I already said that being more efficient, while still meeting the goal, was better. The case in point here is that having a deficit says nothing at all about whether the program is efficient. Efficiency, to repeat, is a measure of how close you come to the ideal of providing value for minimal cost. Please demonstrate that private insurers come closer to this ideal than Medicare.
If you go out shopping to buy 20 items, you can measure the efficiency of your shopping by how close you get to the minimal price for your grocery cart. Not buying the milk to save money is not being efficient.
The real problem with justification is not the cost, but acceptance of the goal. If you don’t accept that it is proper for society to tax its citizens to provide life sustaining healthcare for every person, then the cost is just a sideshow. I’ve asked several times in this thread if those who believe this think it is acceptable for people to die because they couldn’t afford proper treatment. So far, only the sounds of crickets.