Has there ever been a serious actuarial analysis of what “Medicare for All” would cost? In my cursory investigation so far I’ve found Glenn Kessler’s Washington Post back-of-the-envelope calculation:
The Medicare figure of 2 percent is artificially reduced because some key functions are undertaken by other agencies — and because Medicare’s patients are unhealthier. Meanwhile, the 18 percent figure for private plans appears to be inflated, so it would be more reasonable to rely just on the 12 percent estimate.
But even if Democrats were to be conservative and say Medicare had administrative costs of 5 percent and private plans 12 percent, previous estimates of the administrative costs per patient indicate that Medicare is actually more inefficient than private insurance. We would be interested to see more recent calculations on this issue, but it certainly indicates that single-payer advocates are counting savings that might not materialize.
I’ve seen lots of references to the Mercatus Center’s figures.
I’ve seen Heritage House’s analysis which found that Medicare’s administrative costs per beneficiary were actually about 10% higher than the administrative costs per beneficiary for private insurance.
I’ve seen a study from a number of years ago at the New England Journal of Medicine that found that on average administrative costs in Canada were about half what they are here (a pretty fair indicator but a far cry from the 5% figure frequently quoted).
So far the best analysis I’ve found is from Charles Blahouse at E21:
In sum, supporters of M4A are on fairly solid ground when they credit Medicare with having commendably low administrative costs. But in the aggregate, Medicare for All should be expected to drive total costs up, not down.
Dr. Blahouse was also responsible for the widely-touted Mercatus Center analysis.
What I haven’t seen is a serious actuarial analysis. What do I mean by that? What I mean is a complete analysis of the total costs of the program which takes into account all administrative costs for health care, which doesn’t assume putative non-administrative cost savings which may never materialize, and that takes into account the differences among the various populations involved. Simply assuming a linear extrapolation is not a serious analysis.