Multiple insurers are intrinsically more costly than single-payer systems such as Canada’s

“A system with multiple insurers is also intrinsically costlier than a single-payer system. For insurers it means multiple duplicative claims-processing facilities and smaller insured groups, both of which increase overhead. Fragmentation also raises costs for providers who must deal with multiple insurance products — at least 755 in Seattle alone— forcing them to determine applicants’ eligibility and to keep track of the various copayments, referral networks, and approval requirements. Canadian physicians send virtually all bills to a single insurer.” 

Source: https://pnhp.org/publications/nejmadmin.pdf

Steffie Woolhandler, M.D., M.P.H., Terry Campbell, M.H.A., and David U. Himmelstein, M.D. Costs of Health Care Administration in the United States and Canada. N Engl J Med 2003;349:768-75

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