Medical loss ratios affect insurance company stock values.

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1. Medicares 2% ratio is not quite accurate

The IRS handles collections for medicare. The SSA collects some premiums as well. Health and Human services owns the buildings and handles accounting.

Medicare does not pay exise taxes that for profit insurance ccompanies pay (those count as administrative cost).

Medicare also deals with sicker paitents. If my insurance company spend 150 dollars on medical care and 150 on overhead they would be at 50%.

If I get cancer and they spend 100k on medical cost, then their loss ratio improves. Some marginal cost for overhead go up a bit bit the fixed cost stay the exact same.