It's possible that Medicare only has 1.3% because they do not check prevent fraud at all. The most recent reports show Medicare loses $60 Billion in fraud every year.
Further, Medicare is costing us higher premiums. When Medicare cuts how much it pays for services rendered, we pay it with higher insurance costs.
Finely, in looking at overhead costs around the world, the average is between 10% to 20%. In other words, it's right in line with what would be expected.
The problem is simply that the government has setup a system that shifts cost onto the consumer. By law, hospitals must treat medicare, medicaid patients, and will only get how much the government dictates they will pay for it. The shortfall, falls on us. By law, hospitals must treat people who have no intention of paying for services. The shortfall, falls on us.
This is all there is to it. We setup a system that jacks up the price on ourselves, and now we blame others for our own choices.