Medicare Paperwork for All

In making his case for universal health care, Senator Bernie Sanders has reignited a debate over whether the U.S. should have a single-payer system. It would simplify the administration of health insurance, but his proposal is nevertheless ill-advised -- not least because it’s possible to simplify billing and claims processing in health care without making such an extreme change.

In 2014, the net cost of health insurance in the U.S. was almost $200 billion, most of which was for billing and related expenses (as opposed to things like premium taxes and profits). These costs can readily be lowered. After all, other countries with mixed private-public systems -- including the Netherlands, Switzerland and Germany -- have administrative processes that cost 25 to 60 percent less than ours.