So what’s the answer? First, allow anyone at any age to join Medicare.

Medicare’s administrative costs are in the range of 3 percent. That’s well below the 5 to 10 percent costs borne by large companies that self-insure. It’s even further below the administrative costs of companies in the small-group market (amounting to 25 to 27 percent of premiums).

And it’s way, way lower than the administrative costs of individual insurance (40 percent). It’s even far below the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

Second, allow Medicare – and its poor cousin, Medicaid – to use their huge bargaining leverage over doctors and hospitals to change the incentives driving the health care system. Instead of reimbursing doctors and hospitals for the costly tests, drugs and procedures, pay them for keeping people healthy.