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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

#51

Post by kansface »

ravitation wrote: post #13
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.

> Why would you imagine that?

Why do you imagine it wouldn't!? The portions of health care universally not covered by insurance are not subject to the same cost disease of the industry as a whole. Lo and behold, the real cost of eg. breast augmentation is declining (total cost of about 4K)! The cost of lasik has decreased ~50% over the last 15 years, current results are better, and the surgery has the highest rating of patient satisfaction in the entire industry! A similar result anywhere else in medicine in the US is completely unimaginable.

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

Nonsense. The important question is: 'would a "truly free market health care system" be more ethical than the current system'.

Re: Why Single-Payer Health Care Saves Money

#52

Post by learc83 »

shortstuffsushi wrote: post #39
galeaspablo wrote: post #20

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 heal…

This simplification seems disingenuous. Would switching to single payer solve your last sentence / quote from the article? Aka, would putting the US government in the middle make things simpler and more efficient (and cheaper) for the end user (health care patients)? I can't say I'm convinced. Compare with the current system, where any given user is still effectively dealing with a single payer -- their insurance pro…

>I would think that private, competing companies would seek out better deals vs a single government entity who couldn't really negotiate

That's the biggest advantage of single payer, one buyer can negotiate better deals with suppliers because there are no other buyers. It's basically a reverse monopoly.

Re: Why Single-Payer Health Care Saves Money

#53

Post by flavor8 »

cortesoft wrote: post #19
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…

I'm not convinced this is insurmountable. How do countries with single payer handle this?

Surely you could require an newly established resident who wants treatment to pay a portion since they hadn't been funding it directly via taxes, and then add a further penalty if they move back out of state within a certain period of time (to discourage moving in-state just for treatment).

Re: Why Single-Payer Health Care Saves Money

#54

Post by warcher »

It's still absurd to me that we make the false differentiation between taxes and insurance premiums. If you've got a family, neither is negotiable. If you have a job that pays, I promise you it affects your check in nearly identically the same way as payroll taxes do. There's a tradition in America where the price isn't actually the real price, we artificially advertise fake prices to get you in the door and stuff a bunch of surcharges on the back end. I wish we'd cut it out-- our taxes aren't crazy, but the way they're presented make people flip their shit.

Re: Why Single-Payer Health Care Saves Money

#55

Post by dv_dt »

prostoalex wrote: post #41
dv_dt wrote: post #33

Earlier quoted context omitted.

Anti-fraud enforcement is a tiny nit compared to the overall poor performance of US healthcare compared to other single payer nations. We pay roughly double per capita, cover fewer people (which means the people who do pay in our system are paying more than double), and have lagging health measures such as life expectancy and infant mortality rates (2-3x higher in the US!). https://ourworldindata.org/the-link-between…

> infant mortality rates (2-3x higher in the US!). https://www.theatlantic.com/health/archive/2014/10/why-ameri... "The researchers compared data on infant health and mortality in the U.S.; Austria, whose rate of 3.8 is roughly average among European nations; and Finland, whose rate of 2.3 is one of the lowest in the world. One of the biggest differences, they found, was in the definition of what could be considered…

This is often brought up, so show the corrected or aggregate miscarraige and mortality numbers to get some point of comparison. Leaving it just open seems incomplete...

Edit: Absent more aggregated numbers, it looks like Canada records similar to the US, while also having some similar issues with a higher pre-term birth rate, and US rate is still 50% higher than Canadas.

http://data.worldbank.org/indicator/SP.DYN.IMRT.IN

Re: Why Single-Payer Health Care Saves Money

#56

Post by xname2 »

warcher wrote: post #40
ravitation wrote: post #13

Earlier quoted context omitted.

> 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.

It's a fun thought experiment, but we'd never do it. A free market would look something like this: 1) everybody buys their own insurance in a genuinely free marketplace (this is ENTIRELY not the case now and would probably require significant gov intervention to defeat cartel-seeking behavior from insurance co's. There are good reasons insurance is so highly regulated, only the first of which is that insurance compan…

"2) if you can't pay, you die in the gutter."

No. It is simply false. Even a 100% free market does not exclude charity.

Re: Why Single-Payer Health Care Saves Money

#57

Post by galeaspablo »

shortstuffsushi wrote: post #39
galeaspablo wrote: post #20

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 heal…

This simplification seems disingenuous. Would switching to single payer solve your last sentence / quote from the article? Aka, would putting the US government in the middle make things simpler and more efficient (and cheaper) for the end user (health care patients)? I can't say I'm convinced. Compare with the current system, where any given user is still effectively dealing with a single payer -- their insurance pro…

I want proof. I only see numbers. Everything else is conjecture.

Transparency in healthcare + Single payer (by the government) = Efficiency

(see sources and explanation in my original comment)

So yes, putting the US government in the middle is what I'm suggesting. Or is the US government not a leading force in fighting corruption anymore?

Re: Why Single-Payer Health Care Saves Money

#58

Post by inopinatus »

frgtpsswrdlame wrote: post #37
galeaspablo wrote: post #20

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 heal…

This is a really good point. One problem I think though is that not everyone will come out ahead in a single payer system. Our system is explicitly organized around the fact that you must pay for care and we have the best and most expensive care in the world. Our system is setup so that those at the top of the economic ladder can buy a level of care they could not get anywhere else. They will undoubtedly receive wors…

This is not true, and can be trivially observed to be not true by counterexample, viz. looking at other countries that have a hybrid public/private system e.g. here in Australia.

Incidentally, "level of care" is almost meaningless in most first-world systems. The difference I experience, due to my private health insurance here, is not in outcomes, but in time to service for elective procedures, and access to private facilities (most notably a private room for overnight/extended hospital stays). And that time-to-service difference vanishes for emergency care.

EDIT: additional insider tip. If you have private health cover in such a system, and are being treated for a major medical issue, ask for a private room in a public hospital, because that is where our clinicians spend most of their day-to-day. If you are in a room in a private hospital, there are often no specialist clinicians on site. Whilst this may make no difference for most cases, any sudden complication may be dealt with much more quickly. This is possible in our hybrid system because the hospital is a separate institution from the state and happily does both public and private billing.

Re: Why Single-Payer Health Care Saves Money

#59

Post by magicalist »

warcher wrote: post #44
warcher wrote: post #40

Earlier quoted context omitted.

It's a fun thought experiment, but we'd never do it. A free market would look something like this: 1) everybody buys their own insurance in a genuinely free marketplace (this is ENTIRELY not the case now and would probably require significant gov intervention to defeat cartel-seeking behavior from insurance co's. There are good reasons insurance is so highly regulated, only the first of which is that insurance compan…

Point two would be a hell of an incentive to get insurance, by the by. Beats the hell out of some candy-ass tax penalty. "Young invincible bet wrong, got caught in some freak skateboarding accident? Sucks to be you. You an organ donor by any chance?"

> Point two would be a hell of an incentive to get insurance, by the by. Beats the hell out of some candy-ass tax penalty. "Young invincible bet wrong, got caught in some freak skateboarding accident? Sucks to be you. You an organ donor by any chance?"

It wasn't before, so it probably wouldn't serve as one in the future. The issue is that people aren't very good at estimating risk.

I'm young, healthy, and no one in my family has been in a serious car accident/gotten cancer/had a heart attack in the last 15 years. Obviously that happening is a low risk compared to the financial penalty of maintaining insurance today, so why should I worry? Besides, I'm sure I can get some kind of plan from an insurance company if something bad does happen[1]

[1] I'll be sure to look into the feasibility of this statement as soon as I finish all the other important things on my todo list...

Re: Why Single-Payer Health Care Saves Money

#60

Post by xname2 »

warcher wrote: post #44
warcher wrote: post #40

Earlier quoted context omitted.

It's a fun thought experiment, but we'd never do it. A free market would look something like this: 1) everybody buys their own insurance in a genuinely free marketplace (this is ENTIRELY not the case now and would probably require significant gov intervention to defeat cartel-seeking behavior from insurance co's. There are good reasons insurance is so highly regulated, only the first of which is that insurance compan…

Point two would be a hell of an incentive to get insurance, by the by. Beats the hell out of some candy-ass tax penalty. "Young invincible bet wrong, got caught in some freak skateboarding accident? Sucks to be you. You an organ donor by any chance?"

In that case, why would the person choose to do skateboarding? Also, does the individual has any family / friend / church support? If you have no family, no friend, not involved in any community, why do you risk yourself for fun? Because "the society" have to pay for your stupidity?
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