I'm not an expert on what costs would do under a public healthcare system, but I think "self-evident that costs will go up" is very much wrong. You add new bene

I'm not an expert on what costs would do under a public healthcare system, but I think "self-evident that costs will go up" is very much wrong. You add new beneficiaries, but you also change major cost centers. For example, the healthcare industry spends a lot of time and money on medical billing, on the side of providers sending bills and insurers paying them. Clearly some of this would be reflected in new and different bureaucracy, but probably less of it (and certainly not self-evidently more). Also, preventative care can be much better than reactive care. Sure, a public health care provider would have to spend more money on insulin for diabetics when all of them are covered, but maybe it will spend less on emergency room visits for patients who suffer serious complications of poorly managed diabetes and can't pay the ER bill.