I feel people defend them by opposing any other approach to solving this. Politicians in particular say things like "preserving customer choice", which I think just means having the ability to select among all the terrible insurance companies who will treat you poorly.
That excuse doesn't even hold up because in places like the UK which have universal healthcare, private health insurance still exists alongside it as a "premium" option. That's more choice!
And shouting about "death panels" in public healthcare systems, as if the private insurance companies don't have people whose whole job is denying as many claims as possible
Yeah. The biggest difference is you can elect the public healthcare death panels, or call your senator or representative to lean on them. There's not a thing you can do about the private insurers' death panels.
Medicare may turn you down for an organ transplant because there are only so many to go around and you're not the best candidate. Private insurance may turn you down because "shareholder value".
Technically, they have the ability to choose whoever they want, they just have to pay full price with post tax income. If people accept their employer's choice, then they get to pay for a lower, employer subsidized premium with pre tax income.
That is one thing that would fix this problem fast. Let individuals tax deduct the price of their health insurance directly. There’s no reason it should only be up to your employer.