Ok does this seem at all rational, is it just me?

President Obama, in an Aug. 16 Times op ed, made such redistribution seem easy and painless: "We'll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid," he said.

In the text of the speech to Congress on healthcare released by the White House on September 9th he said, "But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers".

How different is Medicare and Medicaid from a public health insurance option?  If these similar government programs have, after years of calling for reform and waste management, billions of dollars of waste and inefficiency then what possible evidence is there that this new program will be any less efficient?  Is this administration that much better a manager than any of the others?  Is there evidence that it is so?

How can the two statements be reconciled?  These huge programs have billions in waste but the new one will save money over the private sector because the private sector has profit and high administrative and executive costs?  What possible motive would the executives in the private sector attempting to pay themselves more and make more profit have to allow waste that simply makes it harder to achieve those goals?