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

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

#371

Post by czgov »

strictnein wrote: post #232
czgov wrote: post #191

Earlier quoted context omitted.

Your linked to article does not demonstrate what you claim it does. Your reasoning is wrong. Medicaid expansion was a big part of the ACA.

> "Findings suggest Medicaid expansion under the Affordable Care Act saved about 27,400 lives between 2010-22, including among younger adults." > "Their findings show that Medicaid expansions led to a 12% increase in enrollment and significantly reduced mortality—not just among older adults, but also younger ones, who accounted for nearly half of the life-years saved." Huh? Did you read it? My point was that we could…

It was the Medicaid expansion that has been cited as saving lives [0].

Medicaid expansion saved lives. That is true and not in dispute. Other lives were saved too. It wasn’t just poor people who obtained life saving care from ACA. In an alternate world where only Medicaid expansion occurred fewer lives would have been saved than were saved with ACA as it exists now.

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

#372

Post by jimt1234 »

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…

My favorite part of the ACA is that the nickname, Obamacare, was created by Republicans, thinking it would fail and the nickname would make that failure stick to Obama better. Problem was, the ACA helped a lot of people, particularly people in red areas. So, then Republicans started complaining that Obama and the Democrats were being arrogant for putting Obama's name on the ACA.

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

#373

Post by missedthecue »

nradov wrote: post #351
sys32768 wrote: post #194

Earlier quoted context omitted.

Pre-ACA, I could afford family insurance. My family premiums went up ~$500 a month post-ACA, while the coverage worsened. My afib ER trip three years ago cost me $7k out of pocket even though I left the hospital still in afib. Today in my 50s, my deductible is now $8,500. My partner doesn't have insurance because she's not poor enough or rich enough. We had an insurance rep come to my work last year who said after AC…

Your blame is misplaced. Costs are increasing in spite of the ACA, not because of it. Pre-ACA your family insurance policy was likely worse in some key ways: it probably excluded coverage pre-existing conditions and had a lifetime maximum coverage limit.

But then the blame might be correctly placed? If he had no pre-existing conditions and was on a no-existing conditions plan, that plan might have saved him a lot of money.

Imagine car insurance regulations changing in such a way to force underwriters to blanket-assume everyone has had a couple speeding tickets this year. I understand why we do it. We are ok with speeders paying more for insurance, and not ok with someone born with diabetes forced to pay more for health insurance. But it is the end result in any case.

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

#374

Post by 0xy »

theappsecguy wrote: post #43
afavour wrote: post #15

In a more sane world the Republican Party would be in favor of universal health coverage. How many potential entrepreneurs stay working at BigCorp because they need the health benefits? How many small businesses are crushed by the cost of providing healthcare to their employees? It would be great for business to remove any involvement they have in personal healthcare. But I suppose they are the party of big business,…

The party in the pocket of BigCorp, that party...?

The insurance companies had substantial input to the specific text of the ACA. I'm not sure how you can imply the ACA was not a BigCorp bill when BigCorp wrote it.

It's also well known from leaks that the first Obama administration selected his cabinet using recommendations from Citigroup.

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

#375

Post by HumblyTossed »

iambateman wrote: post #129
greenpizza13 wrote: post #53

The US is far too broken for such a thing to ever come to be. Politicians are bought and paid for, and the impact on the insurance companies and their profits make this impossible. US legislators will never, ever, ever put the needs of the people above the needs of corporations, not as long as corporations can wield their massive wealth as "free speech" in the form of lobbying and political donations. Sounds nice, th…

When I was a kid, my parents would say “with that attitude, you’re right.” We can and should expect a lot out of the people around us and especially the ones who choose civil service. Our grandparents ended slavery, got votes for women, established a merit-based civil service, fought fascism, passed equal rights legislation, and created the most dynamic large economy in history. We have problems, too, but we are not…

Sadly so much of that, people are actively trying to undo it.

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

#376

Post by 0xy »

poncho_romero wrote: post #30
solaarphunk wrote: post #19

What about quality of care tradeoffs? In Canada, for example, you are forced to use the government system, and if it doesn't deem you important enough, there is no private option.

What about them? The Canadian healthcare system has better outcomes than the American healthcare system in several areas. Most simply, Canadians live longer.

Can you reconcile this with skyrocketing Canada to US medical tourism?

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

#377

Post by nradov »

loeg wrote: post #71
_heimdall wrote: post #64

Earlier quoted context omitted.

These types of studies, and the goals they aim to support, always frustrate me as solving a surface-level problem rather than root cause. The problem with US healthcare isn't who pays for it, its how damn expensive it is. As always there are multiple factors at play, my list would include corruption, lack of legal accountability/responsibility, and a population that is much less healthy than reasonable. Go after any…

Americans just consume a lot of healthcare services. Any substantial cost savings requires providing less healthcare service.

Something like 20% of healthcare services are "low value care" which aren't justified by evidence-based medicine criteria and may even harm the patient. Regardless of the financing system we could free up a lot of capacity and slash costs by eliminating that low value care. Of course in practice it's difficult to do that at scale.

https://www.bloomsbury.com/us/price-we-pay-9781635575910/

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

#378

Post by jonhohle »

lotsofpulp wrote: post #318
jonhohle wrote: post #303

Earlier quoted context omitted.

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…

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

Then turn it into a tax and be done with it. I don't shop for my tax collector and I don't pay taxes to companies with the biggest buildings in the city. Companies that don't actually provide health care, but just collect their pound of flesh from patients and providers, driving up costs for everyone.

I'm glad your child has received care. I'm very much behind the idea that pre-existing conditions should not preclude anything from receiving _care_. I'm completely opposed to mandating a private 3ᴿᴰ party be between me and my provider.

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

#379

Post by jonhohle »

dummydummy1234 wrote: post #321
jonhohle wrote: post #303

Earlier quoted context omitted.

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…

Out of curiosity what state are you in?

Arizona

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

#380

Post by Aurornis »

nullocator wrote: post #345
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% Very curious where this comes from and how accurate it is. For example the $37 a provider charges for an Aspirin seems like more than 2-5% margin.

Insurance pays the higher of their negotiated rate or the billed charge. Medical facilities set their billed rates so high that they’re guaranteed to be higher than all negotiated rates, ensuring that they get paid.

When you see $37 aspirin on the line, nobody actually pays $37 for it. The billed amount is replaced with whatever insurance rate is allowed for that. If someone is cash paying they get a large discount.

The billed items also have to cover everything. It’s not directly $37 for the aspirin, or the $5 or whatever allowed coverage it ultimately gets billed it. That had to cover the facilities, the salaries of the pharmacy staff who reviewed the request and dispensed it, the staff who inventory and order the medications, and the cost of billing insurance.

The only part that nationalized health care would change are the allowable billed rate and maybe the administrative overhead of billing different insurances. Even nationalized health care systems have admin overhead though.

You can think of it like when you have to pay $11 for a single glass of wine from a bottle that the restaurant paid $10 for. You’re not just paying for the liquid, you are paying into a big bucket of charges that all need to add up to more than the cost of the supplies, staff, building, and everything that goes into running it. The margin on individual products doesn’t make the entire operation profitable.

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