Excerpt: This issue brief examines the sources of administrative costs and describes how a private?public approach to health care reform -- with the central feature of a national insurance exchange (largely replacing the present individual and small-group markets) -- could substantially lower such costs. In three variations on that approach, estimated administrative costs would fall from 12.7 percent of claims to an average of 9.4 percent. Savings -- as much as $265 billion over 2010?2020 -- would be realized through less marketing and underwriting, reduced costs of claims administration, less time spent negotiating provider payment rates, and fewer or standardized commissions to insurance brokers.