Admin Cost---SP Key---1AR

Kenneth Shuster 13, The author, a rabbi and attorney, received his rabbinical ordination from the Rabbi Isaac Elchanan Theological Seminary, an M.S. in Jewish Philosophy from Yeshiva University, a J.D. from New York Law School, and an LL.M. from NYU School of Law. He is an expert in comparative Talmudic and American law and Jewish medical ethics, and has published numerous articles on Talmudic and American law, and comparative Talmudic and American law. 2013. Article: Because of History, Philosophy, the Constitution, Fairness & Need: Why Americans Have a Right to National Health Care. 10 Ind. Health L. Rev. 75, Lexis

Fourth, it is argued that a competitive, private, free market approach to health care would streamline health care costs to make them more cost effective. 102 However, it is precisely the competition between insurance companies in the private sector that has caused the costs of health insurance to spiral out of control and become unaffordable for so many. 103 A single-payer plan, by providing health care to all Americans regardless of their ability to pay, would keep health care costs down particularly because such a program will not need to spend small fortunes on advertising, consumer influence, and the administrative costs associated with these realities. 104 The lack of competition as a cost-controlling mechanism would apply to hospitals as well as private insurance companies. 105

Only way to solve is to change the portfolio of administrative actions for which insurers are responsible

Mueller et al. 17. Dutch Ministry of Health, Welfare, and Sport. 01/10/2017. “Administrative Spending in OECD Health Care Systems: Where Is the Fat and Can It Be Trimmed?” Tackling Wasteful Spending on Health, OECD Publishing, pp. 229–264. CrossRef, doi:10.1787/9789264266414-en.

Find the right size of administrative bodies to generate economies of scale. Finally, many recommendations to improve administrative efficiency with organisational changes are around redefining the size of governmental bodies and redesigning the portfolio and operations of health administration entities. The overall aim is to find the optimal size of an administrative entity to achieve efficiency gains without compromising responsiveness. These changes can be part of a major system overhaul or refer to smaller organisational changes and include the mergers of previously separate administrative entities, or in other cases, their separation. For example, Korea’s move from a multi-payer to a single-payer health insurance system considerably reduced resources devoted to administration. This move facilitated a more standardised use of ICT and a standardisation of processes, and is generally associated with greater economies of scale in purchasing, but also in performing administrative tasks. Merging insurers resulted in a reduction of health insurance staff by about a third. The share of administrative costs in total SHI spending went down, from 8.5% in 1997 to 2.4% in 2008 (Jeong, 2010). In Iceland, the Ministry of Health merged with the Ministry of Social Affairs in 2008, while in the Slovak Republic two state-owned insurance companies joined forces with insurance companies in 2010, reducing their number of staff by 10% between 2010 and 2011. As part of the rescue financing deal with the European Commission, the European Central Bank and the International Monetary Fund, Greece merged the health divisions of the four main social insurance funds into one health insurer – the National Organization for Healthcare Services Provision (EOPYY) – and limited its role to purchasing services. Previously separate administrative bodies were also merged in Belgium. In Denmark, however, organisational change referred to the separation of institutions; in this case the Medicines Agency was separated from the National Health Authority to better streamline procedures to license new medicines.Whether agencies are merged or separated depends on the country-specific context but generally countries try to find the most appropriate organisational size to achieve efficiency gains. Consolidation of administrative activities of public insurers or governmental departments can be the result of efficiency targets striving to improve operations within administrative institutions, as was done in France and Australia. These consolidation efforts typically result in a reduction of administrative staff. Again, improvements in the processes of governmental operations can be facilitated by better use of ICT, as seen for example in Korea and Slovenia. Consolidation and separation initiatives typically involve regulators, while the finer organisational changes can also concern managers, and to a certain degree, physicians.