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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

#221

Post by n9 »

Ghjklov wrote: post #194
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....

Do you think they'll give me free health insurance as a 23 year old who lives with a parent? I don't have any interest paying a dime for health insurance because I could use that money to eat healthily instead and try to stay out of trouble. Otherwise, I'd starve or sacrifice my diet in order to afford the health insurance. It has never made sense to me.

You are risking bankrupting you and your parents for a single hospital visit. Friend had a heart arrhythmia scare at 28 years old. Lost consciousness, ambulance to ER, admitted and then stayed in hospital for three days. $67k in Billings that they negotiated down to about $50k. That’s why.

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

#222

Post by ChrisLomont »

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…

> calculated by extrapolating the overhead in medicare to the entire US healthcare economy

Many friends in healthcare have pointed out (correctly it seems) that medicare has lower overhead because medicare shifted that cost onto the existing admin, and many places lose money on medicare, but are forced to take it. So it's simply not possible to extrapolate that to all hospitals without bankrupting many.

Here's a WaPo article with ample links to peer reviewed papers on the issue. (Note the part WaPo rates as false is that ALL hospitals would close; WaPo does admit with cited sources that there is ample evidence Medicare pricing would cause less service and less capacity from many fronts).

https://www.washingtonpost.com/politics/2019/07/03/would-med...

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

#223

Post by n9 »

fzeroracer wrote: post #49
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....

When I lost my job in 2018 and had to pay for health insurance myself, even a relatively low tier plan would cost me upwards of 400+ a month while still leaving me on the hook for a majority of the bills if I got sick or injured. Thankfully the COBRA loophole meant I could avoid paying the costs if I ended up finding a job quickly, but during that period I was travelling with a check for the full amount of the insura…

That’s not a loophole. It was the intention of the lawmakers who passed the law!

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

#224

Post by newguy1234 »

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…

Interesting I didn't know it had those issues

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

#225

Post by pkaye »

apta wrote: post #161
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…

> And on top of it I get a better deal if I use no insurance at all for prescriptions. Interesting. So is it also the case that you can "negotiate" medicine prices? Is the actual price then different from what is on the tag?

Drug companies are using price discrimination to maximize their profits. Charge a lot to the insurance companies but less to others with no or poor insurance. If a drug only costs $10 to make, they can mark it up to $100 for the insured people. Then insurance charges a $20 copay. The drug company now gives a $20 copay assistance card to make it "free". The net profit is $100-20-10=$70.

This is why California recently made is illegal to provide copay assistance to drugs where generics are available. I have a drug which cost $800/month to the insurance. My copay was $80/month. The manufacturer was so helpful to give me a $75/month copay card to cover this. Around some point the patent expired but the manufacturer continued to give that card out. Eventually the drug became generic and my pharmacy offered the generic version at $10/month. So my copay is higher but insurance cost is much lower. In fact the original manufacturer bugged me to petition the state legislature to change back that law.

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

#226

Post by codegeek »

rayiner wrote: post #210
codegeek wrote: post #178

Earlier quoted context omitted.

Yes but at least, Govt. is not looking to make record profits.

No, but government has strong incentives to deny claims to control costs. At least at the state level, governments have gotten extremely aggressive about money collection. E.g. $50 administrative fee for not paying a $4.00 toll.

Personally, I would go for ANY system right now other than what we have. I am too pissed off at how our healthcare system is. Single Payer may or may not have the same issues but I am ready to take my chances. Status quo is not good enough for me.

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

#227

Post by james-mcelwain »

chasd00 wrote: post #118
ncallaway wrote: post #52

Earlier quoted context omitted.

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…

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

Well, first of all, because there's no medical billing in M4A. It's free at point of service, so I'd hope they do better at billing considering they don't need to bill at all.

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

#228

Post by n9 »

xmly wrote: post #218
jandrese wrote: post #177

Earlier quoted context omitted.

Probably no employer sponsored healthcare for the most part. That money would go towards the Medicare coverage. There might be some supplemental plans for people who want to skip lines but most people will just use Medicare.

Is that what Canada has right now? For US, the real problem is still health cost is too high. The market regulation seems doe not work, at least for this decade.

From what I see about half the cost is the admin overhead and another huge chunk is providers billing very high rates because they end up paying a lot less to the insurance companies. If you want to optimize the lowest fruit is the admin overhead, which means just go single payer.

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

#229

Post by retrac »

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 am paying nearly 20k a year for possible emergencies?

Kind of, yes. The vast majority of healthcare spending is, unsurprisingly, on very sick people.

Insurance is for the outlier cost. The difference from other insurances is that almost everyone faces that outlier cost eventually in their lives, assuming they don't get hit by a bus in their 20s.

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

#230

Post by n9 »

mrfusion wrote: post #105
grayed-down wrote: post #89

My neighbor, a colorectal surgeon and very into what he does, has remarked on several occasions that if single payer ever happens, he and most of the other surgeons he knows will likely walk away from the profession very shortly thereafter. There would be no financial or professional motivation to continue practicing.

People say a lot of things.

You are my favorite for today.
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