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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

#431

Post by xboxnolifes »

warkdarrior wrote: post #177
shigawire wrote: post #109

Earlier quoted context omitted.

We still have Social Security for now. Entitlements are sticky for better or for worse.

Social Security in its current form will be gone within two years. Instead you will be required to pay a contribution (just as you are now) but the money will be managed by a private company who will charge fees and provide no guarantees. Current retirees will get to keep the current arrangement, everyone else will be moved to the privately managed Social Security option.

Is this based on something real happening within 2 years, or just a continuation of the 30 year sentiment that social security will be gone before my generation will get access to it?

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

#432

Post by peezd »

tptacek wrote: post #273
jandrewrogers wrote: post #264

Earlier quoted context omitted.

ACA also greatly increased costs. As an entrepreneur at the time, insurance premiums increased 25% overnight for the same plan. Many people had similar experiences. That the ACA forced a large number of people to pay a lot more for literally the same product is not a good outcome for those people. Too many people try to pretend this didn't happen.

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

You are both sort of right and wrong; based on a quick analysis, knowing this isn't perfect due to how plans have different characteristics, and states had different characteristics..

in the 2000s (pre ACA); * Employer plans averages 6-10% increase per year * Individual plans averages 10-15% increase per year

Rollout (2010-2017) * Employer plans averaged 3-5% increase per year * Individual plans averages 0-10% the first couple of years, but spiked hard to 25%+ from 2016-2018.. with lots of volatility (one stat I found shows 130% increase between 2013-2019)

Post (2018 to today) * Employer Plans averages 4-6% increase per year * Individual plans were generally stable but with huge volatility; also expansion of gov't subsidies absorbed much of the increases for those earning up to 400% of fed poverty level

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

#433

Post by onraglanroad »

consensus1 wrote: post #119
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…

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…

> someone has to approve or deny healthcare. Every universal system does it too, but by government policy instead of corporate decision

That's another lie you've been told and believed.

With Universal Healthcare the government just provides the funding. Medical decisions are made by Doctors.

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

#434

Post by nradov »

wmorgan wrote: post #407
missedthecue wrote: post #352

Earlier quoted context omitted.

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.

Yeah, if the hospital is part of an HMO, it wouldn't even be legal. The ACA sets a floor on medical loss ratio.

[dead]

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

#435

Post by kaibee »

GuB-42 wrote: post #337
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…

> these are about rebuilding an entire economy, a painful process.

"Sorry kids, can't turn off the Orphan Grinder 9000, there's a whole supply chain behind it that would have to restructure."

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

#436

Post by nradov »

well_ackshually wrote: post #339
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…

Every country with nationalized healthcare systems has lower wages for clinicians. So the notion that this wouldn't lower salaries is just ludicrous. That might be an acceptable trade-off but let's not pretend it doesn't exist.

In practice what we would see under a single-payer system is that many doctors would opt out and shift to a cash payment model. So the shortage of doctors would get even worse for patients who can't afford to pay out of pocket.

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

#437

Post by alistairSH »

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%

How does this work when many/most US hospitals operate as non-profits? Quick search shows the for-profits have operating margins nearly triple your figures. And the non-profits are beholden to the community to provide some level of "freebies" to maintain their status, right? IE, they're aren't really all operating on razor thin margins.

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

#438

Post by roncesvalles »

cactacea wrote: post #210
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…

> These are life-changing possibilities, especially for entrepreneurs. I would quit my day job and completely focus on my side business if I didn't have to worry about healthcare.

Then you should consider emigrating to a country with universal healthcare such as Canada.

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

#439

Post by dualvariable »

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,…

Republicans are the party of pulling up the ladder behind you.

They don't give any shits about free market economics or struggling entrepreneurs. They care about protecting their own money.

And it isn't about big business; that's the Democratic Party. It is about hoarding wealth and gaining more.

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

#440

Post by nradov »

jandrewrogers wrote: post #264
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 also greatly increased costs. As an entrepreneur at the time, insurance premiums increased 25% overnight for the same plan. Many people had similar experiences. That the ACA forced a large number of people to pay a lot more for literally the same product is not a good outcome for those people. Too many people try to pretend this didn't happen.

I don't believe you. It wasn't the "same plan". I guarantee that the plan you had before the ACA had a lifetime benefit limit, perhaps as low as $1M. Read the fine print. A single complex episode of care could easily blow past that limit and leave the plan member functionally uninsured.
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