I agree. But a single payer system will lead to rationing and death panels. Just because the government would never call them that, does not change the nature of a bureaucrat or bureaucratic committee in effect sentencing people to death by denying them treatment or coverage or whatever else the single payer claims to be providing to disguise that it is running the healthcare industry. As I pointed out to Legolas when he raised the same comparison, having private medical care forces the government to spend more so that its beneficiaries can enjoy something comparable. The government does not hand out rations to those in need, they give them money (or stamps or a card) to buy food in the same store as everyone else. People on welfare or without money to buy their own insurance or medical care will not be satisfied with government clinics and VA hospitals when they see what the private industry has to offer, so there is pressure on government to spend more to match it. So yes, from one point of view, we will save money switching to a single payer system, or rather, less money will be spent (meaning fewer, i don't know, jobs, in the medical industry). But once the single payer system takes over, there will be no other options. How do you enjoy the current government monopoly on law enforcement? Do you like their level of customer service, especially to the most marginalized? That's what you are going to get from the government for health care once they have a monopoly on it.

The other aspect of the current high spending on medical care is that government interference in the market (such as their regulations in the insurance industry) drives up costs and prices. The degree of regulation and bureaucracy vastly increases the costs of overhead for the medical industry. My father is an optician and when he ran his own store, refused to take Medicare because he never got reimbursed, or not for the full value. He also counted on significant sales at the end of the year, when people had room under their insurance plans to splurge on eyeglasses. Because the regulations on the insurance industry minimize competition, people end up with bloated plans including coverage of things they don't need, so they use it as much as they can to get their money's worth. They don't get back the money they don't spend, so they spend as much of it as they can, like government employees splurging to use up their budget at the end of the year so they don't get it cut the next. A comparison would be in housing, where the government does not build homes for those in need, instead it imposes rent control, or mandates the building of cheap housing, that poor people can better afford. And the reality is, we end up with less housing, because no one wants to invest in owning property when he can't charge tenants enough to cover his expenses or needs an act of legislation in order to raise the rent to cover increases in costs. There is a corrlation between homelessness rates and rent control laws in cities across the country, with New York and the Bay Area having the highest of both. That's what happens with regulation of any industry. It is a law of economics that when you put a price cap on any commodity, whether goods or labor or services, you end up with a shortage, just as when you put a minimum price on anything, you end up with a surplus. A price cap on housing results in a shortage of housing, which leads to homelessness. Price controls on health insurance leads to shortages of health insurance. Giving people money to spend does not increase the supply, it just changes the prices. When they started giving out Pell grants, college tuition began rising, because they could get away with charging more, and because so many more people were able to afford college, that they filled their classrooms more easily, and could be more choosy about their accepted applicants. The rich could still easily afford the rising costs. It was the middle class that got squeezed out, or were forced to get grants themselves to catch up with the rising tuition. Throwing a lot of money into the system will just raise the prices, which the rich will barely notice, but the working class will feel the bite. Price caps will reduce the incentive for expanding services, or lead to finding new ways to get money.

The whole employer-insurance paradigm that is causing problems today grew out of attempts to circumvent wage caps (imposed by the government, naturally, to keep the private sector from luring employees away from war factories with better pay), during a time of high labor demand. So employers started offering health coverage in addition to the fixed salary. The insurance industry started wagging the dog of the medical industry, forcing medical providers to spend more of their and/or hire superfluous personnel in order to keep the necessary records and process the necessary paperwork, to price certain services up in order to cover the things that insurance companies refused to cover after the fact, and the costs of compliance with insurance companies and with regulations on the same. Between the concerns of insurance mandates and malpractice (and the insurance expenses and dictates to protect against the same), the patient's interest has definitely lost out. It is no longer the doctor's call as to how he should deal with a patient who cannot pay his fees, because he has to shovel so much money into the overhead and operating expenses created by the insurance industry and its government protectors, that the wrong independent choice can cost him his practice.

The solution to the current high spending on medical care is less regulation, and making the market responsive to the consumers. There are any number of practices, hospitals and clinic who operate entirely by charging their patients directly, at greatly reduced prices, by simply refusing to accept insurance or government programs. They offer their patients a choice, and the patient decides if he can afford it or if he needs the treatment at that cost, and he pays or does not. They get their money and do not have to worry about jumping through the hoops of the insurance companies, HMOs or Medicare & Medicaid.

If insurance is TRULY optional, rather than propped up in an artificial market that makes forgoing insurance a practical impossibility, then they will have to compete, and if they have to compete, will be more responsive to the consumer. If your employer is paying into your group plan, the same for each employee, the insurance is getting paid for me no matter what. I am losing money by seeking other insurance on my own, since I have no other way to access the money my employer is spending on my insurance. If they did not have the guaranteed income from employers forced to buy insurance, or government regulations mandating everyone sign up for a policy (not to mention raising their costs by forcing them to cover certain procedures or treatments that have good enough lobbyists to be mandatory), insurance companies would be forced to offer more convenient or cheaper plans. If insurance companies were not the primary spenders on medical care, medical providers would have more freedom to be responsive to individual customers, the same as they do with every other commodity on the free market.