Single payer

There is an old adage that says, figures don’t lie but liars can figure and this is evident when it comes to comparing the administrative cost of Medicare vs private health insurance. Those who promote Medicare for all calculate by comparing administrative cost to total cost on a per patient basis. Since Medicare patients incur higher overall medical cost the percentage is lower. For example if the administrative cost per patient is $30 and a Medicare patient has $1,000 in cost then the percentage is three percent. If that same patient in private care cost $100 then the ratio is 30%. This is because administrative costs are fixed costs. There are other reasons why the administrative cost is skewed in favor of Medicare. First, other government agencies help administer the Medicare program. The Internal Revenue Service collects the taxes that fund the program; the Social Security Administration helps collect some of the premiums paid by beneficiaries (which are deducted from Social Security checks); the Department of Health and Human Services helps to manage accounting, auditing, and fraud issues and pays for marketing costs, building costs, and more. Private insurers obviously don't have this kind of outside or off-budget help. Medicare's administration is also tax-exempt, whereas insurers must pay state excise taxes on the premiums they charge; the tax is counted as an administrative cost. In addition, Medicare's massive size leads to economies of scale that private insurers could also achieve, if not exceed, were they equally large. While the calculations may be in dispute one thing is for sure and that is if the country moves to Medicare for all then many people in the private insurance industry will be out of a job. The big savings in going to Medicare for all is that care can be rationed and this will be most noticed in care for the elderly. Private insurance is rationed by price so the more you pay the more you get but with one plan for all you get what you get.