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

#361

Post by bcrosby95 » Sat, Feb 22, 2020, 1:22 AM UTC

mrep wrote: post #336

codegeek wrote: post #301

Earlier quoted context omitted.

You are missing the point. It is not about being healthy. You are always worried about the "what if I have to go see a doctor" situation in America because you don't know what it will cost and you definitely don't know what kind of issues you will have to fight through with incorrect claims, incorrect bills and what not. If someone can address that here in US, I am willing to keep the current system as is.

My max out of pocket spending is $2,600 a year and I can put $3,500 pretax money into my HSA every year which I do. What I am supposed to worried about?

And it always covers everything?

We have a pretty pricey insurance plan: family of 4, 36k/year. When my wife had a gall bladder attack and had to get it removed, the insurance company quickly paid the surgeon's bill, and followup doctor visits.

But the insurance company denied the anesthesiologist bill, the hospital surgery room rental bill, and the hospital recovery room bill all as "medically unnecessary", also known as: they won't be covering it.

We tried talking to the original doctor and surgeon but of course they got paid and their offices said the rest of this wasn't their concern. We weren't really sure who we should be talking to to help us show the insurance company that anesthesia is fucking necessary when someone cuts you open.

After about 8 months of stress it was all eventually resolved for a fraction of the original price. In those 8 months though everyone who wasn't getting paid were sending us notices about how we didn't pay yet and how we could set up a payment plan. We talked to hospital billing and they said they usually just drop bills insurance doesn't cover. Usually. And that we shouldn't worry since this happens all the time and that it usually isn't resolved until lawyers get involved.

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

#362

Post by [deleted] » Sat, Feb 22, 2020, 1:27 AM UTC

leetcrew wrote: post #350

mrep wrote: post #336

Earlier quoted context omitted.

My max out of pocket spending is $2,600 a year and I can put $3,500 pretax money into my HSA every year which I do. What I am supposed to worried about?

I have a similar plan and a good income. I am in good health and I make my yearly budget assuming I might have to pay the out of pocket max if I have a health problem. the usual "gotcha" that people mention is going in for a planned procedure and accidentally receiving care from an out-of-network physician. this makes your out of pocket max irrelevant. I've never had this happen to me and I have no idea how often it…

[deleted]

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

#363

Post by carterehsmith » Sat, Feb 22, 2020, 1:30 AM UTC

bureaucrat wrote: post #352

grecy wrote: post #296

Earlier quoted context omitted.

I live in Canada, and haven't even earned $20k of income in a few years, but I still have excellent cover. I broke my nose, was seen within 5 minutes and it was straightened (after anaesthetic). I got hit by a car on my bike, was seen in 5 minutes, no worries. Needed and x-ray for my lugs to get residency. Took 10 minutes. Free. My brother broke his leg horribly. Multiple surgeries, a month in hospital, etc. etc. The…

Don't forget 6 months waiting time for breast cancer diagnoses. Don't forget over a months waiting time for a simple antibiotic shot, which my friend died while waiting. Don't forget, can't see a doctor for two freaking weeks for a simple stomatitis. Don't forget 3+ months and waiting for a freaking endoscope procedure. For everyone not in critical situation, your country's health care is shit. Don't even deny that i…

Sadly, the coverage does seem to vary widely.

I heard the absolute horror stories, and the opposites, too.

What province/territory/city were you in?

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

#364

Post by pjmorris » Sat, Feb 22, 2020, 1:53 AM UTC

macinjosh wrote: post #313

pjmorris wrote: post #75

Earlier quoted context omitted.

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.

US pharmaceutical company R&D spending is ~80B per year [0]. Healthcare spending is ~3.6T, making pharma R&D about 2% of overall healthcare spending.

Based on the above back-of-the-napkin math, I'm inclined to think pharma R&D isn't really the main factor.

What is your support for believing it is the case?

[0] https://www.biopharmadive.com/news/phrma-research-developmen...

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

#365

Post by philipkglass » Sat, Feb 22, 2020, 2:02 AM UTC

Ghjklov wrote: post #266

frosted-flakes wrote: post #260

Earlier quoted context omitted.

What happens whenyou get run over by a drunk driver? You don't get to choose when that happens, and there's little you can do to prevent it.

In that case, the drunk driver/his insurance would pay for the hospital fees, no? That is, in the more optimistic outcome where I actually survive.

Reckless drivers may not have insurance, or enough assets to pay off your hospital bills.

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

#366

Post by grecy » Sat, Feb 22, 2020, 2:21 AM UTC

bureaucrat wrote: post #359

grecy wrote: post #354

Earlier quoted context omitted.

It depends entirely on where you live. Out West there is no waiting and I've never experienced any of what you're talking about. I've only heard stories about how it is in the East, I've never met anyone first hand that has experienced it, or really hates it.

Because you haven't experienced a problem in your body that is rotten deep inside but shows little to no symptoms. My friend died in Alberta. It took two weeks to even see a doctor and more to wait for antibiotic shots. Doctors try hard to not make problem a problem because the system is fucked in a way that doctors benefit from less patients. They don't try to cure. They wrap up the symptom and makes patients think…

I lived in Alberta for 2 years, I've got many friends living there still. I have never heard of what you're talking about, and certainly never experienced it.

I can't help thinking you over exaggerating the issue to avoid single-payer heathcare in the US at all costs.

Also, I lived in Australia for 23 years. It works great there.

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

#367

Post by LordFast » Sat, Feb 22, 2020, 2:26 AM UTC

UnFleshedOne wrote: post #264

LordFast wrote: post #102

The problem has never been about what system works, that's always been clear. The problem has been, and will continue to be about all the people that are currently employed by the dysfunctional system. Managing that situation is the meat of the challenge.

It was never a problem when companies started outsourcing to developing countries in droves...

"Hey if you join me in this scheme to make more profit by squeezing other people out of what they have today, I'll give you a cut of that profit. What do you say? I promise you'll keep getting a cut until it makes sense to squeeze you out as well."

Less obvious, and more eloquent, of course.

Better choices, better opportunities, and real innovative solutions to solve real problems. Those are the rising tides that will raise our boats instead of sinking them.

I concede though that it's easier when we're talking about 10 people and a startup, rather than 330 million human beings across 3.8 million square miles.

I want to see more leaders focus on the real crux of the problem, taking into account human nature while we're at it. I'm not holding my breath.

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

#368

Post by sitkack » Sat, Feb 22, 2020, 2:56 AM 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…

They will send you to collections w/o warning. Good luck getting the credit hit removed.

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

#369

Post by claudeganon » Sat, Feb 22, 2020, 2:58 AM UTC

wahern wrote: post #255

claudeganon wrote: post #206

Earlier quoted context omitted.

> those who want a public option or single-payer--willfully ignore the evidence. What you say is true about the public option, because it incentivizes insurance companies to dump expensive patients onto the public dole, while charging ever increasing premiums for those who either don’t need healthcare or are self-rationing because of things like co-pays or high-deductibles. Obamacare and Medicaid in tandem also don’t…

> It’s not true for single payer systems, who across the world pay less than what we pay in the US. It's also not true for systems with public options, like Germany. You're making a hypothetical claim about the abstract economic incentives of a public option. But like many such economic arguments, without accounting for the technical realities these arguments have exceptionally poor predictive power. The cost problem…

> The debate is far too abstract, with unsupported, sweeping claims about comparative efficacy.

It’s not at all abstract, you’re just obfuscating. If your concern is costs, we should have a fully nationalized model like the UK because that has lower expenditure per capita than single payer or mixed public-private systems. Or, if we can’t have that, have single payer, because it too still has lower costs than the mixed systems in the developed world.

It’s not cargo cultism by way of arguments from analogy. It’s Americans irrationally clinging to their exceptionalism in the face of stark counter examples while their people die in the streets, ration care, and go bankrupt.

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

#370

Post by Balgair » Sat, Feb 22, 2020, 3:14 AM UTC

codegeek wrote: post #148

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…

I'll chime in with my anecdata on US health insurance:

My SO has a condition that requires a pill to help out with. My SO has some trouble working regular hours due to this condition and takes one pill per day. Depending on the insurance, we have paid between $1 and $5 per pill in the past. This particular chemical is a part of horse feed. Like, how we just put Vitamin D in Milk, or Iodine in Salt; they put this chemical in horse feed. It does not change the cost of the horse feed appreciably, just like with human additives.

I was once offered a job. When we dug into the insurance that the job had, it would have cost us ~$100 per pill, or ~$3k/mo. It was an otherwise dream job, perfect for me. But a ~$36k/year increase in our yearly cost of living. We had to turn the job down, of course.

For a substance that they put in horse feed for basically free.

The last time that I posted this issue on HN, a VERY kind person pointed me to a way to buy this chemical online and in bulk. It comes to your door in volumes of about ~$100 per CUBIC METER. They ship by volume, not weight.

US Healthcare is totally, completely, utterly, broken.