Reply #112: Are You Seriously Pressing This Further, Sir?

[The Magistrate]

You are now claiming your suggested system will have lower administrative costs than what is essential a several times upscaled Medicare program?

Your system requires means-testing for subsidies, and loans, and maintainance of sequestered bank accounts, means-testing for collection of loans, collection of loans, a sizeable number of different private companies with different policies, separate facilities, and that is just off the top of my head. This you feel will have lower administrative costs than a system where all medical establishments send a bill to a single government authority, which pays with a check on the Treasury according to a schedule worked out by a single office within legal guidelines set by the Congress. The contrast between administrative costs of Medicare and the sum of those of private insurance companies already makes hash of your supposition: yours costs far more to administer, in total.

Again, what is paid for basically in the provision of medical care is the application of personal skill to a problem, and that is the bulk of the charge billed. Certainly the costs of drugs can be subject to economies of scale; indeed, a monopsonist purchaser can dictate prices, and that is what a government administered single-payer authority would be, in chemically pure form. This sort of power over price cannot possibly be provided by the fragmented system you are pressing for cost containment.