Follow up

Gnote wrote:
And this works in many industries, but it doesn't work in insurance. The further you can spread the cost, the cheaper it will be for each person in your plan.

But without other methods to control those costs (competition, supply, etc.), the net effect would be quite slight. I'm not going to deny that ceteris paribus a larger client pool will decrease overall costs (that is after all the principle of insurance: pooled risk), but you seem to be suggesting that's the only or even the predominant factor, in determinining premium. It's not.

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Profit really isn't the issue, for the purposes of this comparison.

But it is, since competition is the primary force by which a private company is compelled to control their costs. A combination of underwriting and investment profit is how insurance companies make money. Competition in the market means that underwriting profit is as low as possible, to the point where many if not most insurance companies actually operate with an underwriting LOSS for the sake of keeping business. Without competition, there would be no reason to do that.

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The issue is really administration of the program. In a multi-payer system, you not only have multi-payers, you have multi-secretaries, multi-lawyers, multi-facilities, multi-everything

Well, lawyers aren't part of an insurance policy. Lawyers operate independently and are part of a panel counsel, with many insurance companies sharing the same law firms. Secretaries, facilities, etc is fair enough, but those are both functions of the size of the client pool as well. I dare say that any single-payer system would require at least as much manpower (and possibly as much physical space) to operate.

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In the Woolhandler & Himmelstein article I cite (available from one of the links I posted above), they discuss the cost savings that would accrue to the U.S. due to savings on administration alone.

And again appeals to the US system mean little to me, seeing that we both agree that it needs serious work.

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In a public system, there is no profit motive. Theoretically - I say theoretically because we all know that it doesn't always work this way - any profit in a publicly administered system will go back to the public. This also separates it from a private system, which requires some level of profit to be paid to investors.

I think it is far too idealistic (and that's coming from me!) to suggest that a single-payer system doesn't operate with a profit motive. They must at least cover their costs, and "profit" going back to the public occurs in both a private and public system (through vastly different means, mind you).