I don't mean to oversimplify and paint a straw man here: These are literally arguments I hear from some family and friends on the topic without much of any nuance to them.
When you turn 65, you receive Medicare benefits after a pretty painless application form, which is mostly to obtain coordination of benefits information for retiree private plans
Aftwards, you have very little interaction with Medicare, other than if you are placed in a nursing home or rehab, at which point you may need to argue for more benefits as the rehab will try to maximize their revenue by kicking you out after 90 days.
My spouse visited a doctor in January 2020, and we recently got yet another Explination of Benefits about that visit, which is probably the 15th time they've sent one. I wish I was exagerating.
I give the hospital my child's medicaid number, they take it from there. Really pretty much that simple. No prior approval. No crazy paperwork. Just give 'em the number and you are off to the races.
I'm sure it would be worse for elective surgeries, but that's not really what anyone is arguing for.
Besides which, unless you have the best gold plated insurance plans or a mediocre plan and never need to go out-of-network, mindless beuracracy and tons of paperwork describes the status quo of private insurance.
And annecdotally, my father on Medicare has far few issues of that sort than I do on my (above average) employer's plan.
There is a stark difference between Medicaid and Medicare. Medicare, for those who can enjoy it (65+ or meeting criteria for chronically disabled), is pretty good insurance. You have your pick of specialists or primary cares, it reimburses providers pretty well, and ironically, processes claims faster than private insurance. There are some glitches that should be fixed sure, but it is definitely viable as a healthcare plan.
Medicaid in comparison, is bare bones - the political reasons I'll let other people comment more, but access to care is severely restricted, it doesn't pay providers enough to keep the lights on, and is not really capable of providing any semblance of the modern standard of care.
In contrast Medicaid is awesome - zero copay or deductible, just show up and use your insurance card.
There is also Medicare Advantage, which actually is quite good - and it's private insurance that the government pays for. So maybe we don't need either "for all" programs, but rather a universal subsidy for people to buy their own insurance.
> it doesn't pay providers enough to keep the lights on
That's true about both Medicaid and Medicare, which is why neither will ever be offered to all, not without a salary cut to Doctors.
Those arguments' flaws aren't corrected with the implementation of a bad system.
If you have Medicare for All, you don't have to worry about getting into the program, because everyone already has it, no?
Example: USA $8360/person/year, 78.9 years; Singapore $1730/person/year, 82.8 years.
People who don't have health insurance are often shafted, but even people who do have health insurance are too: https://slatestarcodex.com/2020/04/24/employer-provided-heal...
Healthcare is probably the single most broken part of US society/economy.
[1]: https://www.gapminder.org/tools/#$model$markers$bubble$encod...
I say funnily, because the US government is know for being light on bureaucracy. Yet, somehow the US healthcare system has given it a run for it's money.
Every hospital has a significant amount of staff dedicated to billing and negotiating with insurance companies. Every insurance company has a fleet of employees who work on optimizing costs, denying coverage when possible, and negotiating bills with hospitals. And on top of that, a large part of the job of HR for employers is managing healthcare benefits and negotiating with healthcare providers.
Layers upon layers of ultimately waste.
A single payer system ends up saving cost because.
A. There's no negotiating bills with the government. You either accept what they are paying or you don't get paid.
B. Because the government deals with every hospital, they've got very good insight into what things ACTUALLY cost. That makes it hard for a medical provider to play fast and loose with the numbers.
In otherwords, admin costs for Hospitals go completely away and the government admin costs end up being a fraction of what the rest of the insurance industry is doing (because a lot of what private insurance is doing is trying to make money off of premiums in the stock market). Government does not have that incentive in the slightest.