It is dishonest to deliberately misrepresent someone's argument in order to refute it. This is what Ezekiel Emanuel does repeatedly in an NYT blognote on reducing health care costs.

He belittles the idea that there could be substantial health care savings at the expense of the insurance industry by telling readers that industry profits are just $11 billion a year, less than 0.5 percent of national health care expenditures. Presumably Emanuel knows that advocates of a universal Medicare type system see the whole insurance industry as a source of waste, not just the profits.

According to the Centers for Medicare and Medicaid Services, the country spends $150 billion a year administering private insurance. In addition, the fact that providers must deal with an array of complex rules from multiple insurers means that they must have additional office staff who would not be needed if they were just providing health care. This has been estimated as increasing health care costs by as much as 15 percent of total expenditures ($390 billion a year).

Similarly he suggests that the potential savings from lower cost prescription drugs are very small, on the order of $6 billion a year. In fact, we spend almost $280 billion a year on prescription drugs. If these drugs were sold in a free market without patent monopolies, they would cost around $30 billion, leaving a potential saving of $250 billion a year. It would be necessary to find other mechanisms to support research, but the potential savings are an order of magnitude greater than suggested by Emanuel.

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