You make a valid point, and certainly any health care provider, public or private, would want to use actuarial skills for budgeting and best-practices care provision. The question is, do we want to let private corporations set the price? Or do we want a government entity, with a far lower overhead cost, handle the actuarial details? Private insurance has 15% overhead costs compared to 3% for Medicaid.

Thanks for your interesting viewpoint.