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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

#111

Post by galeaspablo »

shortstuffsushi wrote: post #80
galeaspablo wrote: post #57

Earlier quoted context omitted.

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…

> 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.

Universal and transparently managed healthcare consistently gives more bang for buck. Note that I said "consistently", not just in a few places.

Yes, obviously you can't know what's going to happen in the US until you try it. But if it has consistently worked around the world, the best guess is that it will work in the US as well. Surely your argument, can't be... "how can I know this ball is going to fall into the Earth, if I haven't dropped it yet".

> 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.

And my point is that transparency in healthcare + single payer makes the system efficient.

Re: Why Single-Payer Health Care Saves Money

#112

Post by coredog64 »

luxuryballs wrote: post #85
leepowers wrote: post #15

> 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 individua…

Yeah, and we ban people from public roads for bad behavior. Will we ban people from public healthcare for bad health choices? Do we really want to give the government that kind of exclusive control over a service while giving up control of our bodies?

Smokers typically exhibit compressed mortality. Yes, they die younger than non-smokers, and yes, they have health issues. But the health issues are typically of the sort that get deadly in short order and so actually save money.

Re: Why Single-Payer Health Care Saves Money

#113

Post by inopinatus »

abalone wrote: post #74
frgtpsswrdlame wrote: post #37

Earlier quoted context omitted.

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 complem…

> And since these private options have to compete with a baseline of quality public care, they may be more affordable.

In such a hybrid system the public hospitals also experience competitive pressures. I can confirm pretty much first-hand[1] that this is why pathology turn-around times in a major metropolitan Australian public health service are measured in hours, whilst in the UK they are measured in weeks.

[1] I am married to the medical director of this service.

Re: Why Single-Payer Health Care Saves Money

#114

Post by ML_God »

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…

The countries, that are not US get better bang for buck, because the US overspends on healthcare. 99% of the new drugs and medical devices are brought to market first in US. After the US pays most of the R&D expenses the rest of the world gets stuff on the cheap.

Re: Why Single-Payer Health Care Saves Money

#115

Post by 0xffff2 »

galeaspablo wrote: post #98
krupan wrote: post #84

Earlier quoted context omitted.

"Or is the US government not a leading force in fighting corruption anymore?" Um...

Put it in perspective (compared with every country on Earth). https://www.transparency.org/news/feature/corruption_percept...

The US is 18/176 on the list on that page; not even in the top 10%. Personally, I would say the top 5% or so could reasonably be called leaders. Where would you draw the line?

Re: Why Single-Payer Health Care Saves Money

#116

Post by warcher »

magicalist wrote: post #59
warcher wrote: post #44

Earlier quoted context omitted.

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 m…

Oh yeah, I don't mean it'd work, I think healthcare neatly falls in the category of collective action problems that are poor fits for the capitalistic profit motive. A lot of people would suffer and die unnecessarily. And in a democracy, enough people would be incentivized to vote for exception after exception to destroy any semblance of market competition. Old people are very very good at two things: getting sick and voting. The pathological dysfunction of American healthcare is pretty much inevitable if you try to stuff for-profit healthcare into a democracy.

I'm really not a socialist, I promise. I just don't see how you'd do it any other better, and it's pretty clear to me that the results are definitively in for our free market experiment.

It's funny how we all pretty much agree the govt should be in charge of stuff like roads, schools, military, police, fire dept, courts, quite a long list of stuff, but adding anything to that is marketed as creeping socialism.

Re: Why Single-Payer Health Care Saves Money

#117

Post by tanderson92 »

leepowers wrote: post #23
peterhadlaw wrote: post #12

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.

Yes, it's a euphemism for price controls. Which may or may not be a no-go depending on your political bent. Another issue here is termination shock - if a provider comes up under the current system, getting into massive student debt in anticipation of a highly remunerative medical career, how will price controls effect him?

By my back of the envelope account it might cost about $36 Billion to forgive the student debt (say $200k average) of a fifth (early career) of all physicians in the US (28 patient care docs per 10,000)

Re: Why Single-Payer Health Care Saves Money

#118

Post by galeaspablo »

0xffff2 wrote: post #99
galeaspablo wrote: post #57

Earlier quoted context omitted.

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?

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

In the grand scheme of things, yes.

https://www.transparency.org/news/feature/corruption_percept... http://www.worldaudit.org/corruption.htm http://www.espn.co.uk/espn/feature/story/_/id/14767250/the-e...

Re: Why Single-Payer Health Care Saves Money

#119

Post by com2kid »

ravitation wrote: post #75
kansface wrote: post #51

Earlier quoted context omitted.

> 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 ac…

> Elective procedures work well in a free market system.

Dental work is only semi-elective, and prices are driven down thanks to transparent pricing.

Likewise, one can argue that vision services are also non-elective (e.g. people need to see), and prices go through a very large range.

Many medical conditions are not "emergencies". And even so, I often get referrals from my doctor to external imaging services. If those prices were transparent, I imagine a downwards pressure on prices would happen quite quickly.

To give an example, ultrasounds for pregnancies cost ~$250, ultrasounds for almost anything else are 50% to 100% higher in price. In a similar vein, x-rays at the dentist are next to nothing (despite involving a cool robot that rotates around my head, and a digital x-ray sensor that lets me look at images right away!), x-rays for anything else can end up in the hundreds.

Hospitals would also benefit from transparent pricing, if there was a legal mandate that all suppliers be open and honest, prices would drop for everyone. When a hospital sees that other hospitals in the area can offer the same service at a lower cost, meeting the same quality standards, then they can start pushing their vendors to lower prices.

Re: Why Single-Payer Health Care Saves Money

#120

Post by methodover »

Yes, a single-payer system would save money, but you have to be honest about the downsides. It's unfortunate that they are not honestly discussed in the article. Or, for that matter, almost anywhere.

The vast majority of the savings come from government price fixing. This is what the article means by "large government entities are able to negotiate much more favorable terms with service providers." It's not really a negotiation; at least not like it is in the private sector. When the government controls an entire market, they set prices. They can (and should) take input from providers and drug/device developers, but at the end of the day, whatever they say goes.

There are incredible risks when the government sets prices for a good/service. We should not take on those risks lightly.

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