Premiums are high because there is disproportionate distribution of participation. Unions bargain with Insurance Companies from a position that represents large numbers , and they bargain for a better deal. Individuals bargain from a much less meaningful position.A Universal Health Care system would require 100% participation , and provide 100% coverage , but Insurance companies would see less profit and loss. Premiums are up because of the Volatility in the market caused by Obstruction from the WH and the Republicans trying to take away from Americans.Time will tell , but my bet is on Single Payer that actually provides care , and forces prices down.