Lloyd,

Is this a belated response or what? Anyway, late or not, I think you can't just say, "Hey, Medicare has lower overhead." That's not the question. You can set up a system in which doctors and hospitals charge whatever they want for anything they want to do, and somebody (whether the government or insurers or some new entity) picks up the bills. That will have zero overhead. But it won't get you to lower health care costs.

That said, I do think insurers' overhead can be lower. And it is in fact much lower for big companies that self-insure but have a UnitedHealth or an Aetna or whatever administer the plans (if I understand correctly, this is a common arrangement for large corporations)