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Honest question as someone who prefers single payer but acknowledged it's not a silver bullet: how much of the costs are nurses and doctors vs. admin? It seems to me there's a lot of overhead in passing the bills around to get paid. I just had my appendix out last year and got billed 8 times by 8 different firms, each with payment portals, call centers, billing providers, etc. I assume there's a lot of inefficiency internally too.

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~40-60% is direct healthcare - not including admin or insurance labor costs.

Pharmaceuticals is ~9%.

Health insurance profits are 1.2%.

Other profits are x%.

Medical equipment, devices, hospital rents, etc are y%.

Most of the remainder is admin & insurance costs - only about ~2% of which is private health insurance operating costs (largely labor).

You're ignoring the fact that all of the large insurers are increasingly also the healthcare providers.

UnitedHealth Group is the owner of both United Healthcare (the largest insurer in the country) and Optum (the largest healthcare provider in the country).

Part of UHG's low profit margin is its liberal use of intra-company eliminations, where transactions between Optum and United Healthcare get zeroed out and don't count toward profit despite it ultimately generating more dollars in the parent company's coffers.

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