Because it’s not the insurance that’s expensive, it’s the medical care, and rooting out the zillion reasons that’s expensive is difficult and involves attacking

Because it’s not the insurance that’s expensive, it’s the medical care, and rooting out the zillion reasons that’s expensive is difficult and involves attacking some sacred cows. Plus, about a quarter of Americans have “free” care already, via Medicaid and Medicare. Many of the rest have their employer hiding the true cost from them - they think the premium that comes out of their check is the actual cost. Some employers apparently even pay 100% of the premium cost. So all these people are okay with the status quo, or even want to defend it. It’s the people on (increasingly common) high deductible plans, people with no insurance, or people who experience a catastrophic edge case (out of network provider for example) that hate it.