It's complicated. 1) "Single payer" is not the only way to deliver universal healthcare. Germany, Switzerland, Netherlands, Singapore all have thriving multi-p

It's complicated. 1) "Single payer" is not the only way to deliver universal healthcare. Germany, Switzerland, Netherlands, Singapore all have thriving multi-payer systems. In Switzerland and the Netherlands, ALL insurance is private. In Singapore, while the government covers catastrophic care, 70% of total health expenditures are private. 2) The biggest problem in the US is that healthcare is just more expensive, and American insurers end up having to pay more. An example: doctors in America earn more (PPP adjusted) than in any other country. MRI's in America cost more (even on the Medicare fee schedule) than almost any other country. A lot of this is actually caused by a series of well-intentioned policies passed over the last half century. 3) In the US, for-profit insurance profit margins are a pretty meagre 5%, which doesn't really make a dent in costs. Also, some of the biggest insurance providers are non-profits (Blue Cross Blue Shield, Kaiser) 4) Medicare fee schedules aren't that much better, in fact the part of Medicare that's actually working the best is Medicare Part C (Medicare Advantage), which relies on private payers. Source: I work at a claims adjuster