Health insurance is a mis-nomer. Fire insurance is “insurance”, health care is not. In your neighborhood, most have fire insurance, and few if any will actually place a claim for a fire – this is the definition of insurance.
Health care is “access”. Almost everyone in a healthcare pool will require some “health care” during the premium period. The penality for not having access is rates 50% to 100% higher for direct pay medical care.
The expense is coming from huge amounts of embedded capital costs, the interest on those capital expenditures, and profit on those assets. Finance, Insurance and Real Estate (FIRE) is the real driver of medical “Access” cost.
The access provider borrows from its huge cash flows to buy equipment and buildings from its non-regulated subsidiary, pays interest to the non-regulated sub, and we get stuck with double the “cost”. The bankers are robbing us in a more creative way.
A non-profit hospital does not mean that no one makes money, only that the expenses equal the huge amounts of revenue. The more capital, the more non-profit!