A recent episode of An Arm and a Leg podcast explains this pretty well (https://armandalegshow.com/why-health-insurance-actually-sucks/ https://armandalegshow.c

A recent episode of An Arm and a Leg podcast explains this pretty well (https://armandalegshow.com/why-health-insurance-actually-sucks/ https://armandalegshow.com/why-health-insurance-actually-suc...). In many areas of the US, health networks are effectively local/regional monopolies and can pick and choose which insurance providers they accept. So there is effectively a "single seller" system for services that are in high demand.