Economic Analysis of Medicare for All • Hacker News Board

Re: Economic Analysis of Medicare for All

#11

Post by ams6110 » Thu, Dec 06, 2018, 12:17 AM UTC

agumonkey wrote: post #8

ArchTypical wrote: post #4

Earlier quoted context omitted.

> that they're underpaid or overworked or whatever Having family in healthcare and being a lifelong patient due to a congenital defect, a job in software (including management obv) is a breeze compared to health care worker jobs across the board. They require more "schooling" (via mind-numbing training), are underpaid, have much more serious consequences from mistakes, have less oversight, work longer hours and under…

People's work shouldn't be reduced, but drugs and devices should be to an extent. Firefighters told the portable EKG costed thousands of dollars (5 or 10 don't recall). That thing had bad 2G connectivity so the graph coudn't be sent to a cardiologist. The sensor/dsp part is worth money, the rest would cost 100$ from any smartphone maker today with better performance and portability. I'm sure the price is rigged for m…

The real cost is not so much in the hardware but in the certification requirements. Medical devices need to be built to and work at a higher standard than consumer electronics, for obvious reasons.

Re: Economic Analysis of Medicare for All

#12

Post by mlthoughts2018 » Thu, Dec 06, 2018, 12:17 AM UTC

zjaffee wrote: post #7

My biggest fear of a bill like this is even should we have the most progressive anti corruption government implement this law originally, whats to prevent this from becoming incredibly wasteful just like our military is. I.e. we spend a trillion dollars over decades trying to develop some drug that turns out to take us nowhere, while enriching pfizer shareholders this time instead of lockheed martin ones. I absolutel…

That is the line of thinking explored in Robin Hanson’s article, “Cut Medicine in Half.”

https://www.cato-unbound.org/2007/09/10/robin-hanson/cut-med...

Combined with research on how wealth, family status, social status, access to sex partners, etc. etc. correlate with health outcomes even after controlling for access to doctors, hospital care, etc., it raises a lot of questions.

It seems most of the money we spend on medicine as a society is just a form of signalling. We “care” if we give X dollars worth of medical service, regardless of whether that led to a positive outcome or if the outcome could have been obtained more effectively through less “showy” ways or unglamorous things that don’t involve medical procedures or treatment.

It goes along with the idea of “betting is a tax on bullshit.” If we paid medical entities based on successful outcomes, including at the population level, then it might incentivize creative, cost-effective solutions instead of providers shoveling more ineffective treatment and demanding high pay just based on administering it.

Re: Economic Analysis of Medicare for All

#13

Post by ribble » Thu, Dec 06, 2018, 12:18 AM UTC

| Medicare for All could reduce total health care spending in the U.S. by nearly 10 percent, to $2.93 trillion, while creating stable access to good care for all U.S. residents.

how? by taxing a few earners to pay for everyone else not earning. is that fair? in that light, a ten percent reduction in cost is meaningless.

Re: Economic Analysis of Medicare for All

#14

Post by bedhead » Thu, Dec 06, 2018, 12:19 AM UTC

entee wrote: post #2

One thing that sometimes gets lost in the "health care is inefficient" discussion is that one person's inefficiency is another person's living. The cost controls the paper appears to advocate for literally mean someone is making less money, that someone will advocate strongly against it. I've spent the past 3.5 years in healthcare, everyone is convinced they're not the problem, that they're underpaid or overworked or…

Like, the living of some drug middleman who is a leach on the system and only exists because of some lobbying or other screwed up structure?

Re: Economic Analysis of Medicare for All

#15

Post by diego898 » Thu, Dec 06, 2018, 12:20 AM UTC

ribble wrote: post #13

| Medicare for All could reduce total health care spending in the U.S. by nearly 10 percent, to $2.93 trillion, while creating stable access to good care for all U.S. residents. how? by taxing a few earners to pay for everyone else not earning. is that fair? in that light, a ten percent reduction in cost is meaningless.

Can you expand on what you mean by "in that light, a ten percent reduction in cost is meaningless."?

Re: Economic Analysis of Medicare for All

#16

Post by jorblumesea » Thu, Dec 06, 2018, 12:21 AM UTC

entee wrote: post #2

One thing that sometimes gets lost in the "health care is inefficient" discussion is that one person's inefficiency is another person's living. The cost controls the paper appears to advocate for literally mean someone is making less money, that someone will advocate strongly against it. I've spent the past 3.5 years in healthcare, everyone is convinced they're not the problem, that they're underpaid or overworked or…

This is the problem with a for-profit healthcare system. Meaningful reform is almost impossible because there's jobs on the line and therefore voters to contend with. More importantly, they are also probably highly educated and well paid voters. Doctors, software engineers, sales, etc.

How much white collar employment comes from healthcare inefficiencies? Probably a good percentage of the sector.

These workers will need to acknowledge they are part of the problem and willingly give up these positions (or their absurd payouts from them) and vote accordingly. Or not and continue being part of the problem, which I think is your concern.

Re: Economic Analysis of Medicare for All

#17

Post by aczerepinski » Thu, Dec 06, 2018, 12:21 AM UTC

ribble wrote: post #13

| Medicare for All could reduce total health care spending in the U.S. by nearly 10 percent, to $2.93 trillion, while creating stable access to good care for all U.S. residents. how? by taxing a few earners to pay for everyone else not earning. is that fair? in that light, a ten percent reduction in cost is meaningless.

High earners were on average raised by high earning parents. Is being born rich fair? Which stages of the game should be fair?

Re: Economic Analysis of Medicare for All

#18

Post by throwaway6734 » Thu, Dec 06, 2018, 12:21 AM UTC

ribble wrote: post #13

| Medicare for All could reduce total health care spending in the U.S. by nearly 10 percent, to $2.93 trillion, while creating stable access to good care for all U.S. residents. how? by taxing a few earners to pay for everyone else not earning. is that fair? in that light, a ten percent reduction in cost is meaningless.

> in that light, a ten percent reduction in cost is meaningless.

If you have the time, could you please clarify what you mean by 'meaningless'?

Re: Economic Analysis of Medicare for All

#19

Post by agumonkey » Thu, Dec 06, 2018, 12:22 AM UTC

ams6110 wrote: post #11

agumonkey wrote: post #8

Earlier quoted context omitted.

People's work shouldn't be reduced, but drugs and devices should be to an extent. Firefighters told the portable EKG costed thousands of dollars (5 or 10 don't recall). That thing had bad 2G connectivity so the graph coudn't be sent to a cardiologist. The sensor/dsp part is worth money, the rest would cost 100$ from any smartphone maker today with better performance and portability. I'm sure the price is rigged for m…

The real cost is not so much in the hardware but in the certification requirements. Medical devices need to be built to and work at a higher standard than consumer electronics, for obvious reasons.

Of course, but the interface and connectivity part of that EKG machine wasn't even up to 2005 cellphones standard. On that point, it's a scam.

Re: Economic Analysis of Medicare for All

#20

Post by marricks » Thu, Dec 06, 2018, 12:23 AM UTC

ribble wrote: post #13

| Medicare for All could reduce total health care spending in the U.S. by nearly 10 percent, to $2.93 trillion, while creating stable access to good care for all U.S. residents. how? by taxing a few earners to pay for everyone else not earning. is that fair? in that light, a ten percent reduction in cost is meaningless.

Uhh, you’re aware hospitals don’t turn people away who are injured and often end up with a lot owed to them they just can’t recover right?

Also if everyone has healthcare they’ll get treated earlier before a condition blows up and... they get stuck at the ER getting a bill they’ll never be able to repay.

Our US healthcare system just sucks compared to other countries UNLESS you are well off.

I wouldn’t short change arguments saying covering everyone is actually less expensive.