The biggest problem with the American system is that it's just illegal for me to sell you good, simple insurance. Let's say I draft an insurance contract that

The biggest problem with the American system is that it's just illegal for me to sell you good, simple insurance. Let's say I draft an insurance contract that says for any treatment if >5 of 10 randomly selected doctors agree that the procedure was warranted, then I have to pay out the cost of the procedure, no questions asked. This contract is less hassle, clear, and doesn't require arguing with an insurance company since it specifies how disputes are resolved. But I'm not going to give it to you for free. I need to know the expected payout in order to come up with a price and sell it to you. You know, like how all other insurance works. There is a price that is positive EV for me, but better aligns with your risk tolerance, and is therefore positive utility for you as well. In America, pricing it is illegal. I cannot, by my own methods, determine a fair price and sell it to you. That's why we can't have nice things, because it's illegal for two people to agree on a price and terms and create a good deal for themselves.