If anything, Medicare gets the best deals because of its huge base that it can use as leverage. TFA mentions that, among the current choices of no insurance, private insurance, and public insurance, the last option gets the best prices. The average-sales-price-plus-6%-premium rule is downright stupid, but it's only a piece of the larger puzzle. Short of a law regulating the salaries and costs of hospitals, bartering is the next best strategy for pushing down prices. Also, FTFA: That's a pretty good sign to see for an organization so closely tied to life and death.Medicare’s total management, administrative and processing expenses are about $3.8 billion for processing more than a billion claims a year worth $550 billion. That’s an overall administrative and management cost of about two-thirds of 1% of the amount of the claims, or less than $3.80 per claim.