I really don't understand why they went with a private insurance company to deliver this program ... they really had to shoehorn a private company into a public service in order to make it happen. Cut out the private company and it would likely save more money in the long run ... money that could be turned around to hire government staff and a new government department to run the program. Instead of having a private company partly work to deliver the program and partly work to try to turn a profit by degrading the service for their monetary benefit.
There will always be fat to the system no matter who delivers it ... the difference is that if you allow private companies into these situations, they'll do everything in their power to deride the new system and turn into something that will only benefit them.