This whole argument stems from the belief that the Insurance companies know nothing about business and markets. The reality is that they have maneuvered the debate over decades to make themselves a comprehensive monopoly.
If the whole thing were to collapse tomorrow, you can bet your bottom dollar they will already have a plan in hand to deliver the market still to their door, with or without the government being their marketing department.
The ugly truth is the whole medical delivery costs are based off one thing and one thing only, the Medicare Billing Codes that Congress sets through legislation lobbied by whom? Figure it out.
you’ve almost got it but you left out cost-shifting
It’s not uncommon for hospitals to have 3 levels of billing:
1) cash - billed at the highest rate possible (really overcharged)
2) insured - billed above medic-aid/medicare rates (overcharged)
3) medic-aid/medicare - billed at medicare rates (undercharged)
Because hospitals are locked into medicare rates, they overcharge the insured and cash people (uninsured) by cost-shifting. The more medic-aid/medicare they treat, the more costs transferred. (We’ve all heard the $4 aspirin in hospital!). Some hospitals in Florida are seeing 20 overdoses a day - crisis uninsured requiring ICU resources. Only a portion of those costs are reimbursed by the govt. Cost-shifting is probably the largest contributor to premium increases. Unnecessary diagnostics (MRI happy, for instance) is also up there as a contributor.