One of the reasons why the current US health care system is so bloated is that it wastes a lot of labor on health insurance administration.

Health care providers have to employ many people to make agreements with health insurers and to bill health insurers. Health insurance companies also have to employ many people to make agreements with health care providers and to pay the bills those providers send them. By streamlining billing and payments under a single national insurer, a single-payer system would eliminate much of this work, which is one of its many charms.

Critics argue that the elimination of this work would strike an intolerable blow to employment in the country. In reality, the loss of employment would be relatively small compared to the overall economy, should only be temporary, and could be cushioned through unemployment benefits and active labor market policies that help reallocate redundant workers into new jobs.