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

#141

Post by jkingsbery » Fri, Feb 21, 2020, 9:49 PM UTC

noodle wrote: post #94

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…

> Not sure what other arguments there are. The one I've heard the most lately is that "people like their existing insurance companies", which I think is an almost absurd thing to say on its face. But its probably just a way to say "people don't like change" that doesn't get insurance companies or "people" salty about it.

I've never heard that - I don't know anyone who likes their insurance company. I have heard some people say that in the current system that there might in theory be some competition, although in practice government rules mean that there isn't really much competition. Most people I've heard want to go the other way from single payer, and increase competition for insurers.

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

#142

Post by adamch » Fri, Feb 21, 2020, 9:49 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-…

How is this fundamentally different from the electorate voting for an army to protect them, or firefighters to put out their fires? These are also paid for by taxes and where the electorate will vote for their own benefit.

Aren't the electorate also the ones voting for tax structures (or for the politicians who'll implement them)?

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

#143

Post by codegeek » Fri, Feb 21, 2020, 9:50 PM UTC

fernandotakai wrote: post #66

ameister14 wrote: post #36

Earlier quoted context omitted.

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 wr…

You are confusing Private Health "Care" wth Private Health "Insurance". The issue with Private health Insurance in US is that they have too much power and strong hold on doctors/hospitals etc and for them to make profits, EVERYTHIng is priced too high, EVERYTHING. So private health "insurance" has to die for this to be effective. They can exist only for supplemental stuff. No one is talking about taking away private health "care". You can still go to whoever you want.

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

#144

Post by refurb » Fri, Feb 21, 2020, 9:50 PM UTC

mrcu5 wrote: post #138

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.

I found this part of the paper to be unreasonable:

Available ER visits and hospitalizations can be avert through improved access to primary care

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

#145

Post by macinjosh » Fri, Feb 21, 2020, 9:52 PM UTC

burkaman wrote: post #72

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…

Did you read it? Also, are you familiar with any modern nations where a single-payer healthcare system has been tried? Perhaps we could use them to predict the effects. > Is waste, fraud, and abuse taken into account at all in this study? From the paper: "In addition to savings on overheads, a comprehensive database of health-care charges would facilitate detection of fraud, which extracts $85·7 billion every year. F…

> You already are? That's how health insurance works.

I am not a defender of the insurance system. It blows. But single-payer is not the only other choice.

I want a freer healthcare market where prices are known before consuming services. Real market competition could actually occur to bring down prices. For drugs, research and development for less profitable cases could be a very worthy target of government funding. I don't have all the answers but neither does single-payer.

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

#146

Post by briandear » Fri, Feb 21, 2020, 9:52 PM UTC

refurb wrote: post #96

The US Department of Veterans Affairs (VA) has the capacity to negotiate prices that align with the therapeutic value of pharmaceutical drugs and could be a potential model for the federal single-payer health-care system. This bargaining power results in pharmaceutical prices that are 40% lower in the VA system than those under Medicare This is a terrible proxy. The VA doesn't really negotiate , the discounts are man…

And, if the VA is an example of single-payer, then we're doomed. The VA is awful. That's the single best argument against single-payer.

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

#147

Post by legitster » Fri, Feb 21, 2020, 9:52 PM UTC

mrfusion wrote: post #91

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…

The 69% figure doesn’t sound right.

It wasn't. Fixed.

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

#148

Post by codegeek » Fri, Feb 21, 2020, 9:52 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…

For a family of 4, I pay total of about 20K per year as well (employer + employee cost) and even after that, we have a $5000 deductible AND on top, we have to be concerned about in-network/out of network bullshit. So for me, unless $25,000 has been spent, insurance company would not even come in the picture AND I am always scared if I wil get a bill that was out of network.

This madness has to end and I don't give a shit that we are trying Single Payer. Everyone talks about Cost but what about Administrative issues ? Fighting incorrect claims, billing errors and what not. As far as I am concerned, this is one area where I am totally against Profit making motive. Let me correct myself. I am totally ok with Doctors and Hospitals directly making some profit but not insurance companies. Private insurance companies can go suck it. I am sick and tired of paying for their profits. Status quo has to change, that's it.

EDIT: I am not against Insurance of some sort but they should only exist for Catastrophic illnesses. I need to go see my doctor for preventive care ? No need to involve Insurance company and wasting time on filing a claim that by definition requires more money to pay for the people involved unnecessarily.

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

#149

Post by beat » Fri, Feb 21, 2020, 9:52 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…

This is where I think political leaders (Democrat or Republican) could do really well. It's not just making sure people are covered. It's the existential dread of dealing with opaque, unpredictable, and incomprehensible bureaucracy that can make life-and-death decisions or drop financially crippling bills in your lap, even if you have good insurance. The American health care system isn't just bad for the poor. It's bad for everyone. We just can't deal with it, because we are exposed directly to unnecessary complexity.

But the fact that the people with money and good insurance are suffering from the system as well as the poor seems to be lost on Democrats, and the Republicans are just paralyzed by the whole idea of fixing health care. It's a massive political failure for both parties.

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

#150

Post by commandlinefan » Fri, Feb 21, 2020, 9:52 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…

Yikes, so you have higher taxes to cover universal healthcare AND you have to pay insurance premiums, deductibles and copays on top of that? That's exactly what we libertarian types are afraid of...