If you look at the actual profit margins it’s low single digit percentages. You could eliminate profits altogether and virtually nothing would change. We even have non-profit insurers to look at

It’s strange how the high prices of drugs and services aren’t drawing the ire of people who complain about costs. Drug prices are nearly 3X higher here than international averages and doctors here also earn a lot more with in many cases fewer restrictions on prescribing or offering services than in most EU countries.

The meme that insurance company denials are generating huge profits comes mostly from the public murder of a health insurance CEO last year. For some reason people assumed that insurance companies and their profits must therefore be the core problem with high costs, without making the effort to see where the money actually goes in our health care system.

As you said, there is no health care system which does not have approval processes, deny requests deemed unnecessary, require step therapy, and establish standards of care.