"All the evidence says that public systems like Medicare and Medicaid, which have less bureaucracy than private insurers and greater bargaining power, are better than the private sector at controlling costs. I know this flies in the face of free-market dogma, but it’s just a fact. You can see this fact in the history of Medicare Advantage, which is run through private insurers and has consistently had higher costs than traditional Medicare. You can see it from comparisons between Medicaid and private insurance: Medicaid costs much less. And you can see it in international comparisons: The United States has the most privatized health system in the advanced world and, by far, the highest health costs."