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# Summary Health care providers, not insurers, are responsible for the excess costs of the U.S. health care system, as private insurers operate on low profit margins and capture only 10-15% of health care spending while providers appropriate or waste the majority. Americans, particularly progressives, disproportionately blame insurers because they are the visible gatekeepers who deny coverage, making them "sin-eaters" for a systemically broken structure. Focusing regulatory and political efforts on insurance companies rather than provider costs is ultimately counterproductive to achieving meaningful health care affordability.
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