Medicare's Administrative Costs

Greg Mankiw wrote Medicare has lower administrative costs? and cited a study that said no.

Paul Krugman pounced on it in Administrative costs saying the study was from the Heritage Foundation and flawed and refuted by Jacob Hacker.

Robert Book, the author of the Heritage Foundation report commented to Krugman's article saying, nope it's valid and ad hominem attacks aren't. "expressing health administrative costs as a percentage of total program costs is silly, since the bulk of program costs are health care claims and administrative costs are mostly unrelated to the level of health care claims. (Medicare claims processing is only about 4% of administrative costs; the other 96% is unrelated to the level of claims). This is clear from a moment’s thought — if you insure a healthy 25-year-old who never goes to the doctor (or at least, not enough to exceed the deductible), a health plan’s cost for that person is 100%, no matter how efficient the administration is. Private insurance has a lot more people like that than Medicare does."

Krugman followed up with A bit more on administrative costs which looks at costs of other large health care systems like Canada's saying that public systems can be as efficient or moreso than private.

And Mankiw follows up with Costs versus Efficiency. "True, Medicare’s administrative costs are low, but it is easy to keep those costs contained when a system merely writes checks without expending the resources to control wasteful medical spending."

Honestly this sounds like economists who specialize in other fields, jumping into the health care economics and trying to find their way. Where are the health care economist bloggers?