Insurance companies make their profit on a margin between the cost of the service and a healthy markup percentage. If the service cost is high so is the markup so they win and win again. They can then pay a big bonus to their fat cats. Somewhere along the line the little guy covers the cost. Competing companies are pissing in the same pot so there is really no competition. The little guy probably is captive in a need for insurance protection so he can't complain or they will cut him off. Free enterprise capitalism working as it was intended!