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Notes -
And, empirically, making that a for profit middleman who gets to keep the money when he says no works badly. There is a reason why self-insured employer plans are the majority of the private market, and the insurers with the best reputation are provider co-ops (like Kaiser) or non-profits (like most of the BCBS affiliates).
The situation in the UK is different because private insurance is a top-up to the NHS, but once you exclude self-insured employer plans the biggest non-profit insurer is sufficiently dominant that "BUPA" is used as a generic term for private healthcare in the same way as "Hoover" or "Xerox".
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