companies have to follow? Not trying to go all UWS but my wife is in the health insurance business at a high level and I hear lots of the inner workings most don't. The regulatory crap they deal with (HIPA etc...) and hoops they have to jump through daily are insane. Yes the insurance and billing is a mess but the government (both Federal and States) created most of it and continue to do so. If you want to fix it you'd have to tear it all down and start from zero. That isn't ever happening. Too many pockets lined at all levels (State, Federal, Private). Only going to get worse and worse regardless of how this goes (single provider or some variation) until the whole system collapses. To blame the problems on the health insurance companies isn't fair in many cases. They are just following the Fed and State regs.