Medicare and Medicaid are far from efficient. Were that truly they would not be hemorrhaging money!
Insurance is part of the reason costs are high, but not all of it, Government regulation is also part of the cause, as well as fear of lawsuit. I question your claim of 23% profits. But even at that level their profits are not the highest rate of return!
As for lowering of costs, private industry can do just that. Providers of insurance are forced to compete for small pools of clients, which increase the level of costs. AN example the flies in the face of your claim is the segment of the health care industry dealing with laser eye surgery. An item not covered by most insurers. Making the payment the responsibility of the customer. Since inception the equipment has improved and the costs have been reduced. What was the cause? Competition! If the customer is not happy with the cost or service they will go to another provider, not possible under most insurance plans.

Quote Originally Posted by SadisticNature View Post
I think the job description changes a little bit.

After all medicare and medicaid are the two most efficient plans in the country, and there are far fewer cases of them aggressively trying to deny care.

For profit insurance is part of the reason costs are out of control. Taking 23% profits, introducing a huge amount of overhead with high level management salaries and benefits, and saying that there will be savings to the consumer is in general quite laughable. There can be other benefits such as diversity of options and varying levels of quality (pay for premium care etc.), but to say that private industry lowers costs is generally erroneous.