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Honestly... I'm not sure that it is. The entire concept of an "insurance company" (particularly health insurance) is inherently predatory.
For profit insurance companies are inherently predatory. But so are for profit hospitals and drug companies.
So yeah at this point, it might be impossible to run a non profit insurance company with the consolidation of hospital ownership by the few big hospitals and Catholic Church, and the vertical monopolies of the insurance, drug and pharmacies.
Have the government run it (if we ever again have a sane government).
Feels like we’ll be lucky if Medicare makes it through the next term.
Remember, one of the provisions of the ACA was requiring insurance companies to ensure at least 90% of expenditure was directly towards covering care, meaning insurance companies are legally permitted an incredible up to 10% profit margin. For context most retailers have profit margins of 1-2%
Don’t forget that the ACA also stipulated they had to send overage checks out to members if they spent more on marketing, bonuses, etc than on services. Getting refund checks from Blue Cross/Blue Shield at the end of the year because they spent too much money on everything but healthcare wasn’t exactly reassuring.
Even worse, they are colluding with big pharma to raise prices, because would you rather get a 10% profit off of $100 or $10000?
They made sense when the only insurance was the kind that paid out if you sent a ship to India and it sank on the journey.
Most other countries have figured out how to prevent people from wanting to murder health insurance CEOs...
Then again there seems to be a few things that other countries have figured out, but American exceptionalism won't consider trying.