I sent this to the Raleigh News & Observer:
Nicholas Kristof, in arguing for a single-payer health care system, explains that the current U.S. system is inefficient because 31 percent of spending goes to administrative costs. He, like many socialized health care advocates, is fixated on monetary costs.
As economist Tyler Cowen explained in a recent New York Times piece, when patients don't directly pay for health care they will demand extra services. Private insurers will spend money to monitor these services to make sure they are not allocated indiscriminately. A single-payer system would have to deal with the same pressures, and, as evidence from other countries shows, the government will require patients to wait for care or not provide it at all. So the costs still exist; they are just non-monetary and are borne by individual patients.