> In the United States, insurance companies are legally mandated to pay out at least 85% of premiums as medical expenses. Which means, of course, that their ma

> In the United States, insurance companies are legally mandated to pay out at least 85% of premiums as medical expenses. Which means, of course, that their main option to increase profit is to increase overall spending on healthcare. Reducing cost is directly against their interests. UnitedHealthcare buys up physician practices, and pays theirs higher rates. That's part of the 85% bucket, but they're profiting off it. https://www.statnews.com/2024/11/25/unitedhealth-higher-payments-optum-providers-converts-expenses-to-profits/ https://www.statnews.com/2024/11/25/unitedhealth-higher-paym... > Single-payer systems still have administrative costs. https://www.healthaffairs.org/do/10.1377/forefront.20110920.013390/ https://www.healthaffairs.org/do/10.1377/forefront.20110920.... "According to the Kaiser Family Foundation, administrative costs in Medicare are only about 2 percent of operating expenditures. Defenders of the insurance industry estimate administrative costs as 17 percent of revenue. Insurance industry-funded studies exclude private plans’ marketing costs and profits from their calculation of administrative costs. Even so, Medicare’s overhead is dramatically lower." > Realistically, switching to single-payer and doing nothing else would reduce costs by a single-digit percent. I mean, that's a start. If you chart the US against the rest of the OECD, we're doing something bafflingly expensive versus everyone else. It is certain to be multi-factorial, but our insurance setup absolutely plays a role. https://commons.wikimedia.org/wiki/File:OECD_health_expenditure_per_capita_by_country.svg https://commons.wikimedia.org/wiki/File:OECD_health_expendit...