Democrats states get ripped off more than Republican ones because Obamacare blocks interstate insurance and then Dems added more coverage requirements. 

As I said:  the problem in the U.S. is socialist medicine with government involved. 

Define the ICD codes for catastrophic insurance (ie actual insurance not known maintainence) and then get out of the industry entirely and you’ll very quickly see a price collapse. 

And that’s before you consider that AI can force multiply doctors now and as a result PCPs could see 1000 patients a day instead of 10. Everything up to the cut can be done by AI at least as well as a doctor and in many cases better.