> graph of the stocks for UnitedHealth, Elevance (formerly Anthem) and Cigna shows that they're all on the growth track for the last five years

Stock price ! profitability, but you're still correct. UnitedHealth's operations have churned out cash each of the last four years [1], as have Cigna [2] and Elevance [3]. Underwriting gains across the industry have been strong for years [4]. The only story I can think of where American health insurers lost money was Aetna with its underpriced ACA plans [5].

That said, whimsicalism is also partly right in that insurers aren't the cause of the unaffordability of American healthcare. They by and large pay out most of their premiums. (With some variance.)

[1] https://finance.yahoo.com/quote/UNH/cash-flow/

[2] https://finance.yahoo.com/quote/CI/cash-flow/

[3] https://finance.yahoo.com/quote/ELV/cash-flow/

[4] https://content.naic.org/sites/default/files/2021-Annual-Hea...

[5] https://spia.princeton.edu/news/why-private-health-insurers-...

I was referring to insurance writ large, but yes it's true recently health insurers have been profitable - but not massively, more like 3-4% average margins. [0]

> If a subscriber pays them what they do, and they don't have money to pay a claim declared medically necessary by a medical doctor, but do have the money to forward to a retirement fund, they are charging too much.

If it is only legal to lose money on providing insurance, nobody would do it.

> Most of the rest of the industrialized world seems to grasp this concept, and their people live longer.

I agree that there are problems with cost/performance in our healthcare market. I think it is largely due to overutilization & misallocation, combined with some poor genetic/cultural luck around opioids and obesity.

0: https://content.naic.org/sites/default/files/industry-analys...