How does the frequency mean that the former should be profit driven and not the later?
Let's try to explain with a little story.
I have a carrot. It's a special carrot but it's an expensive special carrot. You may need it in your life to deal with the Wicked Witch from the West or you may not ever need it.
I'll sell it to you for $1000.
You decide you don't want to waste $1000.
Then 30 years later the Wicked Witch from the West comes along and put a magic spell on you. You realise what the carrot is for now. So you come to me with your $1000 and say "I'd like to buy the carrot"
I say "$50,000 please"
"But you said it was only $1000"
Yeah, that's when you didn't need it. Now you need it, I'm going to charge a fortune.
(Yeah, yeah, I could have just said it, but this is the mood I'm in I guess).
But this is only the start. Because of this you take out insurance. You pay me $100 a year every year in case the Wicked Witch turns up. But the Wicked Witch turns up and I don't bother giving the carrot because I made some small print which means I don't have to.
Damn, you've spent all that money and now you need the carrot you're going to have to pay the $50,000 on top of the $100 a year anyway. Ouch.
So the king sees there's a massive problem and regulates the insurance of special carrots.
Well, back to the real world.
Once you have the regulation of insurance, people are still able to make a ton of corruption. I don't pay the hospital. I pay the insurance company. Why does the hospital need to keep costs down? It doesn't, it gets paid no matter what. Either from the insurance company, the govt or the patient.
Costs go sky high, the insurance companies have no desire to get costs down, the hospital has no desire to get costs down.
The people don't seem to care either, seeing as the words "socialist" and "communist" get brought out by those who seek to profit from the whole thing.