Because it was Every Single Time working with their other counterpart of the triad.
Genius. Actually insurance companies have anywhere from 10-100k employees as a middleman. They make their money by taking yours and then giving you policy limitations. One big problem in healthcare, is that nurses had been dumbed down to candy stripper status with all their education. That increased the cost of health care exponentially. PA's need to be recertified every 2 years and charge almost as much as doctors, so there is little cost savings there too. Do hospitals pay property taxes? They really shouldn't because it should be considered a public utility. All these things are big costs and expenditures.