Where would you like your tax dollars to go?

[popeyespappy]

I've already mentioned a couple of the big additional cost drivers in liability insurance and education costs.

Profits of health insurance and health providers are of course another target for cost reduction. But those profits are probably not as big a portion of the overall cost as many assume. For one thing only 18% of American Hospitals operate as for profit enterprises. 20% are government facilities, and 62% of American hospitals operate as non-profits. So in 82% of our hospitals there are no profit margins to cut. The 18% that do operate as for profits average a little less than a 9% margin. That means the most savings you could see cutting the profits of hospitals would be 1.62% of the total. Reality is it would be a lot less than that because hospital revenue doesn't account for 100% of the total cost.

Insurance companies operate at a lower margin than hospitals. According to some sources as low as 3.3%. But once again health insurance revenues aren't even close to 100% of the total so zeroing out those margins altogether might save another 1.6% of the total. Best case scenario we'd probably be looking at a 3% savings by getting rid of hospital and health insurance profits. Maybe none at all if the government can't manage billing and payments at least as efficiently as the for profits.

Drug company margins are another cost reduction target. One that could pay some substantial dividends since US pharmaceutical companies averaged a 23.5% margin last year. But once again drug costs account for less than 10% of total healthcare expenditures so at the most we'd be looking at a 2.35% savings off the bottom line. Add all those profits together and we'd be looking at a maximum savings of maybe 6%. That would have brought last years per capita healthcare expansive down from $10,335 to $9,715. It is something but not nearly enough to supply healthcare to Americans that don't currently get any without raising the overall cost.

I see those numbers and have no cause to doubt them.
But something must be wrong somewhere, because it's obvious the US is spending much more on healthcare per capita than most other countries, while leaving a large swath of the population unable to access medical care.
The money is going somewhere... somewhere it doesn't go on this side of the Atlantic.
Maybe there are redundancies in place that double or treble the actual cost of procedures?
Maybe the non-profits are doing some creative accounting?
Maybe something else, or a messy combination of many bits and pieces?...
You guys tell me.

Nonprofits earn extra money they just can't pay it out to investors. Most of it is reinvested in the nonprofit or used to fund charitable activities.

Yes a messy combination of many bits and pieces. I don't know how to fix it, and as far as I know no one else does either. As I said, I'm open to suggestions.

I'll ask those of you with single payer systems this. What you have now is apparently working now, but is it sustainable? What will your per capita costs for healthcare be in another 30 years?