[xracy]

Insurance is made in the margins of charging a healthy population more than you will use for them in the year. The reason "Single-Payer" is "the answer" to everyone's woes, is that in order to make anything close to a reasonable amount of money on insurance you need to have an actual population to insure. This typically works because insurance companies are big.

This also means that any new insurance company needs to pick up a ton of customers. This is really hard to get off the ground in a way that will make you money. You would ideally pick up a healthy population (younger folks), and then you'd have to get lucky on your actuarial tables for the population of people you pick up insurance plans for.