[sgerenser]

It's not just profits and management. Administrators, nurses, and yes, definitely doctors, get paid far higher in the U.S. than in other countries. Who wants to be the one to say we need to cut staff, and cut wages for nurses and doctors, in order to bring down costs? Just cutting fat from insurance companies, or having the government step in as insurer with no other changes, wouldn't move the needle much.

[Maarten88]

I'm pretty sure healthcare costs in the US are also higher as a percentage of GDP compared to EU, so higher wages would not explain the difference. Also productivity should be higher?

I think pharmaceutical, hospital, insurance and legal companies take all the money.

[paulsutter]

Doctor and nurse pay is like 13% of costs. Massive savings are elsewhere

[sgerenser]

Yes there’s tons of overhead and extra costs, but it isn’t mostly at the insurance company level. It’s spread all around the system, that was my point. There’s no one “quick fix” that leaves everyone with the same job and fat salary as they had before.

[paulsutter]

That’s right you’d need to eliminate most administrative jobs, all the jobs at PBMs, etc

Then these folks can contribute to the economy constructively, somewhere else instead of being a giant helksink of cost. A win-win for everyone