[cdxx]

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There is a key economic principle you have to understand here - welfare loss. When the government taxes me $100 out of my paycheck, that does not become $100 in Medicare benefits for a retiree - it becomes more like $50 after the original $100 is run through the bureaucratic gauntlet, being syphoned off left and right.

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medicare is insurance, not a private savings account that you can use when you fall sick. think of your tax as the insurance premium. if you were paying $100 to a private insurer, you would be getting close to $50 in actual benefits, due to administrative costs. the reason why medical insurance enterprise is so profitable is because their adminitrative costs are very high.

in fact, since medicare tax is pre-income tax, $100 in medicare payments, and getting $50 back is not bad, and much better than private insurance premiums which may be post-income tax (at least partly).

the problem with medicare is not that it's inefficient. the problem is that your tax payment is not an insurance premium, as it is used to cover current benefits. so everyone who pays into medicare is not actually insuring themselves.

running a national insurer like medicare would be very good if it were run as actual insurance.