All that said, I’m not talking about the administrative costs of running Medicare itself. I’m talking about the administrative costs that are built into the care at hospitals and clinics. This has nothing to do with the administrative costs at the level of the federal government in running Medicare.
What I’m talking about is the percentage of each health care dollar sent to any hospital or clinic that goes to administrative costs vs patient care at that facility. The administrative costs are ‘built in’ to the bill each patient receives. When you look at an itemized list of costs from any health care facility, these figures are not based on actual itemized costs. They are prorated, and incorporate lots of things that don’t show up on that itemized list - including the administrative costs. It doesn’t matter whether Medicare, Medicaid, or private insurance pays. The administrative costs at each hospital and clinic are what they are, independent of the payer. It’s very difficult to get administrators to cut their own numbers, unless the third party payers (no matter who they are) start demanding that the hospitals cut their administrative expenditures.
As a professional in this field, I have watched the death of free market medicine and the greatest medical system for decades. Finding and retaining and paying for a great clinician has never been this impossible.
The solution to the destruction of our once great medical system is to end all government involvement, period. To those who expected their lifelong contribution to the system would mean Medicare would replace their private insurance at 65, where have you been? Social security was raided long ago. You knew that baby boomers would not be funded by the system. We've been expecting bankruptcy since the 80’s and earlier.
To end all government involvement in medicine, it has been proposed that there be a cut-off age where those younger will not receive Medicare. But they will retain their own money to save for old age health costs if they so choose. This was the way our free country worked before the rise of the Welfare State. I remember because I was there. My father gave me $200 for emergency room treatment should it ever be necessary when I left home at 18. Imagine a world like that before Medicare and the end of the Gold Standard?