The profit in insurance is the volume, not the margin. Disrupting it will not dramatically change outcomes, and will require changes to regulation, not business policy.

Profit is a small part of overall revenue.

And "disruption" (a pretty ill-defined term) is the solution to that?

The inefficiency is the buying of yachts for billionaires.

But no business is going to fix it. The market is captured. Only a radical change of insurance laws is going to have any impact. Mandate that insurance must be not for profit. Mandate at least decent minimal coverage standards and large insurance pools that must span age groups and risk groups.

Disruption, yes, in the sense that the current system needs to be overhauled. But this is a space that's frequented by the SV and VC space and "disruption" has very different connotations, usually in the realm of thought that suggests some SV-brained solution to an existing problem. In some edge cases like Uber/Lyft, this upending of an existing market can yield substantial positive externalities for users. Other "heavy industry" adjacent sectors, not so much. Healthcare and aviation, not so much.

Even SpaceX's vaunted "disruption" is just clever resource allocation; despite their iterative approach to building rockets being truly novel they're not market disruptors in the same way SV usually talks about them. And their approach has some very obvious flaws relative to more traditional companies like BO, which as of now has a lower failure-to-success ratio.

I don't think you'll find many providers clamoring for an AI-assisted app that hallucinates nonexistent diseases, there are plenty of those already out there that draw the ire of many physicians. Where the industry needs to innovate is in the insurance space, which is responsible for the majority of costs, and the captive market and cartel behavior thereof means that this is a policy and government issue, not something that can be solved with rote Silicon Valley style startup-initiated disruption; that I would predict would quickly turn into dysfunction and eventual failure.

Enshittification has done a lot of damage to the concept of "disrupting" markets. It's DOA in risk-averse fields.

I sympthatise with the argument. We should test it against real world data.

Eg your argument would predict that healthcare price inflation is not as bad in areas with less insurance coverage. Eg for dental work (which is less often covered as far as I can tell), for (vanity) plastic surgery, or we can even check healthcare price inflation for vet care for pets.