You're spot on, but it's even worse than that - since these pools are administered/owned by private companies, their incentive is to collect money from people w

You're spot on, but it's even worse than that - since these pools are administered/owned by private companies, their incentive is to collect money from people while they're young and healthy, only to push them out once they're no longer young and healthy! I'd say that any sensible reform must intrinsically be based on some combination of a whole-society pool and individual payers. These highly broken approaches of provider networks and custom negotiated pricing need to be completely eliminated. Insurance should then be an optional thing only meant for people who prefer to financialize their life (like pet insurance), and should cover a formulaic amount of any bill from any licensed provider.