This is why the public option was needed as a cost control measure.
I don't know how margins are calculated in the health care insurance industry. A "thin" margin on many billions could be highly profitable in absolute dollars relative to operating costs. It's very hard to get detailed information, since the insurance industry is State regulated and exempt from Federal laws that other businesses have comply with. I do know the health insurance stocks have done well over the last fifty years and there was enough money made in the Mississippi Blues to buy all of the Board members a new set of alligator luggage. (seriously). I also know the Blues were sued in several States for falsely reporting actual costs to policy holders and basing co-pays on jacked up figures. (They lost). Insurance companies often negotiate discounts with providers but don't bother telling their policy holders what the discounted price is.
I am not a fan of socialized medicine. I'd like to see competition in health care. Presently the Medical care delivery "system" in the U.S. operates as a government protected cartel. The result is the highest health care costs in the world (by a fairly large factor), but not the highest quality of care. Until and unless the cartel is broken and competition introduced, things will only get worse. Obama care does very little toward breaking the cartel as far as I can determine. If we are going to have Obama care, then the public option is an essential component.
We are still headed toward a crises.
There are things that will eventually bring the U.S. to its financial knees. Among the most important, and also the least likely to be fixed in time to do any good are:
1) An out of control, government protected, medical cartel whose insatiable demand for more and more of the total economic pie can not be met for much longer.
2) Per capita military expenditures that are 14 times higher than those of other developed countries. (US $4000; Germany $279 per capita)
3) An incomprehensible and unadministratable income tax code with hundreds of billions of unreported private transactions escaping taxation altogether.
ironically #2 and #3 are paid only lip service while Social Security, a highly successful well-administered program is under relentless attack and the subject of all sorts of ridiculous myths. The only problem with social security, other than very minor adjustments to contribution rates and salary caps, is that the government does not have the money to pay the trust fund what it owes, having spent the money borrowed from social security on endless wars and out of control medical costs.