You're blinded by the assumption that this is the model we should go by and you once again have no clue. Despite these programs being fairly efficient within our government, they are still terribly wasteful for one large reason.

Doctors are paid according to procedure based on contracts they or the hospital they work for have negotiated with some private insurance company (like the one I work for) that's been contracted by some state to administer the system. The reason the states can't do it themselves is that these contracts have evolved to be a huge and unmanageable mess.

The only solution to lowering the costs of our healthcare is to completely abolish this insane system of physician and provider reimbursement. Medical claims processing consumes a huge percentage of every dollar spent (I've read figures of up to 30%). Every doctor's office or hospital must now have on staff this enormous workforce dedicated solely to the payment of patient claims. The insurance companies must have an even larger staff working to ensure the claims submitted by the millions of providers are accurately paid. Ask any physician how well that's going Tom. It's a broken mess. I work in that data daily and it's the worst data disaster I've ever seen in my 30 years or so of being a programmer and data analyst.

When this system is coupled to commercial health insurance you add in the market strategy that profit is tied not to providing quality medical care but instead to finding ways to not pay physicians what they're entitled to. This results in denied claims, denied services, bizarre concepts of branding legitimate procedures as experimental. This decision isn't made by physicians but by bean counters Tom.

The cheapest and most efficient system (and the most compassionate) is one where physicians that want to be part of the governmental health system are paid AN ANNUAL SALARY. Now for fairness their salary can be based on their specialty, their education, etc. just like in any other industry. It may not be as high as that physician would be getting today after fighting tooth and nail for every penny from our current bizarre system but no longer would that doctor have to have four fulltime staff members on salary to handle claims processing and billing. Also most countries that take on such a system give those doctors protection from malpractice lawsuits so their expenses there will be substantially lowered.

The doctor from that point on will then have much greater control over the care they can give their patients. If a procedure needs to be performed in their eyes and the resources (hospital rooms, equipment, etc) are available they schedule it and help the patient.

Notice I said that physicians are in this system if they want to be. Nobody's holding a gun to their heads if they want to continue to be part of the health insurance scam. If the wealthy want to have their own private plans and go to their own private doctors I have no desire to stop them but I'd be willing to bet you the number of physicians that would flock to the government system would be mind-boggling.

I'm going to leave this job as soon as I can find a viable alternative because, despite working in the Medicare and Medicaid portion of the insurance industry, I still go home each night feeling my contribution is an unnecessary waste to our society. I sit in a huge building watching hundreds of people pull out their hair daily trying to sort through medical claims data and barely catching but a tiny percentage of the mistakes. That's not because my fellow workers are incompetent. It's because the system is hopelessly flawed.

Your statistics mean nothing to me.

Art