[costcopizza]

I wonder why this is getting downvoted as I've had this exact same thought.

A most efficient insurance program would be a closed loop.

Any leftover money not spent on care would be used to reduce premiums the following year and/or be saved for higher claim years.

I wonder how that could exist in the US? Perhaps these health sharing ministries are as close as we'll get: https://www.medishare.com/

[thanksgiving]

I like the wording leftover money. My index fund has an "expense ratio" of 0.06% or something like that. Any money that doesn't go toward a patient directly, including everything from CEO bonus to call center expenses should be added as an expense that does not go directly to the patient and this expense ratio should be advertised front and center everywhere.

However, I don't think the problem is truly fixable without Medicare for all or similar single payer scheme. There is just a huge gap in not just bargaining power but just knowledge of the market information between the seller (hospitals and health care providers) and the buyers (sick people) that a free market solution can't even work in theory. Even if you ignore the fact that I can't exactly shop around when I have an emergency any more than I can shop around when my house is on fire. The only viable solution is single payer and the sooner we get there, the better for everyone.

[nradov]

Healthcare cost sharing ministries can work for some consumers but there are loopholes which allow them to deny coverage for services that commercial insurers do cover. This can leave consumers with huge surprise bills.

https://www.nbcnews.com/health/health-care/health-care-cost-...

Commercial insurers are already required to rebate premiums if their medical loss ratio is below the limit.

https://www.cms.gov/marketplace/private-health-insurance/med...