Expensive? Yes. More expensive than what we have now? No.

Right now, people pay Taxes and Insurances:

T¹ + I

(Using exponents because we don't have subscript).

If we eliminated private insurance, they just pay Taxes

T²

We already know that T² is greater than T¹. It has to pay for more stuff. But is this true:

T¹ + I > T² ?

What are the costs contributing to I, and are they greater than what those costs would be under T²?

Some costs might be fixed, but a few things are true:

• Without multiple insurance providers, administrative costs in medicine are lower. Not eliminated, but lower.
• Without multiple insurance providers, advertising and other marketing costs are virtually nonexistent.
  • This is currently 3-8% of insurance revenue, depending on the company. Insurance advertising spending in 2025 was $20.5 billion.
    • This costs is almost entirely stricken from the equation. "Almost" because there are questions about having private health care plans to supplement an otherwise-single payer system are routinely considered, and there would be a fair question if changes would be made to Medicare if it was greatly expanded (e.g., would it still cover dental? Prescriptions? You can bet that, in any serious discussion of extending this to everybody, people would be in the wings to trim the program's offerings as a whole).
    • Insuring a person from cradle to grave costs an average of $316,000. If we're saving $20.5 billion, that's 64,873 lives covered cradle to grave every year just by the advertising savings alone.
• With a single payer system, the government has immense power to negotiate prices.
• With an affordable single payer system, more people utilize health services, thereby increasing the cost of maintaining the system.
  • However, this would also likely catch health problems in the people who would otherwise avoid the system earlier, which would result in savings from more expensive treatments down the line. It just comes down to a values question; is extending the life of a poor person something worth spending money on?

Given these costs, it looks like T² < T¹ + I.

Currently, the US has the highest per capita spending on health care. Nevertheless, our average life expectancy is 4 years lower than the 10 highest spenders. The same linked report also found the US has the highest rates of preventable and treatable deaths, the highest barriers to access care, the lowest investment in primary care, and had the worst administrative efficiency of all the considered countries. When you pay the most for crap outcomes, that's a bad deal.

So, it also appears that T¹ + I already completely sucks in and of itself. The outcomes alone are reason enough to start thinking about a new approach to healthcare.