the whole point of insurance is distributed risk, so the largest pool is the most stable and effective. or the theoretically infinite pool of sovereign debt, i.e. insurance provided by the state.

but if you can't issue your own currency, the next best thing is the largest pool you can get and having it run by member-owners as a non-profit cooperative association. because there is no reason to do anything but cover the administrative costs of the insurance pool. the phenomenon of private, for-profit insurance is anathema to logic. it means the insurance is a scam being run by investor-owners who are extracting value from the pool.

it is ludicrous that it is not banned, even by adam smith type liberals. under late capitalism, insurance corporations are among the most powerful and massive capital formations yet, rivaled only by finance and real estate.