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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

#311

Post by sf_rob »

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…

My SO has insurance through/at her med school and has to dispute bills every time she goes in because they bill them as non-covered. Oh and imaging in the same building / under the same hospital wasn't covered. It's crazy that even medical professionals can't get good/clear services.

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

#312

Post by usaar333 »

codegeek wrote: post #308
usaar333 wrote: post #267

Earlier quoted context omitted.

Isn't every Democrat supportive of universal healthcare? (Which at the minimum is just ACA + technical fixes on it) There are differences through whether it should be single-payer or not.

ACA is not universal healthcare. It only made things worse overall except the fact that people cannot get denied due to pre-existing conditions. Obama should have pushed for a public option with ACA at the time. In 2020, fuck that. We want to go straight to Universal healthcare, single payer. No middle ground. Only 1 democrat supports that so I am voting for him.

Why is ACA not universal? (Ignoring technical problems it had that prevented that from actually happening). It guaranteed affordability, coverage, and prevented you from opting out.

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

#313

Post by macinjosh »

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...

> Somehow, the current US health system is the most expensive on the planet

You know why? Because we pay for most of the R&D, done by industry, that the rest of the world benefits from. For example, other developed nations like Canada have been able to benefit from new drugs invented in America's more capitalist system by restricting prices in their country even though we don't.

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

#314

Post by refurb »

markroseman wrote: post #162

People seem to think that if you move to single payer that the single payer would behave like any of the existing payers, i.e. you call to fight for approval for everything you do, argue about fees for each item, denying things is routine, blah blah blah. If you have a single payer system, it doesn't have to work that way. Not even close!

No, you wouldn’t have to fight for everything.

With a single payer, there would be a list - this is what we pay for, this is what we don’t pay for.

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

#315

Post by tptacek »

deugtniet wrote: post #24
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…

All you need to do is look at the health care costs per citizen of other developed countries to understand that the US is paying way too much in their current healthcare system. I'm aware that the US's healthcare system is unique in many ways, but so are all the other countries on that list and they made it work. https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

The problem is that when you break those costs down into buckets and then compare the buckets with other countries, we're overspending in all of them, by very large amounts. Pharma and admin is nibbling at the edges of the problem. We pay way more for inpatient and outpatient procedures than other countries do. We prescribe more procedures than other countries (possibly as a consequence of how well we've gotten at delivering procedures on an outpatient basis; the UK, for instance, apparently fixes fewer hernias, but that's probably a result of the fact that they do a lot more of then on an inpatient basis). Our doctors also just make substantially more money.

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

#316

Post by macinjosh »

yongjik wrote: post #165
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…

> Why should I subsidize other people's bad decision making? This is what you already do when you live in America. Other people made a bad decision to make healthcare a private industry, creating a billion dollar insurance business, and you are writing their paycheck out of yours.

And how is writing paychecks for government bureaucrats any different? I would like to pay my doctor, and my hospital, and my pharmacy for my healthcare costs not some borg.

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

#317

Post by laurencerowe »

tptacek wrote: post #295
bduerst wrote: post #19

Earlier quoted context omitted.

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…

Nobody is saying there aren't real administrative savings to be had, but the amount we spend on administrative costs is something close to an empirically observable fact, and you can do the mental exercise of taking any credible number and zeroing it out to see how big an impact it would have on overall health spending. It's not huge. Which is to say that even in the most optimistic case, where single-payer forces ev…

According to this study healthcare administration costs account for the bulk of the difference between US and Canada healthcare spending. 34% of 18% of US GDP (=6% GDP) vs 17% of 11.6% of Canada's GDP (=2% of GDP). https://www.healio.com/primary-care/practice-management/news...

Other studies looking at only hospital costs put it at 1.43% of GDP. https://www.commonwealthfund.org/publications/journal-articl...

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

#318

Post by joe_the_user »

BurningFrog wrote: post #283
mochomocha wrote: post #64

Earlier quoted context omitted.

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 heal…

> * This whole idea of "free market is more efficient for healthcare" has to die* The current US healthcare system has very little to do with "free markets"!

"The current US healthcare system has very little to do with 'free markets'!"

Sure, the US health care system is certainly not governed by wide open competition, transparent pricing or similar things. But it certainly has something to do with the "free markets".

The system is basically "what you get when you realize you have to insure and regulate but you never, ever do it in a centralized rational way, 'cause that would be socialism - plus you never, ever separate an 'entrepreneur' from a real or potential stream profits". Which indeed, builds the worst of all possible systems, sending risks to the consumer and profits to the investor/rent-seekers.

And from here, we could go forward to actual socialized, state-run medicine as functions adequately in most industrialized economies or back to a "wild west" system, where costs are lower, treatment is often OK and the heroin runs in large rivers as due the fatal scams(as was the US' 19th century health care reality).

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

#319

Post by three_seagrass »

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.

Mandating businesses to pay health insurance costs for employees under the current system is already reducing international competitiveness.

Medicare-for-all makes the U.S. more competitive by making healthcare similar to other developed nations.

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

#320

Post by pkaye »

elihu wrote: post #248
pkaye wrote: post #225

Earlier quoted context omitted.

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…

It also can go the other way. I was once quoted two prices for a CT scan because they weren't sure if my insurance would cover it. If it did, they'd bill one amount to the insurance company. If they didn't cover it, I would be billed directly for an amount that was somewhere around double what the insurance would have been billed. I got the CT scan somewhere else.

Insurance companies negotiate down prices so the hospitals jack up the sticker prices to give room for negotiation. I've read that hospitals typically get 20-30% of what they bill.
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