That's not quite true. Medical billing here is hopelessly complicated, a universal system would likely have universal rules, and streamline the process of billing and payments.

So if a medical practice now needs 5 people to do the insurance billing, it might need only one if there was one payer (Medicare) or two if there was a German sort of system, but not 5.

No. Wrong.

As others have outlined in greater detail... no, you'd have a massive simplification and standardization of such forms, thus a massive reduction in the amount of 'needed' work of such kind.

The entire way the modern US healthcare system works is by making there be so many abstract layers and processes going on at the same time, that it requires an inordinate amount of time and effort to even actually map out what those layers and processes are, much less who is actually responsible for what particular decision or mistake.

And that is the point of it. Its is insanely complex and opaque by design, because it allows them do functionally do whatever they want, and be able to say its all done for compliance's sake.

So, yeah, if you just flatten all that... ~90% of it no longer needs to exist.

Or... the real funny part here is... if we stick with the system as it is, well, this kind of shit is gonna be done by LLMs. So we will probably end up having the same employment void developing under the current hypercapitalist paradigm as well.

I'm from Canada, and I know a surgeon and he has one admin. One (1) secretary that handles patient booking, billing, and payments. The benefit of a single payer system is there's one payer. The government. One set of forms to comply with. No rejections (almost always. Rejections come from foreigners or out of province coverage when determining which province is responsible for paying)

His software system (government provided) auto fills 99% of it. That's why he can have one (1) secretary. The government side Idk but it's certainly not insane ratios like the US since the process is far more streamlined and doesn't rely on appeals or rejections to racketeer more money out of doctors and patients. What's really sad is Americans are so conditioned to believe their way of life is somehow normal, that orphans must also be crushed somehow in Europe or Canada.