The number is large because they are a large entity with 350k employees and something like 400B revenue. They're also a public company with all the financial obligations and market expectations that come along with that.
There's another way to look at this. That's 22B removed from the larger economy ostensibly earmarked for healthcare that provided exactly none of that. That they are a public company is not in question. That the health insurance industry should even exist is certainly up for debate.
If we don't do single payer which seems like something that won't happen anytime soon in this country given the political climate, then at the very least we should force health insurance to be either non-profit or public benefit companies. then there won't be this well they have to deliver prophets to shareholder bullshit excuse about why they aren't giving money to the people they are supposed to insure.
They're a component of the S&P 500 / various indexes, so what is weird is that to some extent the drive for returns from people's own 401ks is the source of the oppression. The human centipede of capitalism.
