enough when it comes to corporate profits.

So the profit ultimately comes by reducing care to patients, and compensation to providers. The whole framework of reimbursement for discrete services is not a health care model, but rather a way to pin down costs in rigid ways that can then be chiseled away, inevitably again by reducing care and provider payments.

None of the touted benefits of free enterprise apply in a system like this. There is no real competition, because people can't really "shop" for health insurance; even under the ACA, they mostly take what their employer gives them, period. And there are so few insurance providers to begin with that they can easily prevent any kind of superior way of doing business from emerging.

It's not even really "insurance." Insurance is a pooled distribution of risk, like the risk of car accidents or fire. Health care problems happen to everyone -- more so to some people, like the elderly -- but ultimately health problems aren't a "risk;" they're an inevitable cost of staying alive for literally everyone.

What we've got is a forced brokerage system, where a multi-billion-dollar industry dictates how health care works on both the patient and the provider sides to ensure it gets richer every year. Their "customers" will never walk away, because (haha) they can't.

No one has to twist their mustache for evil to happen. All it requires is the ungoverned application of normal human greed and short-sightedness, and the unwillingness of enough people to do something about it.