Administrative expenses on the payer side are 7.5% of total US healthcare spending. Even under a single payer system, that number would decrease only slightly.
Bullshit single payer would vastly decrease that number. Only having one payor who has from your perspective fixed rates is going to vastly simplify that process compared to the cluster of today.
Health insurance profit would also disappear as much would their administration costs.
You would still need to determine price structures and deal with fraud but you wouldn't need to network anymore.
I would love to debate the conclusions with the McKinsey team. I think their analysis was highly flawed. Do Americans consume more healthcare? Yes. Is that the primary reason for our escalating cost share? No. Market concentration at multiple layers (Payer, Provider, Tech/Data layers, etc.) is a huge issue in U.S. healthcare. In most markets we basically have 1-3 companies that have market control of the providers and inpatient facilities, and 1-2 companies that have majority market share on the carrier side. Add in the mess that is distribution (broker-controlled, and concentrated as a well), and you have a witches' brew of mis-aligned incentives, excessive costs, inefficient bureaucracies, and plain-old anti trust behaviors.
Summing up that topic that way is disingenuous at best.
The rate of self selection of healthcare is not that different in the US. While our old are more likely to seek care our young are way way less likely to.
A ton of that is unnecessary work to avoid getting sued, unnecessary work because of how our billing works (who would have thought that billing based on services rendered would result in escalating costs?), not to mention the complexity of the system helps make finding fraud more difficult.
