To a Friend

In response to a health-care reform proposal that would allow all Americans to buy into Medicare:

OK. But Medicare "works" partly because it underpays providers, who then charge more (price shifting) to private-insureds (and the private insurers, not the providers or Medicare, take the heat). And Medicare administrative costs appear extremely "low" because Medicare doesn't pay claims (the biggest administrative expense), it contracts with "third-party payors" (some of the same insurance carriers everyone rails against for administrative inefficiencies). Besides, this proposal still doesn't address the MAJOR determinant of health care costs--physician behavior!