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Insurance is a useful model when there is high variability in potential costs. This is certainly true of healthcare, where outcomes range from regular checkups to major surgery. In any given year, healthcare expenditure will not be normally distributed across the population, but instead heavily skewed to a small segment. (I suspect this would also be true even considering the variance in individual lifetime healthcare costs, though it would be difficult to gather this data).
So while it's true that people interact far more frequently with health insurance than other forms of insurance, this doesn't really address the core reason for having an insurance model, which is to protect against those high variance outcomes. Another way to think about this - if healthcare costs were stable and predictable, you wouldn't need government involvement at all (apart from welfare subsidies), as it could be treated like any other essential item you budget for such as food.
To my mind the issue is more a free market vs government regulation issue, and whether or not you have insurers is less relevant. After all, public systems like the NHS are still effectively an insurance model, just one run by the government. The Netherlands may be a useful case study to look at, as its system is entirely based on private insurance, but it is heavily regulated and seems to function fairly well.
I don't have nearly enough familiarity with the US healthcare system to know where it's going wrong, but at least from the anecdotes I hear a lot of it sounds like toothless regulators (or just plain lack of regulation). For example, not knowing what a treatment will actually cost in advance seems to be a common complaint and one that's frankly pretty incomprehensible to me from my experiences in Australia (with both public and private healthcare), as knowing the cost of a service before receiving it is a pretty basic aspect of consumer law. Any provider attempting that sort of thing here would get hefty fines from the regulator. This is a guess though, and it's likely lots of factors, and the US system could well be at a disadvantage just due to the size of the country and the complexity that introduces.
This is extremely true and makes me wonder if we could put a few more chronic conditions in Medicare like we do with dialysis and cut costs enough for everyone else that it could be closer to actual insurance (literally moving the sickest 1% of the population or so could cut premium by 40% - sickest 5%, more like 70%)
Honestly, I kinda wonder why Obamacare wasn't more like this - seems like it would've been an easier sell to put more people on Medicare than what the ACA actually was, and it would've left people alone as far as purchasing more expensive plans? You'd have to figure out how to compensate providers somewhat, but I'd imagine there are ways (bump up Medicare reimbursement rates a bit, slight increase in Medicare taxes, slight increase in corporate taxes to offset decrease in large group premiums from some employees care shifting to Medicare?)
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This only works if the skew is completely random year-to-year. But we know that this is not the case and insurance companies can't really control this with higher premiums.
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