I'm pretty sure it isn't assumed. My main example has been the same since COVID, as insurance is probably the business you can compare 1-1 the most.

Public health insurance in my country, in the last 20 years used 6-9% (depending on the year) of the taxes send to them as administrative overhead, meaning that for each 100 euro that you paid for health insurance, 91-95 are used to pay doctors, hospitals and medication. The average administrative overhead for private insurance is around 14%, which makes private health insurance 50 to 100% less efficient, and means that for each dollar you pay them, only 86 are used to pay health services.

I have other examples, but it isn't fair: municipal water VS private water service are almost always less expensive and better tested in my country. Municipality trash collection Vs private trash collection, same. Public junkyard Vs private junkyard, same. But in my area, when privatised those services tends to be ran by the local mafia (Marseille, Nice), which add a lot of overhead, and they were privatised because the local government was corrupt in the first place, which means they were probably inefficient (compared to the services still publicly owned) first, then sold.

▲

SubiculumCode 19 hours ago | parent | next [-]

Cherry picked examples don't prove that it isn't context dependent.

	▲	orwin 16 hours ago \| parent [-]
		That why i usually keep to the insurance example, i agree that comparing municipality power to private companies owning a monopoly is unfair. Administrative costs for insurance are very easy to verify, and the facts stay consistent across countries. If i cherry picked something, it is the admin overhead for US insurers. US health care insurers are particulary effective with their average of 14% admin overhead, SwissLife, that used to be my private insurer, had a year with 30%, which make the comparison quite unfair).

▲

nonethewiser 20 hours ago | parent | prev [-]

Is your country’s pharmaceutical companies pushing the entire industry forward?

	▲	thomaslord 19 hours ago \| parent [-]
		This doesn't seem to be relevant to the comment you replied to. They didn't mention anything about paying less to pharmaceutical companies, they argued that the administrative overhead of providing the insurance itself is lower. As I read it, your argument seems to be that American healthcare must be more expensive than similar-quality healthcare elsewhere because we're paying higher pharmaceutical prices to fund research. If we accept that premise, shouldn't that mean that: 1. The "medicine" portion of costs increases, causing the total cost to increase 2. Administrative effort, and therefore absolute cost, remains the same (we're paying X% more for drugs, not thinking X% harder about whether a given drug is needed by a given patient) 3. Administrative overhead as a percentage of total cost should be lower given a similar efficiency level, because higher drug prices inflated the divisor (total cost) while having no effect on the dividend (administrative costs)