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

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

#61

Post by Loughla »

secabeen wrote: post #9
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…

The fundamental challenge of any universal health care system is that to cut our spending on health care to the level of other western industrialized countries will take $1 Trillion of annual revenue out of the existing system. There's going to be a lot of disruption and people who need new jobs when that revenue goes to other things in our economy.

Real question, not snarky:

Why is this sort of downsizing always wrong for white-collar workers when blue-collar workers have been dealing with it for decades?

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

#62

Post by megiddo »

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 have a reasonably middle-class income, the plans are prohibitively expensive and unbelievably shitty.

I'm only anecdotal, but by comparison, prior the ACA, my insurance for a family of 3 was $300/month with a $2500/year deductible. That $300/$5000 plan was considered predatory and high deductible.

The first plan offered to me under the ACA was something like $700/month with an $8000 deductible. Plans this year were ~$950/month with a ~$15,000 deductible. It's Cadillac pricing and one-star benefits.

Meanwhile, my "non-compliant, high deductible" plan from a private market is $400/month with a $5000/deductible.

I opted out of ACA - it made sense to opt out even when I had to pay the $2100/year penalty, because the premiums and the deductible were still less. I qualify as "underinsured", but that couldn't be farther from the truth. My plan can be irritating to use, but they have online self-service tools for providing healthcare, and I have never been questioned about paying for necessary treatments. I pay them, they pay the doc. Very simple.

For people who relied on private insurance and weren't destitute, the ACA has been a shit-show from day one.

The only highlight to the ACA for me is the hundreds of thousands in billables I've accrued helping institutions become "compliant" with the ACA.

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

#63

Post by [deleted] »

legitster wrote: post #31

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…

[deleted]

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

#64

Post by mochomocha »

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…

I once worked at a US biotech startup getting paid by insurers where we would build ML models just to reverse-engineer the inconsistencies of CPT coding & claim reimbursement by insurers & hospitals so we could get paid. Basically trying to automate "learn that Karen at insurer X processing claims wiht code Y from hospital Z usually decides to reimburse $XX". This whole idea of "free market is more efficient for healthcare" has to die. All the incentives are backwards. For example: insurers don't want efficient claim processing because that means less revenues for them.

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

#65

Post by fjp »

threeseed wrote: post #43
fjp wrote: post #26

Earlier quoted context omitted.

The important issue with Warren's "plan" is that it's essentially a $8,000 per year per employee head tax, so it's a regressive tax. An afterthought in the expense of hiring a very highly-paid employee, but a not-insignificant expense of hiring a lower-paid employee. Not to mention that her plan exempts contractors and business under 50 employees, so it incentivizes businesses to to lean on contract labor or reorgani…

The problem with a new business tax is that it doesn't come for free. Increasing businesses taxes reduces international competitiveness which can reduce taxation collected in other areas. Also politically it's an incredibly hard thing to implement. And remember you have to do this at the same time as you're implementing Medicare for All. Making it a pretty radical transition by any measure.

Oh I agree it's a radical change from what we have now (Although the resulting system is one many countries have already succeeded with). I was merely pointing out how if the program - and the tax to support it - is not truly universal, you have created incentives for businesses to weasel out of it.

The exemptions are billed as being "pro-small-business" but that's a BS talking point. Universal medicare for all would take away all that healthcare-plan-administration overhead that small businesses already have to deal with and pay for. Plus the extraneous benefits of having employees and customers who aren't pressured to avoid basic health care and preventative care and then go bankrupt when they need a larger procedure.

But I think only a radical change can have any real effect. You have to get the denying-care-for-profit insurance bloodsuckers out of the system completely; any concessions to them should be viewed with extreme suspicion.

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

#66

Post by fernandotakai »

ameister14 wrote: post #36
fernandotakai wrote: post #20

Earlier quoted context omitted.

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.

but... why? i mean, if i can afford it, i would want private health care because it's usually less crowded and you can have stuff done a lot faster.

for example: a friend of mine had to wait 6mo to do a vasectomy through our public health care system.

another friend waited 2w to do his (through private health care)

if you could afford it, wouldn't it be better to pay for it?

for me (and maybe i'm completely in the wrong here) it's like public transportation vs cabs/uber. i know i can take public transportation everywhere, but sometimes i'm in a hurry so i just get an uber. it doesn't mean other people can't use public transportation, it's just that i'm in a hurry and i need to get somewhere faster.

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

#67

Post by huzaif »

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-…

I get your concern of government bungling the financial aspects. However, are we all OK with 68K people dying every year due to lack of coverage? Do we have evidence that medicare recipients ration insulin?

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

#68

Post by ipython »

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…

The part I don't get about this argument is - who is outlawing the ability for physicians to practice privately? I would expect that there would be concierge-style medicine available to those who choose to pay out-of-pocket for it.

You want to contract with the world-class researcher to perform an experimental surgery that is unavailable through the public system? Sure, pay the money and we'll take care of you.

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

#69

Post by Denvercoder9 »

legitster wrote: post #31

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…

> but the total cost would still be in the 10s of trillions of dollars

Source? The linked study gives it at $3.034 trillion/year. That's on the lower end, but consistent with all other studies for single-payer healthcare I've seen, which price it in the $3-$5 trillion/year range.

Note that the US is already spending $3.5 trillion/year on healthcare.

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