There is a special kind of theater that happens in the United States Congress. It is a play we have all seen a thousand times, yet the ticket price keeps going up. This week, the stars of the show were five men in very expensive suits. They are the bosses of the biggest health insurance companies in America. They went to Washington to answer a question that has a very simple answer, even though everyone pretends it is a mystery. The question was: "Why is healthcare so hard for normal people to afford?"

Watching these executives try to explain this is like watching a shark try to explain why it ate a swimmer. They want you to believe it is complicated. They want you to believe it is just how the ocean works. But the reality is much simpler. They are businesses. Their job is to make money. And in the American healthcare system, the way you make money is by charging a lot for things people need to stay alive.

But the highlight of this tragic comedy came from Stephen Hemsley. He is the boss of UnitedHealth Group. He sat there, with a serious face, and performed a magic trick. He announced that his company would give back the profits they made this year from the Affordable Care Act (ACA) plans. He promised to return this money to the customers and the government.

On the surface, this sounds nice. It sounds like a generous gift. It sounds like he is saying, "We made too much money, and that is not fair, so here is a refund." But let us look closer at this gift. He also mentioned that his company is a "relatively small participant" in that specific market.

This is the brilliance of the modern corporate executive. He is offering to give back a tiny slice of the pie, while keeping the rest of the bakery locked in his safe. It is a gesture designed to make headlines, not to fix the problem. It is like a robber taking your wallet, your watch, and your shoes, but then handing you back a nickel so you can make a phone call. He expects you to say, "Thank you for your kindness."

The lawmakers sat there and asked their questions. They acted shocked that costs are going up. This is part of the performance. These politicians know exactly how the system works. Many of them helped build it. But they have to pretend they are fighting for the little guy. They ask, "Why are premiums rising?" The executives use big words and talk about market forces. They talk about "utilization rates" and "cost drivers."

Let me translate that for you. "Utilization" means people went to the doctor. "Cost drivers" means the price of medicine went up. The insurance companies are essentially saying, "Healthcare is expensive because you people keep getting sick and expecting us to pay for it."

The American system is unique in its cruelty, and moments like this highlight it perfectly. In most parts of the world, if you get sick, you see a doctor. In America, you have to pay a middleman for permission to see a doctor. These five men run the companies that sell that permission. Their business model relies on taking in more money in premiums than they pay out in care. That is the whole point. If they actually made healthcare affordable, their profits would go down. Expecting them to lower costs out of the goodness of their hearts is like expecting a casino to tell you to stop gambling because you are losing too much money.

So, UnitedHealth will return some profits. They will write some checks. The news will report that they are being responsible. But next year, the prices will go up again. The deductibles will get higher. The "affordability crisis" will continue. Why? Because the system is working exactly as it was designed to work. It was designed to move money from your bank account into the pockets of the men sitting at that table.

It is all a very expensive show. The executives get to look like they are cooperating. The politicians get to look like they are tough. And the American people? They get to keep paying for the ticket, clapping politely while their pockets are picked. But hey, at least UnitedHealth might give you back a few pennies. Don't spend it all in one place.