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Why Single-Payer Health Care Saves Money

nytimes.com

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Re: Why Single-Payer Health Care Saves Money

#11

Post by nostromo »

martinald wrote: post #3
prostoalex wrote: post #2

> One is that administrative costs average only about 2 percent of total expenses under a single-payer program like Medicare, less than one-sixth the corresponding percentage for many private insurers. That story needs to come with a caveat that Medicare's anti-fraud efforts are covered by law enforcement budgets, namely FBI https://news.google.com/news/search/section/q/medicare%20fra...

And that doesn't happen with private companies? There's loads of fraud that goes on there too.

That's his point. The story doesn't include fraud prevention for Medicare because it's paid for by another agency.

Re: Why Single-Payer Health Care Saves Money

#12

Post by peterhadlaw »

The word "negotiation" is a euphemism here:

> The most important source of cost savings under single-payer is that large government entities are able to negotiate much more favorable terms with service providers.

If there are no other options for clients, it's essentially the government telling doctors how much their services are worth.

Re: Why Single-Payer Health Care Saves Money

#13

Post by ravitation »

nostromo wrote: post #9

I imagine both single-payer and a truly free market health care system would be substantially cheaper than the current system -- which has none of the benefits of either approach. With the federal government unable to act, turning healthcare back to the states to test a number of different solutions seems entirely reasonable. Let California try single-payer and Texas try something different -- after a few years see i…

> a truly free market health care system would be substantially cheaper

Why would you imagine that?

Regardless... You must also then ask the question, whether a "truly free market health care system" would be ethical.

Re: Why Single-Payer Health Care Saves Money

#14

Post by vkou »

fleitz wrote: post #6

A big part of this to is drs in places like Canada get training on how to save costs which generally means not providing service. I had to switch to a private system in Canada to get drs who would take a proactive approach.

Oftentimes, not providing any service is better for patient outcomes then providing unnecessary services. Especially if those services are surgeries. [1]

[1] https://www.usatoday.com/story/news/nation/2013/06/18/unnece...

Re: Why Single-Payer Health Care Saves Money

#15

Post by leepowers »

> It thus makes no sense to reject single-payer on the grounds that it would require higher tax revenues. That’s true, of course, but it’s an irrelevant objection.

> The most important source of cost savings under single-payer is that large government entities are able to negotiate much more favorable terms with service providers.

I agree these objections are not relevant for the overall system. But certain individuals and groups within the current system will get screwed.

The wealthy and upper middle-class will oppose any tax increases, as it will decrease their take-home income. Plus the resentment of having to pay for someone else (the moochers).

Providers will oppose any haircut that comes with single-payer rates and price controls. No more millionaire doctors, specialists, or dentists.

And of course the overhead of health insurance middle-men and the huge administrative bureaucracy costs.

This is the crux of the problem. We could have a reasonably good system for everyone. But it requires a lot of people with heavily vested interests into a less ideal situation.

Re: Why Single-Payer Health Care Saves Money

#16

Post by _m8fo »

The article makes the assumption that the goal is to save money. Perhaps the way things are keeps the status-quo alive for those who make the rules, and that's why we don't have single payer.

I hate to be the conspiracy theorist, but I can't help but think that's the truth.

Re: Why Single-Payer Health Care Saves Money

#17

Post by typomatic »

nostromo wrote: post #9

I imagine both single-payer and a truly free market health care system would be substantially cheaper than the current system -- which has none of the benefits of either approach. With the federal government unable to act, turning healthcare back to the states to test a number of different solutions seems entirely reasonable. Let California try single-payer and Texas try something different -- after a few years see i…

In the meantime, Americans will die needless deaths from not receiving basic healthcare, but the market will win, so their sacrifice will be worth it.

Re: Why Single-Payer Health Care Saves Money

#18

Post by rhcom2 »

nostromo wrote: post #9

I imagine both single-payer and a truly free market health care system would be substantially cheaper than the current system -- which has none of the benefits of either approach. With the federal government unable to act, turning healthcare back to the states to test a number of different solutions seems entirely reasonable. Let California try single-payer and Texas try something different -- after a few years see i…

That would require both ideological sides to agree on objectives, agree on what counts as successful, agree on metrics. Something I doubt will ever happen at this point.

Re: Why Single-Payer Health Care Saves Money

#19

Post by cortesoft »

nostromo wrote: post #9

I imagine both single-payer and a truly free market health care system would be substantially cheaper than the current system -- which has none of the benefits of either approach. With the federal government unable to act, turning healthcare back to the states to test a number of different solutions seems entirely reasonable. Let California try single-payer and Texas try something different -- after a few years see i…

The problem with a 'each state do their own thing' solution is the very problem with health care in this country in general - the freeloader problem.

If California implements a single payer system, it would make people in other states more likely to choose not to get healthcare; if they get sick, they can just move to California.

This is the reason the ACA has the 'individual mandate' to go along with preventing the denial of care because of pre-existing conditions - without some coercive force, there is no reason to buy health care until you get sick.

This is why a national single payer system is the solution.

Re: Why Single-Payer Health Care Saves Money

#20

Post by galeaspablo »

How do we compare apples to apples (between countries)? Compare health expenditure per capita (public and private) with multiple health indexes. I.e. get the bang for buck.

In the list of nations with the best bang for buck healthcare programs, you will notice that top 20 healthcare programs are mostly single payer.

http://www.who.int/healthinfo/paper30.pdf

But there are single payer healthcare systems with bad health indexes, you might say... Well, combine single payer healthcare systems and add some transparency in healthcare and you now have an unmissable correlation.

https://www.transparency.org/whatwedo/publication/global_cor...

The top 20 bang for buck healthcare programs (mostly single payer systems), have an average ranking in terms of healthcare transparency of 18.7.

Are you from the USA? Notice the countries with universal healthcare, who have a similar healthcare transparency ranking to that of the USA: Luxembourg, Canada, Germany, France, Belgium, Ireland, and Chile. Their bang for buck rankings are 16, 30, 25, 1, 21, 19, 33 respectively. All of these countries have a better bang for buck ranking than the USA's 37.

In one sentence... Universal and transparently managed healthcare consistently gives more bang for buck.

And now to quote the original article... "It is a bedrock economic principle that if we can find a way to do something more efficiently, it’s possible for everyone to come out ahead."

EDIT: Check page 18 in the first source. Check chapter 11 in the second source.

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