> 0.7% is an absurdly low profit margin. It just is. The rest of your paragraph is basically true, but doesn't change that. At the same time, the U.S. spends a much higher percentage of GDP on healthcare than most developed nations.
Where do you pull out that profit margin. The healthcare sector does vertical integration - they keep the patient inside their services - from insurance to hospitals - and milk them.
Your system is not inefficient. It is. The efficiency is for the shareholders. Not for you.
It's probably worth pointing out that some of the largest American insurance companies are mutuals. They don't have shareholders, or profits. Admittedly this is rarer in health insurance than some other kinds, but State Farm, for example, does a huge health insurance business and sends its excess revenue, if any, back to its policyholder-owners as dividends.
Insurance companies that do make profits do much better than 0.7%, but then imagine how much worse that means doctors and hospitals are doing in order to drive the average down that far. And this was originally about hospital bills. Americans with insurance don't typically get bills from the insurance company, just statements of what they aren't going to pay.
> The healthcare sector does vertical integration
Here you have a point. American antitrust hasn't been good for some time, and tends to be less effective on vertical than horizontal integration. Nevertheless, while I can't immediately find a number on what percentage of American providers are owned by insurance companies, I'm pretty confident it isn't high.
Where do you pull out that profit margin. The healthcare sector does vertical integration - they keep the patient inside their services - from insurance to hospitals - and milk them.
Your system is not inefficient. It is. The efficiency is for the shareholders. Not for you.