Single-payer healthcare would save $450B and 68k lives a year: study • Hacker News Board

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#31

Post by legitster » Fri, Feb 21, 2020, 9:20 PM UTC

The net savings would be $450B, but the total cost would still be in the 10s of trillions of dollars (Edit: 30-50 over 10 years), bigger than all of our federal spending combined. It's one thing to have as an objective, and another as a plan for getting there. The proposal they cite would make federal healthcare expenditures 69%(!!!) of the GDP (Edit: total federal expenditures). It's simply not realistic to convert our entire economy into a government and healthcare first system within only 4 years.

These calculations also ignore any affects of changed consumer preferences if you eliminate copays and deductibles, something no other universal healthcare system has done.

This is one of those calculations that is entirely accurate, but also entirely misleading.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#32

Post by threeseed » Fri, Feb 21, 2020, 9:20 PM UTC

three_seagrass wrote: post #13

threeseed wrote: post #8

Pretty disingenuous study. If you move to a Medicare for All policy it would shift employer health care costs to the government. Which they would never be able to financially support especially with the challenges of an ageing population and excessive debt. And so when they say it saves $450b it's not taxpayers. It's mostly employers. There is a reason that countries that started with M4A e.g. Australia, UK have all…

That's why the Medicare for all will still be funded, in part, through a business tax. The difference being you've removed the for-profit middlemen, so the healthcare costs are less for businesses than the privatized hybrid version we have now.

Exactly the health care costs are less for businesses. But that's not coming through efficiencies but largely through the US government picking up the tab for it.

Which is completely fine because it's what happens elsewhere in the world. But there is no discussion around the impacts to budgets and taxpayers which is the challenge the faced Australia and UK for example.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#33

Post by pjc50 » Fri, Feb 21, 2020, 9:20 PM UTC

Olscore wrote: post #22

Fundamentally, it is disgusting we are forced by government to buy insurance products (e.g., car, health) provided by for-profit companies; however, I do not support universal healthcare either. The government has zero ability to control its expenditure, because the electorate vote themselves benefits. The long-term financial incentives to maintain a functioning society are all broken because of the misaligned short-…

So that makes it OK for how many people to die due to lack of insulin?

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#34

Post by foota » Fri, Feb 21, 2020, 9:21 PM UTC

newguy1234 wrote: post #15

What I don't get is how do 37 million Americans not have health insurance when the ACA was suppose to fix that issue? All of the plans are adjusted based on your income level and you get a tax credit if you are low income. If you are very poor then you get free healthcare....

I don't believe anyone but the very impoverished get free health care, and I believe the subsidies vary by state.

See the bottom of this for a graphic: https://www.commonwealthfund.org/publications/issue-briefs/2... also the removal of the individual mandate probably contributed to the gap.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#35

Post by dx87 » Fri, Feb 21, 2020, 9:21 PM UTC

newguy1234 wrote: post #15

What I don't get is how do 37 million Americans not have health insurance when the ACA was suppose to fix that issue? All of the plans are adjusted based on your income level and you get a tax credit if you are low income. If you are very poor then you get free healthcare....

If you're willing to gamble on your health, it's still much cheaper to pay the fine than pay for healthcare that isn't through an employer. When I was unemployed for a few months a couple of years ago, I opted to not get any healthcare coverage from the state exchange while I was looking for work because it was going to be over $1000 a month to cover my wife and I, plus it only covered a percentage of healthcare costs instead of 100% with a small copay like good insurance does. It also had a high deductible, around 10k I think, before they'd start covering the percentage.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#36

Post by ameister14 » Fri, Feb 21, 2020, 9:21 PM UTC

fernandotakai wrote: post #20

lwb wrote: post #2

Is this Bernie's plan? I know there are subtle but important differences between all the different varieties of "universal healthcare" that exist in the world. The Twitter account @BadEconTakes enumerated something about this in a recent post: https://twitter.com/BadEconTakes/status/1228143455399858176/... Excuse their obvious bias against it; I wonder what the difference in expected savings (money + lives) might be…

i'm not american, so excuse me for the lack of knowledge, but i've heard that bernie plans to ban private insurance. is that right? i mean, that seems like a really bad idea -- if you have money, why wouldn't you get better health care? edit: btw i live in a country with the largest public health care system in the world https://en.wikipedia.org/wiki/Sistema_%C3%9Anico_de_Sa%C3%BA... and we never banned private healt…

I don't believe he'd ban supplemental insurance, just insurance that covers the same services the State option covers.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#37

Post by coenhyde » Fri, Feb 21, 2020, 9:21 PM UTC

newguy1234 wrote: post #15

What I don't get is how do 37 million Americans not have health insurance when the ACA was suppose to fix that issue? All of the plans are adjusted based on your income level and you get a tax credit if you are low income. If you are very poor then you get free healthcare....

Tax credits don't help people who are struggling to pay day to day bills. What good is a tax credit they'll receive up to a year later? When your horizon is 2 weeks, you're going to prioritize food & accommodation before a health insurance plan.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#38

Post by markroseman » Fri, Feb 21, 2020, 9:21 PM UTC

jkingsbery wrote: post #11

> "Furthermore, we estimate that ensuring health-care access for all Americans" From many anecdotes I've read about medicine in socialized countries, it's unwise to assume that having insurance is the same as access. Many procedures are made unavailable due to being considered cost effective by The Single Payer, and the wait time for specialists can often be long. Further, what counts as "costs" in US health industry…

Yes, in a properly functioning universal healthcare system, wait times for specialists can be longer for things that are less urgent. First priority is those with the most medical need, not whoever steps up to pay to play.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#39

Post by anonsivalley652 » Fri, Feb 21, 2020, 9:22 PM UTC

bduerst wrote: post #19

mgraczyk wrote: post #7

In the study, nearly all the computed savings comes from two sources. 1. Decrease in pharmaceutical costs as a result of better bargaining power. 2. Decrease in administrative overhead, calculated by extrapolating the overhead in medicare to the entire US healthcare economy. I don't have an informed opinion on either of these estimates, but my intuition is that #1 seems reasonable while #2 seems unlikely. The justifi…

I worked in the EMR software industry and have certifications that involve hospital & lab billing, among others. I've been on site with healthcare providers, and there are entire buildings full of people whose job it is just to code and scrub claims, and cover disputes/negotiations with private insurance providers. Consumers do not see it because it's typically off-site from the main hospital care facilities, but bel…

IIRC, coding is on the order of a million jobs across insurance, hospitals and doctor offices. Then there's all the other non-value-add activities of negotiating of prices, authorizing/denying treatment, billing and management. Oh and there's going through bankruptcy while you have cancer... I forgot that one.

Re: Single-payer healthcare would save $450B and 68k lives a year: study

#40

Post by burkaman » Fri, Feb 21, 2020, 9:22 PM UTC

jkingsbery wrote: post #11

> "Furthermore, we estimate that ensuring health-care access for all Americans" From many anecdotes I've read about medicine in socialized countries, it's unwise to assume that having insurance is the same as access. Many procedures are made unavailable due to being considered cost effective by The Single Payer, and the wait time for specialists can often be long. Further, what counts as "costs" in US health industry…

> Many procedures are made unavailable due to being considered cost effective by The Single Payer, and the wait time for specialists can often be long.

Right now, many procedures are made unavailable due to being considered "elective" or "cosmetic" or "out of network" by The Private Insurer.