That ~25% is compounded at every step of the way. 25% of your doctor's office. 25% of the insurance company. Plus don't forget the brokers, which are almost all overhead effectively. 25% of pharmacy. 25% of drug companies.
The people providing actual healthcare end up being a minority in the system.
No, insurance spending is broken out separately in the NHE.
https://nationalhealthspending.org/