"...insurance companies are willing to raise prices and lose customers in an effort to improve their bottom line..."

don't blame that on insurance companies, any business will do the former if it leads to the latter. it doesn't matter how profitable they may already be, their stockholders expect it and will demand it. the only thing that keeps all businesses from doing it routinely is competition from other firms.

if that doesn't happen, then you've either got a monopoly, or price-fixing. doesn't the us have anti-trust regulation of the insurance industry?

if effective health care reforms do not pass, there is no reason to expect that the cost trends of the recent past aren't going to simply continue as before, and it isn't necessarily going to be a deliberate cartel colluding to push prices upward, either. the firms have already modeled the market and calculated all the variables, including competition, and can predict exactly how profits will respond to changes in price. they will simply adjust their rates and sales to the point where profit is maximized. it's all done automatically these days, with software.

that's how free markets work.