From a health insurance insider:
For two years I was the executive director of MCC-Wichita, a managed mental health (HMO) subsidiary of CIGNA. We did very good work, and we were very profitable (26% the first year, 39%, the second year).
I got a new regional manager, who left me alone for a few months before she started throwing darts at me. I sent her a fax, stipulating that my first priority was quality of care, and my second was profitability. She sent me back a fax in which she stated "Only a naive or novice manager would put quality of care as their first priority." Well, there you have it. Insurance companies are about profit; quality of care comes second. That is why we need a government run, single payer system.