I call BS on this. For just one example, consider the sizable armies of workers employed by private-enterprise health insurance companies to seek ways to deny claims--and the similar amount of worker hours on the other side, trying to get health-care providers paid for work they've already done. IIRC, they add something like 1/3 to the cost of health care in the US. Although Medicare is far from a perfect role model, it's vastly more efficient than that..... Private enterprise ALWAYS does it better than government when there is a chance for profit.