>How can I start an insurance company?

One requirement is to be willing to earn returns less than SP500.

Look up profit margins and annual returns for UNH, Elevance, CVS, Cigna, Humana, Centene, and Molina.

You have a billion laws to follow, you’re used as a punching bag by politicians and customers, have to get the price of your service approved by a government employee, and for all of that, you earn a 2% to 3% profit margin.

No it will be a zero profit company. All of the revenues will go to my compensation and bonuses.

> for all of that, you earn a 2% to 3% profit margin.

Yeah -- it seems like a paradox that the insurance companies charge so many people so much money, yet struggle to make a profit.

I've heard that they spend a lot of money handling their "internal friction" -- reviewing claims, handling appeals, etc.

Health insurance premium revenue = medical loss ratio + operating costs + profit margin

Medical loss ratio is the money paid to healthcare providers. Operating costs end up being ~10%, across multiple publicly listed companies. This fact, plus 2% to 3% profit margins means any more cost reductions have to come from legislation, reduction in healthcare prices, or advances in automation.

https://www.oliverwyman.com/our-expertise/insights/2023/mar/...

https://www.kff.org/private-insurance/medical-loss-ratio-reb...

Uh huh, and for them to have inserted themselves between me and my doctor, what exactly did they contribute to the transaction and how much should I want to pay for such a privilege since apparently $30k a year isn't enough? A measly 2-3% for adding no value and creating friction, egregious, we must get the profits higher!

First of all, some or much of your premium is a wealth transfer (from young and healthy to old and sick). So consider that portion a tax (it literally is, just not collected by the government directly):

https://news.ycombinator.com/item?id=45800973

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

https://www.healthcare.gov/how-plans-set-your-premiums/

>what exactly did they contribute to the transaction

Obviously this varies based on personal experience, but the biggest benefit is usually covering the big expenses beyond the out of pocket maximum, such as premature babies, bypass surgeries, cancer treatments, hemophilia treatments, etc stuff that costs hundreds of thousands and millions of dollars.

Second would be negotiated pricing with healthcare providers. If you think you can do a better job negotiating, you are welcome to not pay the health insurance company (better referred to as managed care organizations), and see what kind of deals you can get.

Third would be services as an agent that knows something about healthcare to be able to discern necessary and unnecessary care, since most buyers are unable to discern that information. This is, of course, highly subjective based on personal experience and the lack of government audits here leaves much to be desired.

>how much should I want to pay

When you have 7 publicly listed managed care organizations along with numerous non profits such as the various BCBS and Providence and Kaiser Permanente all selling insurance at roughly the same price, it's sufficient to conclude prices are about as low as they can get in this business environment.

>A measly 2-3% for adding no value and creating friction, egregious, we must get the profits higher!

This sentiment really doesn't make sense, unless the goal is to just be outraged for the sake of being outraged, because it has been clearly shown that there aren't much profits to be had in the first place. It's such a shitty business that one will end up with more money by investing in SP500.

I think my sentiment is that with single-payer we could go from arguing about how expensive health care is and how much money should middle-men be able to extract from the system, to mostly just arguing about how expensive health care is.

Great. So this system provides guaranteed healthcare at the worst possible point, the emergency room, AND funnels these 'wealth transfer taxes' of yours through for profit corporations? Sounds like a really bad way to be doing this. Crazy also that we have a government insurance/payment program on top of this for old and sick people. So why have a government program and an additional private wealth transfer tax?

I have never met a normie whose insurance covers more than 1 million in yearly benefits. So no, they aren't covering millions of dollar claims.

> I have never met a normie whose insurance covers more than 1 million in yearly benefits. So no, they aren't covering millions of dollar claims.

Legally, an ACA compliant plan has to cover healthcare expenses more than the out of pocket maximum. “Benefit maximums” are not allowed under the ACA.

https://www.healthcare.gov/health-care-law-protections/lifet...

> Lifetime limits

>Insurance companies can’t set a dollar limit on what they spend on essential health benefits for your care during the entire time you’re enrolled in that plan. Yearly limits

>Insurance companies can’t set a yearly dollar limit on what they spend for your coverage.

Here is a famous example of a single healthcare recipient causing an insurer to stop selling insurance in a state:

https://www.desmoinesregister.com/story/news/health/2017/05/...