Because insurance companies are fighting at both ends. If their payments are too low, their network providers will stop taking that insurance plan or company an

Because insurance companies are fighting at both ends. If their payments are too low, their network providers will stop taking that insurance plan or company and then they lose customers for lack of network reach. Also, well-intentioned overhead limit regulations to spend at least 80% of funds on care, creates a countervailing accounting pressure to increase costs so that administrative spending can be higher - flowing more money to the insurance company. I actually agree w/ overhead limits, but you also need other efficiency metrics to keep the anti-optimization in check. Or, personally I think we should go to some form of universal healthcare and wipe out private health insurance as it's currently constituted.