American health insurance companies are some of the most profitable entities in the world. Year after year, they post jaw-dropping earnings, enrich shareholders, and shower their executives with astronomical bonuses. Meanwhile, the people they’re supposed to serve—ordinary Americans—are left drowning in medical debt, delaying life-saving treatments, or skipping doctor visits altogether because they can’t afford the cost. This isn’t a system; it’s a racket. And the biggest con of all is pretending that healthcare insurance belongs in the same category as selling widgets or streaming subscriptions.
Some industries are simply incompatible with the profit motive, and health insurance is one of them. Allowing insurers to operate as for-profit, publicly traded companies has created a perfect storm of moral compromise and systemic dysfunction. Their primary allegiance isn’t to patients but to shareholders, and they have no problem sacrificing your health if it means boosting their stock price. It’s time to end this charade. Health insurance should be run as nonprofit entities or co-ops, focused on serving people—not Wall Street.
The Revolving Door of Corporate Greed
If you want to understand the moral rot at the heart of the health insurance industry, start with the numbers. In 2022, UnitedHealth Group, the largest health insurer in the U.S., raked in over $20 billion in profits. Their CEO, Andrew Witty, took home more than $20 million in compensation that same year. This is a company that doesn’t just provide insurance—it also decides how much care you get, how much you’ll pay, and, in many cases, whether you’ll live or die. Every dollar they deny in claims, every treatment they delay, isn’t just a bureaucratic annoyance—it’s another boost to their bottom line. And the system incentivizes them to do exactly that.
For-profit insurers thrive by denying care, not providing it. They impose labyrinthine prior authorization requirements, reject claims on technicalities, and limit coverage to narrow networks. Their goal isn’t to keep you healthy; it’s to spend as little as possible while collecting as much as possible. In a rational world, this behavior would be considered predatory. In ours, it’s just business as usual.
What We Lose When Profit Comes First
The profit motive doesn’t just harm individual patients; it undermines the entire healthcare system. Here’s how:
1. Denying Care, Maximizing Revenue
For-profit insurers have one primary strategy for increasing profits: paying out as little as possible. They delay or deny claims, limit access to specialists, and push costs onto patients through rising premiums and deductibles. These practices leave millions of Americans either uninsured or underinsured—functionally locked out of the very system that claims to exist for their benefit.
2. Administrative Waste
For-profit insurers love to argue that they’re models of efficiency, but the reality is just the opposite. They spend billions on marketing, executive salaries, and lobbying to maintain their privileged position in the system. By comparison, Medicare—a nonprofit government program—spends just 2% of its budget on administrative costs, while private insurers often exceed 15%. When you pay your premium, a good chunk of it goes toward padding executives’ wallets, not your health.
3. A System of Inequity
Insurance companies love healthy people because they don’t cost much to cover. If you’re older, sicker, or dealing with chronic conditions, they see you as a liability to be managed, not a person to be helped. This is why insurers design plans that discourage high-risk patients from signing up—an ethically bankrupt strategy that nonetheless makes perfect sense in a profit-driven model.
A Better Way: Nonprofits and Co-ops
It doesn’t have to be this way. There are already successful examples of nonprofit and cooperative health insurance models that prioritize people over profits. These organizations prove that healthcare can be both efficient and humane when it’s designed to serve patients rather than shareholders.
Kaiser Permanente: Doing It Right
Kaiser Permanente operates as an integrated nonprofit system, combining health insurance with healthcare delivery. Unlike its for-profit competitors, Kaiser reinvests all its earnings into improving care, expanding facilities, and keeping costs manageable. It focuses on preventive care, reducing long-term costs and improving outcomes. Patients get better care, and the system wastes less money—proof that you don’t need a profit motive to run a successful insurance operation.
Healthcare Co-ops: Community First
Healthcare cooperatives, though less common, offer another promising model. These member-owned organizations prioritize local needs and reinvest earnings to improve coverage and lower costs. In a co-op, members have a voice in decision-making, ensuring the organization serves its community rather than external investors.
Medicare: The Gold Standard
Medicare is a nonprofit program that provides efficient, reliable coverage for millions of Americans. It consistently outperforms private insurers in cost control and customer satisfaction. Expanding its principles across the broader insurance market could revolutionize healthcare in this country.
Healthcare Is Not a Marketplace
The defenders of the current system will tell you that competition breeds innovation and efficiency. But healthcare isn’t a marketplace. It’s not about finding the best deal on a new phone or choosing between brands of cereal. When you’re sick or injured, you’re not a consumer—you’re a patient. You don’t shop around for the cheapest cancer treatment or haggle over the price of a heart surgery. The very idea of healthcare as a competitive marketplace is a cruel joke, one that only benefits those at the top of the corporate ladder.
Why the Time for Change Is Now
The American people are increasingly fed up with the broken promises of for-profit healthcare. Polls show widespread support for systems that prioritize universal access and affordability. And it’s no wonder: the current model has left nearly 100 million Americans struggling with medical debt, while insurance executives walk away with millions.
The solution isn’t complicated. By transitioning health insurance to nonprofit and cooperative models, we can create a system that works for everyone. Nonprofits don’t have shareholders to satisfy or stock prices to inflate. They focus on care, not quarterly earnings. They invest in prevention, improve efficiency, and treat patients like people—not revenue streams.
Healthcare: A Moral Imperative
Healthcare insurance should never have been a profit-driven enterprise. Allowing corporations to profit from illness and suffering is a moral failure that has warped the very foundation of our healthcare system. Nonprofit models like Kaiser Permanente and Medicare prove that there’s a better way—one that prioritizes human dignity over shareholder dividends.
This isn’t just about fixing a broken system; it’s about reclaiming healthcare as a public good. The health of a nation shouldn’t depend on the whims of Wall Street. It’s time to put people before profits, once and for all.