To the editor:

The recent election revealed affordability as a dominant concern, with healthcare costs as a major component. Reducing the current $5.3 trillion annual cost falls into four categories. One would be using less healthcare services. This runs the risk of allowing mild, treatable problems to progress into serious and expensive problems. A second would be negotiation with providers — doctors, hospitals and drug companies — to accept less for their services, a difficult task under our current diverse payment system. A third would be having government cover a greater portion of the cost, by expanding Medicaid and restoring the recently lowered subsidies for ACA coverage. This would help, but is a temporary band-aid further stressing a budget already $2 trillion in the hole.

I would submit that Medicare For All is a better path. The administrative cost for Medicare is 1.3% That cost for private insurance is about 15% to 20% including marketing and profit. Additionally, private insurance occasions at least another 10-15% in overhead for the providers in running their business offices and obtaining prior authorizations, required by most private insurance. These savings would be in addition to the value of increasing negotiating power with providers to control their charges.

Just reducing the administrative costs would save about hundreds of billions a year, for the same or better care. These savings could be used to reduce the current approximate $2.8 trillion of cost covered by employers and households.

Steven Bruner, MD,

Lawrence