In a very limited way, this Slate piece that rather snottily argues that insurance companies aren't to blame for high health care costs is true. On the other hand, insurance companies have fought hard to preserve and protect the fractured, inchoate system that is to blame for high health care costs, so they're rather decidedly part of the problem, at least at the moment. Saying that their profits don't add up to all that much is basically a debater's point. They occupy a crucial mediation space that could instead be filled by a centralized bargainer who could drop prices through monopsony buying power or enwrapped in a larger, better regulated system that could use standardization and rearranged incentives to better bring down costs. But for the moment, they're standing in the way of both solutions, because they're trying to protect their revenues. In other words, it's the politics born of their profits. But that doesn't mean it's not, in part, the insurers.
