>>What I like best is the efficiency of government run programs. Not to worry though, I’m sure the 1.45% of my gross wages and my employer’s 1.45% (what a joke) is safely tucked away with my SS contributions in a government “Lock Box”. Someone tried to tell me that the government had already spent that money and there were just IOU’s in the lockbox. The government wouldn’t do that, would they?

LOL, it was Dragan who observed the pillaging of your contributions in exchange for IOUs. It's true that assets appreciated marvelously in recent decades to the advantage of the scheme had usual underwriting principles been used rather than low interest-bearing IOUs - but it's too late now. I think Medicare contributions may be a little more than you quote especially if self-employed, but I agree the contributions are inadequate even to pay today's Ponzi costs, let alone yours in future..

FWIW, the rest of the free world has universal healthcare schemes costing a fraction of your spend, without leaving out millions of citizens or residents. The US system is the most expensive and by extension the least efficient of all first world nations'. It's not as if you're getting the best delivery for your top dollar, either: every Commonwealth Institute comparison of healthcare system has the US languishing at the back of the pack.

As for fraud:

>>No one knows for sure how much of that is embezzled, but in 2012 Donald Berwick, a former head of the Centres for Medicare and Medicaid Services (CMS), and Andrew Hackbarth of the RAND Corporation, estimated that fraud (and the extra rules and inspections required to fight it) added as much as $98 billion, or roughly 10%, to annual Medicare and Medicaid spending—and up to $272 billion across the entire health system.

Issue is that mistakes used to be tolerated, but now systematic mistakes can leave physicians and administrators labeled fraudsters, complete with orange jumpsuits. It's serious. Medicare billers are subjected to RAC audits where auditors are paid/incentivized according to the wrong claims they discover, with sheets of likely/common mistakes to go for, caused by ambiguous or difficult rules. Auditors are like the IRS meaning that once an audit commences they'll keep digging until they find something, because nobody is perfectly clean and also because otherwise there's no pay- so you might as well deliver up some oopsies early, wear the "take backs" and penalties, and implement strategies to make it a little less expensive next time. By 2012 take backs approached $1B/year, but numerous successful claims against practices like demands for huge volumes of records that swamp the target caused a partial hiatus starting 2014. This year RAC is back, complete with a whole new ICD-10 coding system with plentiful opportunities for discovering wrong coding. If you want a reason why admin gobbles more than 40% of healthcare spend in the US - then this starts to tell the story. Some experts observe that shaving efficiencies out of the 40% is a lot more cost-effective than trying to reduce 10% which drives up the 40% further!

Unfortunately focus on fraud is required because in any self-reporting system there will be crooks bilking the system and abusing the trust on which the scheme relies. Overt healthcare fraud still is so occasional that it still makes news when they're caught, unlike (for example) gun crime in Chicago where there's so many that only the shooting of a child or some other innocent is worth more than a paragraph. There have been some truly vile healthcare fraudsters including some physicians, generally those also running facilities or abusing stock. I recall one terrible example where the surgeon drew from a vial of extremely expensive drug for more than one patient, then billed full fee as if he'd used one vial for each in normal fashion. That's outright fraud with no credible belief that this could be reasonable, so he deserved the book thrown at him.