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

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

#391

Post by ButlerianJihad » Mon, Aug 17, 2026, 5:43 PM UTC

strictnein wrote: post #131

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…

> ACA has saved tons of lives It was the Medicaid expansion that has been cited as saving lives [0]. An expansion that has almost nothing to do with the rest of the ACA. > "There's a very clear type of fallacy you are engaging ... There's no intellectual rigor or honesty in that sort of thinking" So you're claiming that the person who posted that is not only falling into a fallacy, but they are neither intellectually…

"Saved lives" or "Could Save Lives" is a ridiculous, un-falsifiable, and unprovable claim.

First, it involves twisting correlation and causation into an Escher knot. Secondly, it's not even what cited source says.

Yes, "reduced mortality along a timeline for a certain demographic" is a good and desirable statistic, but there is no way that it translates into the self-aggrandizing and sensationalistic "ACA/Medicaid saved tons of lives" (whatever "tons" is supposed to mean, in terms of lives. Perhaps grossly obese people died less.)

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

#392

Post by autoexec » Mon, Aug 17, 2026, 5:43 PM UTC

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'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.

At this point it says more about the state of our democracy than it does about any proposed solution. Even policies widely supported by the American public these days are met with obstructionists who care less about the welfare of the country than they do about scoring and blocking political "points".

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

#393

Post by czgov » Mon, Aug 17, 2026, 5:43 PM UTC

saghm wrote: post #225

czgov wrote: post #149

Earlier quoted context omitted.

George Bush Sr. made a deal with Democrats to raise taxes and cut spending. Ever since then the Republican strategy has been to oppose pretty much anything a Democratic President proposes. The ACA was a Republican healthcare idea and they didn’t support it because a Democrat proposed it. There are only two realistic possibilities. Get a Republican to propose some sort of national healthcare or have Democrats fully em…

> There are only two realistic possibilities. Get a Republican to propose some sort of national healthcare or have Democrats fully embrace socialized medicine and not give a shit what Republicans say or think. It's worth keeping in mind that Eisonhower's cabinet argued against the idea of giving the polio vaccine away for free on the basis of it being a "backdoor to socialized medicine". We're over seven decades past…

Would that Obama, Jeffries, Schumer, and others felt the same way!

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

#394

Post by lotsofpulp » Mon, Aug 17, 2026, 5:44 PM UTC

jonhohle wrote: post #378

lotsofpulp wrote: post #318

Earlier quoted context omitted.

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 h…

>Then turn it into a tax and be done with it.

Democrats tried, they did not get 60 votes in the Senate between Jan 2009 and Jun 2009. What we have is because at least 41 other legislators, including all Republicans, decided not to offer the US public this option, and since then Democrats have had nowhere near the numbers to enact any further reaching legislation, except the No Surprises Act in 2021.

https://en.wikipedia.org/wiki/Public_health_insurance_option

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

#395

Post by bpt3 » Mon, Aug 17, 2026, 5:44 PM UTC

well_ackshually wrote: post #347

tptacek wrote: post #309

Earlier quoted context omitted.

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.

>The US has top-tier cancer survival-after-diagnosis outcomes. "Airplanes that get shot in the wing always survive" logic. People _do not get diagnosed and die_ because the US healthcare system is inaccessible to close to 50% of your population. A diagnosis easily reaches a few hundred dollars for the best cases (and several thousand if you need multiple tests/blood tests/operations like colonoscopies). And when you…

> US healthcare system is inaccessible to close to 50% of your population

So you have no idea what you're talking about. What is the point of making comments like this that are both verifiably false with about 2 seconds of online research and just sound incorrect based on anecdotal data to anyone living in the US.

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

#396

Post by toomuchtodo » Mon, Aug 17, 2026, 5:44 PM UTC

tptacek wrote: post #390

toomuchtodo wrote: post #248

Earlier quoted context omitted.

Part of the reason why there is no effort to fix this, to keep you a slave to a job that provides healthcare. Imagine the reduction in labor supply and increase in labor costs if healthcare did not require employment. On can, in many cases (facts intensive), bail to a developed country with healthcare if you want to realize this dream earlier than whenever the US will achieve the outcome (and your life situation supp…

That's not how this system came into being. It's a path-dependent quirk of the tax codes of the 1940s. We got into this predicament because of WW2-era wage controls (a dollar spent on health care by your employer was literally worth more than a dollar in wages). This is one major reason why most of the world's universal systems make private insurance work, and it doesn't blow up the way ours does. But I don't think e…

You are of course correct on how we got here, I argue we are still here for many reasons, one of which is what I stated. I mean, there is no will to fix healthcare, but lots of will to spend $100B+ to go to war with Iran, right? I simply do not see anyone who cares enough to fix this exceptional mess, even taking into account the coordination problem of doing so. We could treat this as an emergency requiring a fix, but we don't. Why? We can certainly find this will for, "low ROI nation state actions".

Can we afford it? Doesn't stop trillions of dollars for DoD spending for middle east wars or tax cuts for the wealthy, so that isn't an argument, that's subjective cover for not fixing it, we do lots of things we cannot afford (current sovereign debt outstanding is ~$40T, as of this comment). Can't be done? Almost every other OECD country has solved this in some way. Therefore, as a scholar of systems, the root cause I am left with via Occam's razor is "This is an active choice to not fix this suboptimal system, where the fix would be both more economically efficient and humane, For Reasons while the electorate is lied to or paid lip service."

Employers, who supposedly are unhappy with their healthcare costs, could form a coalition and lobby for legislation and fund PACs to fund candidates who would fix this state by state with universal healthcare systems (Canda's universal healthcare system started in a single province as an experiment, for example). Why don't they? Are the costs not high enough yet? They can't argue they don't have enough power, they already, in many ways, bend the US government to their will. They have the power, they actively choose to not use it to fix this system failure.

https://en.wikipedia.org/wiki/The_purpose_of_a_system_is_wha...

https://en.wikipedia.org/wiki/Five_whys

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

#397

Post by jimt1234 » Mon, Aug 17, 2026, 5:45 PM UTC

davidfekke wrote: post #306

"You can have state of art Healthcare, or you can have Universal healthcare, you can't have both." -- Malcolm Gladwell The way that universal health coverage saves money is by rationing care. You do not save lives when you ration care.

What's the point of "state of the art healthcare" if it's only for rich people? If Jeff Bezos and I get the exact same health issue - say, some form of cancer, we're going to have radically different treatments and mostly likely outcomes. His will be "state of the art", mine will (hopefully) be good, but definitely not be like his.

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

#398

Post by onlypassingthru » Mon, Aug 17, 2026, 5:46 PM UTC

missedthecue wrote: post #352

onlypassingthru wrote: post #316

Earlier quoted context omitted.

> 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?

Are you saying that most hospitals have 50% profit margins, of which 90% are paid to the chairman leaving only a thin margin? That seems difficult to believe. They may have 4.2% margins knocked down to 4% by exec comp but I don't see that how that fact would change OPs point.

I'm saying if you think that administrative expenses (among others) can't be inflated for a profitable company, I would like to run your company and demonstrate what executive compensation can include:

- Base salary

- Bonuses

- Stock options

- Perquisites (perks) like company cars or private jet usage

Just to be clear - I like my private jet(s) on call in case I want to get away for the weekend. TYSM

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

#399

Post by Merad » Mon, Aug 17, 2026, 5:46 PM UTC

skuzye wrote: post #32

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.

Same here in the UK. If you need to see a specialist, you regularly have to wait months, assuming you can even get a referral in the first place.

That's not at all unusual in the US. My dad saw a neurologist for chronic severe headaches. It was very common for us to go to an appointment, have the doctor request a follow up appointment in 3 months, then be told during checkout that the earliest available time was in 5-6 months.

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

#400

Post by cyberax » Mon, Aug 17, 2026, 5:47 PM UTC

jandrewrogers wrote: post #293

tptacek wrote: post #273

Earlier quoted context omitted.

No it didn't. The ACA slowed cost growth, which was already skyrocketing by the time it passed.

The sharp discontinuity in insurance costs over a single year for many people when ACA went into effect isn't explained by your dismissal.

Insurance prices _dropped_ in NY after the ACA was enacted. Not "slowed down the growth" but actually dropped in absolute numbers.

That's because NY had enacted a coverage mandate even before the ACA, so insurance companies were forced to offer policies to everyone. This resulted in a runaway spiral where only sick people were getting insurance.

The ACA forced all large employers to buy insurance, greatly increasing the risk pool.