Per a KFF report, the US government spent less than 1.3% of Medicare expenses on overhead in 2021 – the remaining 98.7% went directly to paying for healthcare. For comparison, private Medicare (called “Medicare Advantage” by some) spent 17% on overhead, making the government ~13x more efficient at running healthcare insurance than private companies. Even this stacks the deck in favor of private companies; the 1.3% figure includes spending on overseeing private Medicare.

This isn’t new, either – the government has been much, much better than private companies at this for a long while.