Barry, I think Stilly is saying that the insurance industry is gambling for the sake of profit.

Can't always trust the accuracy of my memory, but I think Blue Cross/Blue Shield was the very first medical insurance company.   If my memory serves me well, BC/BS came into being, not to insure that people were able to get medical care, but to insure that medical providers got paid for the services they rendered. At one time, all Blue Cross/Blue Shield organizations were non-profit. I think, but do not know, that some of them are still non-profit companies. (Non-profit does not, by the way, signify that a company is not in the business of making money.)

The goals of insuring that people have medical care and that providers get reimbursed are certainly interrelated, but the difference in emphasis matters. Most medical insurance companies in the USA are now for-profit, and are therefore engaged in the business of insuring their stockholders make money. There is much talk of cost containment regarding medical care. But it is not about containing costs. Insurance companies do not pay providers at rates that cover the over-all cost of services. They do contain the price they pay through contractual arrangements. The difference between what they pay and what it costs to provide services translates into 1. profits for the companies and shareholders, and 2. The hidden costs of providing urgent medical care to those who can not pay and are uninsured.