Having to be familiar with a variety of forms is an additional cost. But the forms, at least for claim submittal, were/are largely the same. And there has been ever increasing work done to standardize XML forms across the industry. One company I am familiar with ([link|http://www.realmed.com|Real Med, Inc.]) built its company on the disparity among forms and the delays in receiving payments for services provided.

I'm not taking issue at all with the superiority of "single payer" systems. In my experience there is not a single aspect of the delivery of healthcare which is not better performed by single payer systems than by private insurers.

While I'd agree with your position that once all administration fees are counted, the total is higher than 16%, I cannot believe that any healthcare practitioner spends as much as 9% of his "take" on dealing with forms.

And Thane, getting Fee Schedules is very difficult business (those are considered trade secrets and are highly protected). The NCQA sells a report (the old ones used to be free, but apparently are no longer free) called HEDIS. Check out [link|http://www.ncqa.org|http://www.ncqa.org] for more info. I guess I didn't fully appreciate how much "inside info" I was getting during my years with HMO's. Another source of information would be Insurance Brokers. They usually know more about the insurers in your area than just their fee schedules. I'm not sure which state you are in, and state laws vary considerably. But check your state's Department of Insurance for information concerning Plan performance versus Medicare. Some states require a bunch of info (like % of Medicare Fee Schedule, C-sections/1,000, Beta Blocker treatment for MI patients, etc.) and some states require almost nothing. Almost all states require all healthcare insurers to report their profit or loss yearly.

HTH.