[eviltandem]

They could be. I'd argue the real problem is competition. A person buys their car insurance. The purchaser is the customer, there are lots of competing companies, and prices are good as a result.

In health care typically your employer is the customer. The doctor and/or hospital also are customers. The insurance company is itself a customer.

Unlike - say - car repair you don't get a good estimate up front so it's hard to shop. Many times there aren't many good alternatives anyway. If you don't like a choice one of the actual customers made it doesn't matter because you have no real purchasing power anywhere in the system.

[dsfyu404ed]

For almost all non-emergency care you can get a good cost estimate up front though. Even for much "emergency" care it wouldn't be hard to provide an estimate and then stick withing a certain % of that. Stuff like stitches, pulling fish hooks out of people and all sorts of other "routine" things that are uncommon individually but are common from the perspective of the emergency room can also be estimated accurately. Chronic illnesses and long term care are what's really expensive.