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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

#71

Post by bradleyjg »

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…

"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.'"

That's a really important "possible" though. It is a near certainty that if were to transition to single payer healthcare we would not do the transfers to hold everyone profiting from the current system harmless (e.g. health insurance employees). In any realistic scenario there would be winners and losers which is why you see fierce lobbying on both sides of the issue.

It's the difference between Pareto and Kaldor-Hicks (See this prior comment for the definitions: https://news.ycombinator.com/item?id=14605477 )

Re: Why Single-Payer Health Care Saves Money

#72

Post by specialist »

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…

Word salad.

Our system (the USA) maximizes rent seeking, thru obfuscation, disjoint regulation, spotty oversight and enforcement.

Re: Why Single-Payer Health Care Saves Money

#73

Post by donmatito »

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…

If by "truly free market" you mean that healthy people can opt out of being insured, no, that would drive the costs up.

Risk selection is a very driver of prices in health insurance. If you can spread the risk between healthy and sick people, the price goes down. If you can't, the price goes up.

Secondly, having a population that has no health insurance means less prevention, i.e. worse health problems down the road, again driving the costs up

Re: Why Single-Payer Health Care Saves Money

#74

Post by abalone »

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…

> They will undoubtedly receive worse care

You're going to have to provide a lot more support for that claim. All you've really provided is the implication that "most expensive" = "best". But expense is also a result of inefficiencies, and we "undoubtedly" have a less efficient system (more administrative overhead.. I can cite sources if anyone doubts it).

Other single-payer systems, for example, also provide complementary or supplementary private options.[1] And since these private options have to compete with a baseline of quality public care, they may be more affordable.

[1] https://en.wikipedia.org/wiki/Two-tier_healthcare

Re: Why Single-Payer Health Care Saves Money

#75

Post by ravitation »

kansface wrote: post #51
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.

> 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…

Elective procedures work well in a free market system. That is not surprising at all, nor is it incredibly meaningful when trying to look at the health care industry as a whole.

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

If you want to be overly semantic, which you clearly do, that's actually not "the important question" since it actually tells you less than my original question. You care about "a truly free market health care system's" relative ethicality not just in relation to the current system, but also in relation to (all) other potential alternative health care system (like a single payer system)...

Re: Why Single-Payer Health Care Saves Money

#76

Post by magicalist »

buckbova wrote: post #22
typomatic wrote: post #17

Earlier quoted context omitted.

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.

> Americans will die needless deaths First off everyone dies. Who's not receiving healthcare right now that would be ultimately saved by the government? Secondly let's cut the hyperbole and have a rational conversation about this.

> Who's not receiving healthcare right now that would be ultimately saved by the government?

People not receiving basic preventative care with problems that are only going to snowball until emergency services can try to treat a much more complex situation in the future?

> Secondly let's cut the hyperbole and have a rational conversation about this.

You could have maybe had a point by quoting "but the market will win", but "Americans will die needless deaths from not receiving basic healthcare" is literally what's at stake. What exactly do you think the downsides of people not being able to afford healthcare are?

Re: Why Single-Payer Health Care Saves Money

#77

Post by luxuryballs »

cortesoft wrote: post #28
_m8fo wrote: post #16

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.

Anytime one person saves money, it is also costing someone else money (the person or people that money was going to). Saving money on healthcare will cost money for people who are currently making money from the excessive costs of healthcare. This is not a secret, and not really a conspiracy; the groups that make money from the current system are always the ones opposed to change. It just sucks because there aren't n…

But the 'rest of us' can only gain for as long as those people stick around to pay for it. There is a lot of wealth in this country, for now. If you wanna really see things go down hill then watch the wealth scramble out of the country as soon as we tell them they're going to have to fund the healthcare of everyone else.

Re: Why Single-Payer Health Care Saves Money

#78

Post by ravitation »

xname2 wrote: post #56
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…

"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.

So, the people too poor to pay but not poor enough for charity die slowly in their hovels?

Re: Why Single-Payer Health Care Saves Money

#79

Post by luxuryballs »

yegle wrote: post #4

I find it hilarious that this article uses state government taking over road maintenance as an analogy and claim it will save money, while it's known that California has a bad reputation in road repair, due to funding problem. http://www.latimes.com/politics/la-pol-sac-road-funding-prob...

Yeah plus what a terrible analogy. The road is shared equally by everyone for the most part, my car tools along in a single lane. However if I smoke cigarettes and get cancer or eat myself into heart disease, this still doesn't cost any more for the road. It's something that can be mostly shared in a fair way. Healthcare cannot be shared in a fair way.

Plus if I don't play well with others the government will take away my license so I can't drive anymore. I don't want the government standing between me and healthcare in any sense of the term. If they are the ones in charge of a limited resource that means they are also the ones that have to say 'no' when there isn't enough to go around.

Re: Why Single-Payer Health Care Saves Money

#80

Post by shortstuffsushi »

galeaspablo wrote: post #57
shortstuffsushi wrote: post #39

Earlier quoted context omitted.

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?

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

But wait, is this not conjecture, since it doesn't currently exist? Sure, you have sources where it has worked, but the proof would only be implementing it here.

> Or is the US government not a leading force in fighting corruption anymore?

What? I don't understand what you're getting at here. My point isn't that the government is corrupt, it's that it's inefficient.

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