> The profits may be capped but US healthcare is still insanely expensive compared to other first world nations. Number 1: It's not the profits that are capped

> The profits may be capped but US healthcare is still insanely expensive compared to other first world nations. Number 1: It's not the profits that are capped. Profits plus operating expenses are capped. Operating expenses (like paying folks in the call center to answer questions about coverage, adjudicating claims, etc.) come out of the insurance company's 15/20% (national/regional). If medical claims are less than 75/80% of premiums, the insurer is legally obligated to issue rebates. If the cost of administering the plan is more than 15/20%... too bad, so sad: the insurance company is legally obligated to loose money and (eventually, if they don't fix it) go bankrupt. Number 2: I never said that it wasn't more expensive in the US. Just that health insurance companies are not the reason it is so (which was the reason you cited for the US's high healthcare costs). Mathematically, even if you assume it's entirely graft and profit (and it's not--processing claims is not free), the very best you can do is a 20% reduction in costs. What accounts for the rest? Bear in mind that medical doctors in the USA earn as much as FAANG engineers. The average doctor salary across all specialties in the USA is $300k. Many earn 2x that. By way of comparison, it is unusual for a doctor in the UK to earn even as much as $200k, and the average is around $100k. Unless the UK is somehow finding people who will pay money to the NHS in exchange for the honor of answering phones and administering claims, I find it difficult to believe that health insurers are anywhere close to the biggest driver of healthcare costs in the US.