The “middle-man” is accounted for in the 20% administrative number he sited (think CEO, claims adjuster, customer service, the agent that sells the policy) Each of these are doing something in the process.
The math is that for every dollar collected in premium, $.20 goes to pay for everything excluding the claim.
Can this $.20 number be driven down? Sure, but you are still faced with the fact if a type of coverage is mandated by the government the money to pay for that coverage must come from somewhere. That is the $.80 of the $1.00 in premium.
Again, where does the $.80 come from to pay the claims? Is it generate from the customer in the form higher premiums?
Is it from the income generated from investments the company makes with the money? Probably not since the market is down.
Or is there a subsidy that must take place to aid the company to pay claims since they can not raise it from premiums from the customer due to regulations preventing rate increases or from the investment market?
The portion of the interview I watched had him raving about privatized Swiss care, but it was cheaper, more efficient. Well I guess so! The Swiss don’t let folks in who can’t afford to live there. Everyone has a job, or has bundles of cash. If you aren’t subsidizing 30% of the legal population and another 10% of illegals...
Being in a similar business I am used to these studies. They are complete and utter HS. The question is not what fraction of HC insurance dollars does for administration of health care insurance. The question is what fraction of health care dollars does to pay the salaries of doctors and nurses, the purchase of drugs and equipment, etc. It is a whole lot less than the other 80%.