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

#131

Post by chasd00 » Fri, Feb 21, 2020, 9:47 PM UTC

burnte wrote: post #83

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 work in healthcare as a CIO. I interact with all of our billing systems, processes, and departments. Frankly, I think the estimate of a 14% savings due to reduced administration to be low. Single payer would eliminate 30% of non-medical jobs in my company. Teams eliminated or dramatically reduced: * VOB, verification of benefits, they fight with the insurance company just to determine what coverage the patient has,…

i said this in another thread but you're assuming the single paying entity gets it even close to right.

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

#132

Post by Retric » Fri, Feb 21, 2020, 9:47 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…

The bill might have shown 150k, but costs to a hospital for 2 a weeks stay due to an infection should be a long way from 150k.

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

#133

Post by jandrese » Fri, Feb 21, 2020, 9:47 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…

If an employer decides to cut 30% of their workforce for tax resasons, who is going to do the work? Do they make the rest of the staff work overtime to cover for the people they fired? Are they just going to produce 30% less product/service and let the market sort it out?

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

#134

Post by madengr » Fri, Feb 21, 2020, 9:47 PM UTC

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 assume you are in a high deductible plan (HDP)? They don’t pay anything until you hit ~$4k/person, then 80% until OOP maximum of $7k for a family. But yes, a physical should have been 100% covered.

Yeah, so between my employer and I, it is $20k for my HDP for family of 4. Then I sock away the HSA max of $7k every year to pay for the actual costs (including dental, which I don’t have).

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

#135

Post by burkaman » Fri, Feb 21, 2020, 9:47 PM UTC

bduerst wrote: post #59

markroseman wrote: post #48

That also doesn't factor in the indirect benefits to the economy, like all the people who can't start a new business (etc.), being stuck in jobs they don't want because if they left they'd lose their benefits.

Or the boon from not having one of the highest infant mortality rates in the developed world.

The US also has the highest rate of maternal mortality in the developed world.

https://www.propublica.org/article/lost-mothers-maternal-hea...

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

#136

Post by riazrizvi » Fri, Feb 21, 2020, 9:48 PM UTC

Currently that money is flowing from the pockets of everyone into the pockets of investors, legislators and workers tied to the healthcare industry. What is the correct amount of profit? Who is to say the healthcare industry was making enough before they started hiking prices? Perhaps they saved their industry? Other countries have cheaper healthcare costs, but maybe they have less healthcare? Sure other countries might be living longer but perhaps that is tied to diet/lifestyle. Maybe Americans are living less because they are working harder, are being destroyed by a bountiful food industry that they can't resist, maybe the healthcare industry is picking up the slack... The solution offered here is a state-controlled market, which didn't work well for the Soviet Union so is it good now, or is this just our last desperate attempt to pick the lesser of two evils? But then is that the solution for out of control internet charges? For out of control property prices?

The single issue we should be focusing on in America, across healthcare, tech, government contracts, is fair markets, not free markets. Free markets are the flag which incumbent industry rallies behind because they can rig the system when there are no rules. Similar to the Glass-Steagall Act which enabled a fairer market for average investors competing against financial institutions, the hospitals, pharmaceutical companies and insurance companies need to be broken up, so that we can restore a fair market for healthcare. Politically it is our best strategy for an improved service. Since it will raise industry allies, those with solutions that are being unfairly crushed by an uncompetitive industry. Remember we are living in the Citizens United era, corporations have very strong political power. Universal Healthcare is going to cause the healthcare industry to stop infighting, they will circle their wagons, and collude with better effect by engineering supply shortages, confusing legislators using bribery and misinformation, and doubling down on pricing loopholes...

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

#137

Post by refurb » Fri, Feb 21, 2020, 9:48 PM UTC

jkingsbery wrote: post #106

ipython wrote: post #68

Earlier quoted context omitted.

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.

I'm not an expert, but my understanding is that it is common in single-payer system to outlaw at least some forms of private practice, see for example: http://www.canadian-healthcare.org/page6.html > In addition to public health care providers such as primary care doctors and hospitals, many private clinics offering specialized services also operate in Canada. Under federal law, private clinics are not legally allowe…

Canada forces physicians to choose - work in the public system or work in the private system. You can't do both.

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

#138

Post by mrcu5 » Fri, Feb 21, 2020, 9:48 PM UTC

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…

My wife is a pediatrician and sees about 80% medicaid patients. People absolutely go in more often than they need to because they don't pay a single cent. I'm talking going to the ER because their kid has a cough or is running a fever. These are usually also the most demanding patients.

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

#139

Post by protomyth » Fri, Feb 21, 2020, 9:48 PM UTC

I just want an explanation of how this would work out better for the general population of the US than Indian Health Service has worked out for the tribes? I just don't trust any of these studies when the refuse or are ignorant of what the government is currently doing and how problematic the governments approach is.

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

#140

Post by refurb » Fri, Feb 21, 2020, 9:48 PM UTC

SketchySeaBeast wrote: post #53

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-…

> The government has zero ability to control its expenditure, because the electorate vote themselves benefits. Could you give me some examples of this? Living in a nation with universal healthcare, I've never seen this.

Prop 13 is a great example in California.

Vote to freeze my property taxes? Yes!

Vote to increase spending? Yes!