11/10/2025
So let's lay out details not spoken by Congress.
1/3 of healthcare spend in U S covers 226 million people through private coverage.
That 1/3 is in premiums with a specific formula spelled out by law.
The formula is
paid claims and paid health benefits,
and those claims include taxes on medical services imposed by 49 states, used to fund medicaid (remember this tax)
+ up to 15% gross margin in group, up to 20% gross margin in individual coverage
+ state and federal taxes on policy premiums, and states tax gross premiums, not just net profit.
That's averaging under 6,000 per insured.
Add in average out of pocket, and the private and copay is averaging under 7,500 per person.
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Government run coverage is 2/3 of U S health spend, and covers the other less than 115 million people that are legally allowed to be covered.
Many people have more than one of these at the same time.
The 3 main government insurances are
Medicare at over 15,500 per person, for worse than 80/20 coverage, 62 million peolle
Medicaid at over 11,500 per person, 70 million people
VA at over 10,500 per person, 17 million people
These 3 programs are the 3 most expensive per capita in the world.
And each of them is also paying claims that include taxes on medical services to fund Medicaid, so Medicaid is inflating it's own claims with taxes.
Plus the kicker. Each one of the programs hires private insurers to do the actual coverage, because they can not do it in house.
The data comes from
U.S. Health Care Coverage and Spending | Congress.gov | Library of Congress https://share.google/1kYhUamnXIFv8GJzK
If you would like to fact check the math and data. If it does not open for you, send me your email.
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