[pieceofthepuzzle]

The first thing I would do with Medicare is mandate that no more than 12% of every health care dollar spent by Medicare can go to administrative costs - with cheating punishable by mandatory imprisonment for at least 2 years. Administrative costs are over 26% in US healthcare, as opposed to 12-15% in Europe and elsewhere. By doing this, you wouldn't have to specifically address how to decrease administrative costs. The administrators whose salaries are paid out of that money would sort themselves out - likely by decreasing the number of administrators markedly. This would be an automatic cost reduction of at least 10-15% across the board. Insurance companies would follow suit. It would streamline medicine, and put more of the money where it's supposed to be, in the direct care of patients.

[Rockingham]

What you describe as administrative costs are mostly the costs of compliance with federal regulations. Some of those regulations are well-chosen, while others are expensive vexations that serve little good purpose. Rooting out such expensive regulations is difficult and will require action by Congress.

[semimojo]

Administrative costs are over 26% in US healthcare, as opposed to 12-15% in Europe and elsewhere.

The admistrative costs for Medicare are much lower.

Most sources estimate 2%-3%. Some much higher but I don't think anyone says they're close to the private insurance average.