[nineplay]

All of the job of for-profit health insurance companies is to make money for their investors. Everything else they do works towards that goal.

Now all of the job of any for-profit company is to make money for their investors, that in and of itself is not a problem. The problem is that specifically, for health insurance companies, they make money by denying people health care. They have no incentive to pay claims beyond the minimum necessary.

We have public health care too and it isn't perfect but they don't lie to our faces when telling us why they won't cover something.

[s1artibartfast]

With the 80-20 rule they actually make money on the claims they pay, not the ones they deny.

It is essentially cost plus 20%.

The tricky parts are balancing opex to profit, and balancing coverage with competitive costs.