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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

#331

Post by bpt3 »

expedition32 wrote: post #238
bpt3 wrote: post #147

Earlier quoted context omitted.

The people who avoid care they need because they can't afford it are a very small portion of the population that gets an outsized share of attention on the issue. Until public healthcare advocates understand this and make actual attempts to convince the majority of people who are satisfied with the current system that there are benefits, the status quo will remain.

Half the population does not vote. This is the problem socialists have- how do you get the underclass to exercise their power against the bourgeois?

No, the problem socialists have is that most people are smart enough to realize they won't be better off under a socialist regime, to the chagrin of the self-selected vanguard.

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

#332

Post by khriss »

jtbayly wrote: post #179
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…

I lost my individual healthcare plan, and I couldn’t afford the new ones. Remember when they said you could keep your plan? Yeah, that’s the one I lost.

I'm curious as to how your experience actually using the plan for more than preventive coverage? IIRC, plans before the ACA had a ton of customer unfriendly provisions which made the insurance far less usable in practice. E.g. denying coverage for preexisting conditions.

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

#333

Post by garbawarb »

karakoram wrote: post #31
garbawarb wrote: post #7

Earlier quoted context omitted.

That would be a massive hit to our GDP.

In all seriousness, this would be a massive stimulus to the economy. Americans are consumers at heart. All the money saved on insurance and/or other healthcare related costs would then be spent elsewhere. Cars, clothes, TVs, Labubu dolls. People will use the savings to buy things. In massive quantities.

Some would, but some would just put that money into savings and investments instead.

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

#334

Post by while_true_ »

saghm wrote: post #128
jvanderbot wrote: post #21

We've been down this road. ACA was predicated on studies like this, to no avail (it turns out that intense opposition chips away at it over time regardless of these studies). I'm of the opinion that, if your solution requires perpetual majority control of legislative, executive, and judicial branches, your solution is in fact a campaign slogan. I'm not saying that this is what is happening now , but I am saying that…

I mean, the original plan for what became ACA was single payer. They didn't have the votes from the moderate democrats though, which is why the "private plans on public exchanges" became a thing instead. You're not wrong at at least for the forseeable future, single payer does seem untenable politically, but I'd argue that dismissing studies like this on the basis that it needs solved before debating it on its merits…

They had 59 votes from Democrats for the public option, not single payer. Public option is to let people choose either a non-profit government insurance plan or private insurers. They needed 60 votes to break a Republican filibuster. Joe Lieberman (Ind-CT) said he would filibuster the public option but would vote for the ACA without it.

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

#335

Post by vlabakje90 »

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.

That overlooks the 27 million uninsured Americans. Uninsured cancer patients are more likely to be diagnosed at a late stage, less likely to receive treatment, and have substantially higher mortality than insured patients.[1] They also have worse survival, even after accounting for cancer stage.[2] So excellent U.S. outcomes among those who access care don't rule out preventable deaths caused by barriers to accessing it.

[1] https://pubmed.ncbi.nlm.nih.gov/25092774/ [2] https://doi.org/10.3322/caac.21732

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

#336

Post by lokar »

It looks like this does not even include the current disincentive for insurers to treat chronic issues effectively early on. Since people switch insurers so often the odds you will be their “customer” in 5 or 10 years is low, so investing if your long term health won’t generate a return for them.

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

#337

Post by GuB-42 »

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…

Yes, I consider big numbers like this to be red flags.

The GDP of the US is $32T. Saving $1T will essentially make 3% of the US economy vanish. You don't vanish 3% of an economy without wide ranging repercussion, it would be a crisis similar in scale to that of 2008.

With such numbers we are not "saving money", these are about rebuilding an entire economy, a painful process. So either the effect will be much smaller than that, or there will be riots.

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

#338

Post by mempko »

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…

Yes, these cost savings would be a deflationary event. Most layoffs will come from insurance companies and administration necessary to satisfy them in hospitals.

One reason hospitals have such low margins is many people simply can't pay. If you have a payment guarantee like a medicare for all system, this will increase the stability of hospitals. In fact likely bring back some hospitals in places that didn't make sense like rural areas, which have been struggling via hospital closures.

If you are worried a low cost system will reduce doctors and hospitals per capita you don't need to, as countries that have universal healthcare often have more per capita.

https://worldpopulationreview.com/country-rankings/doctors-p...

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

#339

Post by well_ackshually »

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%.

I don't see you complaining that the US military has a low operating margin, so maybe we can just agree that some things are just normal expenses for a population. Which therefore leads to step 2: nationalize every single hospital.

>cutting salaries for doctors/nurses/etc

Considering that over 50% of the money that goes into healthcare is just siphoned off by middlemen, no, just getting rid of these means that your health workers do not have a worse salary.

>But, we're actually in a primary care shortage.

Because people do not even go see their GP since there's a chance it leads to life ruining expenses.

> fewer residents are going into family medicine.

Because they're going where money is. Remove that from the equation, and all you have is a public service with public servants.

>a lot of people in the industry believe that Medicare has a large amount of undetected fraud.

Aside from the fact that "people in the industry" have a financial interest in making you believe Medicare is a net negative, there's a great thing that comes from making healthcare a public service: there's no longer any fraud. And those "fraudulent" expenses you used to have that were costing you millions anyways have just had their costs cut in half.

>Healthcare reform is hard.

It's the easiest thing in the world when you have the amount of money the US does. Healthcare reform isn't a financial or infrastructure problem, it's a political one. Cuba has a working healthcare system despite being under US embargo. Botswana has a working healthcare system. Rwanda has a working healthcare system. Azerbaijan, Sri Lanka, Turkey, Serbia, and the list goes on.

Once you grow the balls to nationalize everything, even a first year economy student could make a plan that works.

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

#340

Post by jsrozner »

For the most part, any time one person in the economy saves money, another person loses money. So, what about all the insurance company, private equity, and hospital system profits that would be eroded by a system that better serves individual humans?

/sarc

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