Private health insurers provide under 40% of healthcare funding in the US today. Their average medical loss ratio is 90% -- that is, out of every $1 in ratepayer money, 90 cents goes out to pay claims. What that means is that if they had $0 profit and 0% overhead, we as a nation would save a whole whopping 4% of our national health care costs.
So it's not insurers that are causing your 20% rate increases every year. It's providers -- the people who say, literally, "your money or your life", and refuse to provide life-saving procedures until you agree to pay them enough for a third or fourth home and a private jet of their own. Providers have no -- zero -- incentive to contain costs, because they know they're holding a loaded gun to your head. Either you pay what they demand that you pay, or you die. (This, BTW, is why primary care physicians are *not* paid very much -- you don't die if you don't get a physical, so they don't have that deadly force available to force you to pay outrageous amounts of money for medical procedures).
We need to deal with the way that insurers are handling the problem of rapidly escalating health care costs -- i.e., by kicking people out of the system and arbitrarily denying approvals for expensive procedures in hopes that the sick people will die before they have to pay out -- and handle the issue of people who can't afford insurance for whatever reason. So insurers are evil, but they're not the evil that's causing your 20% rate increases every year. To handle the rate increase problem we have to go to the core: the people who are literally saying, "your money or your life" and hijacking us all at gunpoint so that they can have the same gleaming under-used medical diagnostics equipment as the hospital across the street or otherwise provide healthcare services in an inefficient manner. Because those are the people who are causing your rate increases -- *not* the insurers. The insurers aren't good guys here, but unless you identify the correct culprit in the costs escalation problem, you haven't a hope in hell of solving it. Hint: Demonizing the insurers and accusing them of causing the costs escalation is about as idiotic as blaming President Obama for the Bush recession...
To summarize: We solve the costs issue by adopting the French system of government-mandated rates for every provider who accepts government-regulated insurance, we don't need to go to single-payer for that. (France is not exactly single-payer -- various guilds have their own insurance funds separate from the overall public fund). Blasting the German/Swiss amalgam set up by the current healthcare reform bills as "can't contain costs" because it's not single-payer simply isn't a reasonable criticism, because it's not the payers that's the problem with costs -- it's the providers. And demonizing the payers doesn't do shit about that.
-- Badtux the Healthcare Penguin