Originally Posted By: Peter B.
It is a Fact that as the size of an operation increases efficiency decreases.

Really - is that a "Fact"? So the principle of 'economy of scale' has been cancelled? Not according to CAHI, a private health insurance industry organization:

"Medicare covers around 42 million individuals with one program which should provide it significant economies of scale. The private under age 65 market covers around 165 million individuals through hundreds of companies, suggesting much less ability to create economies of scale.

"The Federal government usually reports its Medicare administrative costs at about 2% of total payments under the program while private costs vary dramatically from market to market, but frequently are cited to be in the 15-20% range on average." http://www.cahi.org/cahi_contents/resources/pdf/CAHIMedicareTechnicalPaper.pdf

Originally Posted By: Peter B.
I also don't believe the federal government can efficiently run any comprehensive program.

Try comparing the adminstrative cost of Medicare to private health insurance, Peter. CAHI, the private insurance industry advocate, has done that, and even they had to come to this conclusion:

"Medicare’s actual administrative costs are 5.2 percent, when the hidden costs are included...average private sector administrative costs, about 8.9 percent – and 16.7 percent when commission, premium tax, and profit are
included. http://www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf

Interesting that they had to factor out commissions, taxes and profit (What? No profit?) to get their costs down to about 60 percent more than the gov't health plan. Including all costs for both plans, administering private health insurance costs over 200 percent more than administering Medicare, according to a private health insurance industry source!

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