Medicare is more efficient than private insurance. Medicare has roughly a 2% admin overhead and private health insurance about 12% (off the top of my head).

The reasons are simple:

- Medicare does not have entire divisions dedicated to finding obscure justifications to not provide coverage when it clear coverage should be provided

- Medicare is not for profit, so the amount of overhead for profit in private care is spent on actual care in public systems

- Medicare employees are all or nearly all public servants. Particularly at the top medicare does not have hundreds (compared with the many private health care providers) of C-level executives pulling down 6, 7 and 8 figure compensation every year. For every private excutive making $10,000,000 you can have 100 medicare experts making $100,000.

This is why EU countries all pay roughly half what the US pays for healthcare, but we are getting - on average - much better care: Meaning we wait less and we live longer.