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Total US National Health expenditures are $3.6 trillion. 10% of this is out of pocket, the lowest-paperwork form of spending, so M4A is apparently going to shave almost 20% from the remaining $3.24 billion, *just from bureaucracy reduction.*

But that's not all ...
Another 3%, about $100b, is in government public health stuff. How is Medicare for All going to reduce paperwork at the CDC or streamline our anti-smoking PSAs? Seems ... unlikely. Now we need to get $600b from $3.14 trillion--inching closer to a full 20%.

And we're not done ...
Another 8% comes from private efforts like worksite healthcare, and public stuff like workmen's comp. How is Medicare for All going to lower paperwork at your company nurse's office? Can it eliminate workmen's comp hearings, which cover lost wages as well as healthcare?
Oops, we just lost another $250 billion from the denominator, more or less. Now we have to save *more* than 20% on paperwork.

Oh, and we're still not done ...
Of the 75% of US health expenditures covered by insurance, less than half (34/75) are covered by private insurance. Most are covered by Medicare, Medicaid, one of the military programs, or CHIP (41/75).

How is Medicare for All going to make that government slice more efficient?
I'm not saying I can't imagine ways to make the government healthcare programs more efficient. Many, many people have imagined this. Some of their imaginings are plausible! But they have turned out to be very, very hard to implement in practice.
But if you cannot make these programs *massively* more efficient, then you have to take almost all $600 billion out of the 34% of total US health expenditures paid for by private insurers. That's $1.2 billion, for those following along at home.
In case you're wondering, private insurers ain't spending no 50% of their revenues on unnecessary bureaucracy and paperwork.
All numbers from here: cms.gov/files/document…

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