[ajross]

> Medicare is 13% of the US government budget. More federal money goes to Medicare than to the Department of Defense.

These are not measures of efficiency. Medicare outlays are about 30-40% of private insurance for the same demographics.

> the care that people get from Medicare is substantially worse than what you get from private insurance

And this is, in fact, not true at all. US citizens on medicare beat their cohorts not only vs. other nations but vs. private insurance in the US too. Don't make the mistake of comparing your corporate insurance for a workforce with a median age of 30 with what retirees in the private market have available.

[pclmulqdq]

There is no doubt that Medicare has the bargaining power to drive down hospital costs compared to private insurance: Medicare gets 10c/$1 on the chargemaster at hospitals (and hospitals set prices so that Medicare's payment rate has a small profit), while private insurance tends to be able to negotiate 15-20c/$1. Individuals who are good negotiators can reportedly end up paying only 20-30c/$1, so if you have a big hospital bill, it can pay to call them up and negotiate.

Retirees on the private market get completely shafted, though: almost everybody in their age group uses medicare, so the insurance will need very high premiums to cover their risks. From what I have heard, people who are on employer plans at that age have better health outcomes than retirees, regardless of where the retiree gets their healthcare.

[amusedcyclist]

Libertarians are generally more interested in ideology than policy research