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Universal health coverage could save $1T and 114k lives a year: study

ysph.yale.edu

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Re: Universal health coverage could save $1T and 114k lives a year: study

#311

Post by mindslight »

_heimdall wrote: post #262
hnlmorg wrote: post #155

Earlier quoted context omitted.

The point of nationalisation is to address those underlying concerns. But it’s fair to say that in practice, nationalisation doesn’t always solve those problems. The problem is you either need to regular or nationalise. And neither of those are particularly “American”.

I don't think our problem is a lack of regulation though. If anything its a lack of market competition, and that is caused by over regulation and legal protections that make holding companies responsible difficult or impossible.

It's also caused by absurd nonsense like how doctors can't tell you how much anything they're proposing to do actually will cost (a necessary condition for entering into a contract!), but then the system makes up arbitrary bills after the fact - with fraudulent amounts that nobody actually pays! No other industry works like that, as it's not the foundation of a market in the first place. Imagine if going to the grocery store involved "paying" some token amount at the cashier for their time to put your items in bags, then for the food you received shakedown bills for years afterwards, that you had to spend time going through your old documentation to refute and bargain down. Absurd.

Regardless of "insurance", who is ultimately paying, or subsidies to provide a baseline of care - there needs to be reform that mandates simple up-front prices, constant per-provider regardless who is paying, and ruling out any other theory of billing. Doctors throw up their hands and act like they're dealing with some special problems, but there are plenty of other industries we can look at for the dynamics of how to handle routine procedures versus emergencies (and knowns vs unknowns) in a consensual and market-responsive manner.

Re: Universal health coverage could save $1T and 114k lives a year: study

#312

Post by seanmcdirmid »

Universal Health Coverage has a lot of other benefits:

1. It detaches health insurance from the employment market. This means those minimum wage walmart jobs just became more feasible, or any low end job really, since their is no pressure to provide "benefits" anymore. This would seriously lubricate the labor market, because the friction to providing, taking, and changing a job is reduced.

2. It ends a bias for group plans. If you are poor or are a trades worker and need to buy insurance outside of a group plan, you are going to be in an expensive high risk pool.

3. Its a benefit we can fund socially with taxes that will immediately have a positive impact on lower income workers, as well as poorer regions of the country (e.g. red states).

Re: Universal health coverage could save $1T and 114k lives a year: study

#313

Post by triceratops »

lapcat wrote: post #266
triceratops wrote: post #207

Earlier quoted context omitted.

> Democrats had 60 during Obama's first term. They'll always find a rotating villain to oppose it, Joe Lieberman, Joe mansion, etc. So what do you propose? Is there a 3rd party that has a reasonable chance of doing it? Maybe if you flip a few Republicans (to supporting UHC) it might go easier. It'll give their leadership something to think about at least.

> So what do you propose? Is there a 3rd party that has a reasonable chance of doing it? No, I propose calling out Democratic leaders for corruption, removing corrupt leaders from their leadership positions, and running primary challenges against them. As you said, Republican leaders are calling single payer "Communist". When the Democratic response is, "I no longer support single payer", they're essentially allowing…

> removing corrupt leaders from their leadership positions, and running primary challenges against them

Godspeed.

Re: Universal health coverage could save $1T and 114k lives a year: study

#314

Post by pythonaut_16 »

SoftTalker wrote: post #221
TimorousBestie wrote: post #197

Earlier quoted context omitted.

Here you go, a recent survey: https://www.jgwentworth.com/resources/medical-emergency > The survey showed that over nine in ten (92%) of insured respondents had delayed or avoided medical care because of concern about cost. > In fact, 95% of those surveyed said a medical emergency would likely put them into serious debt even with insurance.

An unexpected car replacement would put most people into serious debt. And there's no insurance for that. People get so hung up on the idea that they should have to pay for health care, when you have to pay for every other necessity in life.

Why are you moving the goal posts? You asked for a citation and were given one and now you just change to a different argument.

Re: Universal health coverage could save $1T and 114k lives a year: study

#315

Post by Aunche »

jgwil2 wrote: post #253
consensus1 wrote: post #119

Earlier quoted context omitted.

Nobody, including congress, gives a rat's ass about insurance companies and their profits. The truth is that someone has to approve or deny healthcare. Every universal system does it too, but by government policy instead of corporate decision. After the CEO of United Healthcare was gunned down in the streets for doing that thankless job do you think congress is saying to themselves "hey, maybe we should get into that…

> thankless job His annual compensation was over $10 million.

That's their point. Congress isn't going to get $10 million from providing universal healthcare (at least for any system that is any good), so they have no incentive to pass it. The year the ACA passed, Democrats suffered one of the worst legislative defeats in history. Nobody wants to be the person to tell millions of people that they can no longer see their chiropractor for free or that their healthcare is not longer paying thousands of dollars a month for weight loss medications.

https://en.wikipedia.org/wiki/2010_United_States_elections

Re: Universal health coverage could save $1T and 114k lives a year: study

#316

Post by onlypassingthru »

brandonb wrote: post #113

I'd like to believe this, but the study makes a bunch of really hasty assumptions. The authors derive the $1T number from $1.3T in total cost savings and $304B in incremental spend (incremental spend is due to insuring more people). The $1.3T in cost savings come from five big buckets: lower pharmaceutical prices, Medicare-level payments to providers, reduced administrative overhead, less fraudulent billing, and fewe…

> Hospitals have an operating margin of 2-5%

There's no way a Chairman/CEO would ever reduce the operating margin by just giving themselves and their buddies a raise is there?

Re: Universal health coverage could save $1T and 114k lives a year: study

#317

Post by SpicyLemonZest »

_heimdall wrote: post #287
SpicyLemonZest wrote: post #219

Earlier quoted context omitted.

It's extremely challenging to go after high costs in the current system, because the doctors who charge them are popular and the insurance companies who pay them are hated. There was a 2024 story that stuck in my mind ( https://www.npr.org/2024/12/05/nx-s1-5217617/blue-cross-blue... ) when Anthem tried to negotiate down the rate of certain anesthesia procedures; the public was absolutely outraged, successfully demand…

The disconnect between prices and end consumers is itself a huge problem. I should know what care costs before I get it, and I should know how much my instance company is paying on my behalf before I get care. For prices to be sane we need people being able to compare prices, decide what care they want and can afford, etc. Our prices are so high because its a closed market acting as though it were a free/open market…

I think that’s a reasonable model to want, but it’s what we call “preauthorization”, and many patients along with most doctors absolutely hate it. In order to know with certainty what your care will cost and how much your insurance company will pay, the doctor has to contact them in between deciding what treatment you should have and giving you the treatment.

You can and I do solve that annoyance with an HMO, where the doctors and insurance can communicate more effectively because they’re part of the same organization. But that also means it’s difficult or impossible for me to get the kind of care that a normal insurance company would hesitate to approve.

Re: Universal health coverage could save $1T and 114k lives a year: study

#318

Post by lotsofpulp »

jonhohle wrote: post #303
epistasis wrote: post #75

Earlier quoted context omitted.

ACA has saved tons of lives. Due to the intense opposition, it was not structured in a way that could save money, but rather structured in the way that it could get through congress. Additionally, as somebody who was around pre-ACA, I can not tell you how much better, in every single way, the post-ACA healthcare world is. Pre-existing conditions? Access to healthcare as an individual? These are life-changing possibil…

Before I went indie, prior to ACA requirements I researched private insurance and found plans for around $3K. This year I’ll pay over $20K for a bronze plan for my family. 700% increase in less than a decade. Aetna left the marketplace input state and no pediatrician in a 10 mile radius takes the most cost effective ACA plan. The pediatricians we found are actually just GPs who have training in pediatric medicine, bu…

ACA premiums are literally taxes, the price you pay has nothing to do with your health risks.

You are paying more because a lot more healthcare is being delivered, to people who never used to either due to exceeding maximum benefits (we have the opposite today with out of pocket maximum), or being denied for pre existing health conditions.

So to answer:

>Who is it better for?

My 4 year old, who has received hundreds of thousands of dollars of cancer treatment, and will need a bunch more over the coming years.

Re: Universal health coverage could save $1T and 114k lives a year: study

#319

Post by remyp »

DrScientist wrote: post #230

As I understand it - ~30% of US federal spending is on health care. In the UK it's about 20%. Yet apparently the UK is mostly nationalised under the NHS, while in the US there is huge additional spending on private insurance. Can somebody from the US explain to me how that's the case and why American's still put up with it?

We hate it and are more and more powerless to change it every day. The parties are entrenched and swing districts are becoming increasingly rare. Those competitive districts that remain are flooded with unlimited campaign funds from big business and plutocrats, thanks to Citizens United.

Re: Universal health coverage could save $1T and 114k lives a year: study

#320

Post by Alex3917 »

tptacek wrote: post #309
RunSet wrote: post #305

Earlier quoted context omitted.

Even if universal health coverage lost money it would be better than the current system that is based on a "causing cancer is better for the GDP than curing it" mentality.

The US has top-tier cancer survival-after-diagnosis outcomes. We spend too much to get there, and other countries in our cohort would "argue" that we get those numbers in part by diagnosing earlier and that our outcomes are broadly similar, but if you're going into these debates with "the US private health care system causes cancer deaths", that's a pretty rebuttable argument.

I think the parent comment was a reference to the famous “Economists must learn to subtract” commercial that AdBusters ran.
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