> For-profit companies ...

They can, however, be regulated. At it's core an insurance company should just be a risk pool that gives premiums for that risk, and covers its cost + profit on getting to hold your premium for the period.

IMO what's really missing in America is a collectively incentivized set of activities to deeply reduce risk, for example one of two should be true -- smokers pay way way higher premiums, or perhaps baking in incentives by taxing cigarettes heavily like they do in Canada, for example. I see so many opportunities for healthcare to be much much cheaper just unused -- Smoking, Alcohol, THC products, risky driving, lack of exercise, high body fat, Standard American Diet (SAD) all could save a lot. Just a WAG but probably on the order of many billions in the USA.

I think one thing that makes it a mess is that healthcare comes from your employer, and your employer isnt going to diagnose each employee's lifestyle factors and pass on the risk pool savings of good choices. If the individual paid and could somehow capture that incentive profit then they'd at least have the financial incentive to be healthy.

Edit: An example I see frequently of shirking the risk/incentives structure is how Auto insurance seems to have shifted from investigating to just 50/50 outcomes unless you have a dash cam to prove your innocence. Those with risky patterns are not paying their share of insurance premiums. So until everyone dashcams it's now under penalized to do risky behavior.

Not to mention the uninsured motorist issue.