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

#111

Post by ogre_codes » Fri, Feb 21, 2020, 9:43 PM UTC

xmly wrote: post #85

Universal Care = Medicare + Medicaid + ObamaCare + Employment sponsonered care ??? My opinion is that we should first optimize the existing system to lower the medical cost first. Health insurance is just prepaid medical costs. If the cost is lowered, no system would work.

No, this is talking about single payer healthcare which would mean the current insurance industry would be out the door. No Obamacare, just one government agency paying for healthcare.

Employment sponsored healthcare will likely still exist in some form, perhaps to ensure speedier access to some care.

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

#112

Post by scottmcf » Fri, Feb 21, 2020, 9:43 PM UTC

grayed-down wrote: post #95

dboreham wrote: post #6

As Churchill said... “You can always count on the Americans to do the right thing. After they have tried everything else.”

Would the right thing be single-payer or what would have to replace it once the economy and the medical profession have been destroyed?

Alarmist nonsense.

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

#113

Post by beefalo » Fri, Feb 21, 2020, 9:43 PM UTC

megiddo wrote: post #62

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…

Do you live in a state that rejected ACA funding?

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

#114

Post by macinjosh » Fri, Feb 21, 2020, 9:43 PM UTC

pjmorris wrote: post #75

macinjosh wrote: post #30

I am sure, on paper, it is a brilliant plan. Unfortunately, reality and human behavior almost never follow the plan. Is waste, fraud, and abuse taken into account at all in this study? What about the inevitable changes to consumers' motivation, behavior, and decision making around healthcare? It will change drastically as the cost of their care is even further removed from them than it is now. People who have a procl…

Somehow, the current US health system is the most expensive on the planet [0], for outcomes that aren't better (and in some cases worse) than the rest of the developed world. Have you considered the possibility of waste, fraud, and abuse being high in the present system? [0] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

I am not defending the current system. My point is that insurance and single-payer are not the only 2 possible models. A freer healthcare market, not encumbered by the inefficiencies of insurance, could actually put market forces to work in the industry. If prices were known prior to service competition would begin and people could vote with their feet. Right now we have a overly consolidated monstrosity in the insurance and drug industries sucking profits out of the public, and these guys just want to switch it out for a different monstrosity.

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

#115

Post by ve55 » Fri, Feb 21, 2020, 9:44 PM UTC

zanny wrote: post #107

ve55 wrote: post #55

I dislike how often I see justifications for the sources of inadequacies of current systems supposedly shown by comparing different countries to the US. An example of this in the paper is when they state that the US has more expensive healthcare, but yet worse metrics such as life expectancy. As the differences in healthcare systems between the US and these other comparison countries are obvious, they want to clearly…

> has significantly worse problems of obesity and drug overdoses Which can easily be caused by a destructive and broken healthcare system leaving the ill unable to seek treatment and thus left to fend for themselves. Even for those with insurance the costs - in time, in bureaucracy, in often money when your insurance provider refuses to cover - are unreasonable to consider seeing a doctor in a thousandfold situations…

The reason I disagree with this is because our healthcare system is largely built upon treating someone after they have an apparent issue, instead of preventing the issue.

It seems very difficult for a healthcare system to stop someone from becoming obese to begin with, or stop someone from abusing drugs that is intent on it and not seeing anyone intentionally, or stop problems like depression by their root cause instead of attempting to fix all of these things afterwards.

I'd be surprised if you really think a healthcare system by itself could be powerful enough to stop obesity.

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

#116

Post by macinjosh » Fri, Feb 21, 2020, 9:44 PM UTC

elicash wrote: post #81

dx87 wrote: post #73

Earlier quoted context omitted.

My wife's aunt has been on disability for years because she hurt her back and refuses to quit smoking. The doctors said the smoking is preventing her back from healing correctly, and 3 back surgeries later, she still hasn't quit. Because she's poor and on disability, she doesn't have to pay for any of it, and is pefectly content sitting in her trailer watching TV and taking pain killers as her health deteriorates.

And you think if she wasn't allowed to either have private health insurance (which is subsidized by others with health insurance) or have government-paid insurance, that she would suddenly stop smoking?

Insurance and single-payer aren't the only two choices. It is possible to not like either.

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

#117

Post by Denvercoder9 » Fri, Feb 21, 2020, 9:45 PM UTC

dcolkitt wrote: post #92

> Employer contributions to health insurance currently average $10446 per employee and cover 71% of a household’s premium. These employer premiums are equivalent to a 12.29% tax on payroll exceeding the first $2 million... Therefore, any payroll tax less than 12.29%, our upper bound in the SHIFT interface, would result in savings for employers. This excerpt makes it glaringly obvious that no economists were consulted…

Why won't the rising cost of labor for the employers that currently pay less be offset by the falling cost of labor for the employers that currently pay more?

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

#118

Post by chasd00 » Fri, Feb 21, 2020, 9:45 PM UTC

ncallaway wrote: post #52

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…

We do a lot of development work for client's in the medical and medical billing department. > Decrease in administrative overhead, calculated by extrapolating the overhead in medicare to the entire US healthcare economy. That doesn't strike me as unlikely at all. Maybe their extrapolation is aggressive, but there are people at nearly every practice who spend a large portion of their day just managing the billing of c…

i've done medical billing systems too and it is, indeed, crazy but what's make you think the gov. would be any better?

I wrote a specialized service dealing with Medicaid in a handful of states and it was even worse than normal. The incompetence at Medicaid is dangerous. Formularies, eligibility, reimbursements changed randomly with reimbursement changes retroactive to some random date. I have zero faith in any part of gov to get it close to right.

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

#119

Post by arebop » Fri, Feb 21, 2020, 9:45 PM UTC

pfarnsworth wrote: post #98

onemoresoop wrote: post #79

I'm paying nearly 20k (parents+child) on insurance I don't have time to use (and luckily no serious need) and once my son went to see his pediatrician and our 'private' insurance company (that i'm not going to name) sent us bill of $500, for a check-up. We disputed the charge with the insurance and they agreed to wave the payment next month. Next month comes and guess what? The same letter comes in mail. We disputed…

I was in the hospital over Christmas because of a very severe infection. I was there for 2 weeks, and am lucky to be alive. The costs were over $150k, but I ended up paying $1500 in various deductibles to Kaiser, etc. I was happy to pay $1500 and am alive because of the care that I got. I pay about $6000 a year in medical insurance per year through my employer and it ended up being totally worth it. Not a few weeks p…

$6000/year sounds very low for healthcare in the U.S. When you say "I pay" are you really only counting the employee contribution? For purposes of analyzing aggregate healthcare costs for a whole country, we ought to be using combined employee+employer costs (W2 DD) and not just the (usually small) employee portion highlighted by HR at benefits season.

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

#120

Post by notatoad » Fri, Feb 21, 2020, 9:45 PM UTC

dx87 wrote: post #101

Loughla wrote: post #45

Earlier quoted context omitted.

That's what I've never understood about the arguments against single payer: >You can't pick your own doctor I already can't. If they're in network, I'm good, but if they're out of network - like my doctor was - then I have to find a new one. >You can't pick your treatments My spouse was denied medication by an insurance company because it was too new. So. >You don't get to have all the healthcare you want I already h…

I know it's an edge case, but there was that kid in the UK with an easily fixable, but fatal, heart condition. Their health association refused to pay for it because no doctors in the UK knew how to perform the surgery, and they weren't willing to pay for them fly to the USA where there were specialists who could do the surgery. After they started a GoFundMe to pay for the surgery themselves, and there was a lot of p…

>there was that kid in the UK with an easily fixable, but fatal, heart condition

i'm curious what story you're referring to. The two that were in the news recently were Charlie Gard and Alfie Evans, but neither of those were heart conditions and neither were easily fixable. They were denied access to treatments that most medical experts agreed would not be effective.