It's not a great comparison for a lot of reasons (not least of which the first being that Medicare is legally not able to negotiate drug prices), but despite all of that, yes Medicare is dramatically more efficient.
Medicare is the core of all regulatory and pricing issues in the healthcare space. And if medicare were expanded to the entire population of the us, its expenditures could be 40-45% of gdp.
> Medicare is the core of all regulatory and pricing issues in the healthcare space.
I can't see a reasonable argument for that.
> And if medicare were expanded to the entire population of the us, its expenditures could be 40-45% of gdp.
Even with a naive covered-population-number based extrapolation that ignores that Medicare currently covers the elderly, who tend to have greater medical needs than average, that's not right; national health expenditures are about 18% of GDP, Medicare is about 20% of NHE, and Medicare currently covers around 15% of the population, so a naive population-based extrapolation would put Medicare-for-all at about 24% of GDP.
Medicare is the reason there is fee-for-service, which is the biggest administrative overhead design if there is one. Also all private insurance works based of of medicare in the rates they pay, the way they code themselves etc.
On the extrapolation, of course they are all simplistic and wrong, both mine and yours. You are capping the NHE of GDP to cap medicare, as if the expansion of medicare were going to eliminate out of pocket or private health. Because it doesnt, if it replaced only half of expenditures, the 24% becomes 33%.
Its true Medicare takes care of older patients, but also private insurance subsidizes medicare all along the path to that because it pays more than medicare to every provider, which means on the pool of patients, the medicare patients tend to represent losses and the rest profit. Furthermore there is the argument that if medicare expanded 7 fold, it would also be less efficient the bigger it gets, which is true of private and public organizations alike.
We cant know, its messy and even expert economists cannot get this right: but it has to be in the order of magnitude of 25 to 40% of gdp. That is state-crushing expenditures.
> On the extrapolation, of course they are all simplistic and wrong, both mine and yours. You are capping the NHE of GDP to cap medicare
No, I'm not, I'm using the current expenditures as the projection baseline. I'm clearly not using the current NHE share of GDP to cap Medicare because the projection (24% of GDP) is greater than the current NHE share of GDP.
> as if the expansion of medicare were going to eliminate out of pocket or private health.
No, you made a claim about Medicare expenditures being 40-50% of GDP if it covered the whole population, not other expenditures. Now you're moving the goalposts (and still not supporting your mutating guess with any actual concrete basis.)
> We cant know, its messy and even expert economists cannot get this right: but it has to be in the order of magnitude of 25 to 40% of gdp.
Well, that's a sudden drop in your estimate of what now seems to be total NHE from your earlier claim that Medicare expenditures alone would be 40-50% of GDP. Another round of this and you'll be conceding costs below the current 18% of GDP.
