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

#451

Post by nradov » Mon, Aug 17, 2026, 6:28 PM UTC

onraglanroad wrote: post #404

_heimdall wrote: post #259

Earlier quoted context omitted.

I understand that theres an argument for removing private insurance companies in favor of thr government can cut costs. It can also increase them. I'd argue that the primary issue with insurance costs today is the lack of market competition, obscurity of what costs and prices are, and government protections that prevent insurance companies from being legally liable for many of the problems they cause. Corruption and…

>theres an argument for removing private insurance companies in favor of thr government I don't see why you'd need to do that. Just expand medicare to everyone and if people want to also buy private insurance they can. They'd just need to be more competitive and add significant value, which they don't currently do.

And then more and more providers would opt out of taking Medicare at all, so we would quickly end up back where we started.

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

#452

Post by atmavatar » Mon, Aug 17, 2026, 6:29 PM UTC

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'm curious where you got this figure, because it doesn't track with my own experience.

I used to work for a place that worked closely with hospital clients (and prospective clients) to resolve billing issues with a particular EMR system, and we regularly discovered that a given hospital was losing hundreds of thousands to millions of dollars weekly due to missing charges. The problem was, so much money was sloshing around that the hospitals were virtually always unaware of the missing charges, and many CIOs were more interested in saving face by shutting down further discussion than in walking through the collected data, how to fix the charging issues, and even claw back some of the lost charges (which you can generally do up to several months after the fact).

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

#453

Post by HDThoreaun » Mon, Aug 17, 2026, 6:29 PM UTC

nradov wrote: post #428

Certhas wrote: post #358

Earlier quoted context omitted.

The US spends more than 16% of GDP on health. The UK around 11%. Shrinking US health expenditure by 3% of GDP while roughly maintaining health outcomes is eminently, obviously doable.

Sure, it's possible in principle. But the US also has a much higher GDP per capita than the UK. The UK is a (relatively) poor country and is increasingly being left behind.

Thats why they used percentage of GDP instead of raw

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

#454

Post by stronglikedan » Mon, Aug 17, 2026, 6:29 PM UTC

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…

The US has gone through a lot of changes since it's inception, so there's no reason we can't change this. Preferably to a system where people have the freedom to pay out of pocket for whatever level of care they want when they can afford it, avoiding the "death panels" and extended wait times that exist just about everywhere that already has a universal health system.

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

#455

Post by halJordan » Mon, Aug 17, 2026, 6:29 PM UTC

01284a7e wrote: post #421

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…

"Healthcare reform is hard." People tackle hard things for nothing, never mind billions in savings.

Yes, but there's a difference between finding out whether P=NP and some of the brightest geniuses in the country actively opposing you.

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

#456

Post by autoexec » Mon, Aug 17, 2026, 6:30 PM UTC

hintymad wrote: post #244

_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…

> The problem with US healthcare isn't who pays for it, its how damn expensive it is Exactly! There's so much paperwork that a doctor sometimes need two assistants just for the paper work. There's so much cost for independent practice that increasingly more doctors end up joining big hospitals. Charges with and without insurance have a huge difference. Just to name a few.

Universal healthcare would cut down on the paperwork needed and provide opportunities to simplify it

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

#457

Post by HDThoreaun » Mon, Aug 17, 2026, 6:32 PM UTC

hintymad wrote: post #244

_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…

> The problem with US healthcare isn't who pays for it, its how damn expensive it is Exactly! There's so much paperwork that a doctor sometimes need two assistants just for the paper work. There's so much cost for independent practice that increasingly more doctors end up joining big hospitals. Charges with and without insurance have a huge difference. Just to name a few.

medicare is basically the biggest culprit for the "too much paperwork" stuff. A m4a plan that doesnt involve capitation would have even more paperwork than the current system does.

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

#458

Post by lovich » Mon, Aug 17, 2026, 6:32 PM UTC

lvl155 wrote: post #138

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…

Let’s be honest, it was DOA. Even Gruber admitted to it later. The whole thing was basically a scam. Edit: I will never understand why people think ACA was so great. It was a bad policy because they couldn’t get it through whole. They passed it with all the compromises that made it DOA. You can’t fix something when you are still in denial about it being bad. ACA is not a transition to universal healthcare when you al…

> I will never understand why people think ACA was so great.

I would never have healthcare without it due to pre existing conditions from childhood. I literally was going to be locked out of healthcare barring becoming wealthy enough to afford everything out of pocket until it passed. And that’s really wealthy not just software engineer money. I know a lot of doctors are offering routine services for cash at a discount in increasing amounts but if you need anything with a hospital or a specialist it’s a nightmare to even find out the price before agreeing to the service.

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

#459

Post by fragmede » Mon, Aug 17, 2026, 6:33 PM UTC

sahila wrote: post #410

Aurornis wrote: post #380

Earlier quoted context omitted.

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. That's the same as any? CVS charging $5 for aspirin has to cover…

The nursing staff to give the patient aspirin costs a lot more than someone stocking boxes on shelves.

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

#460

Post by dbbk » Mon, Aug 17, 2026, 6:33 PM UTC

0xy wrote: post #382

dbbk wrote: post #270

Earlier quoted context omitted.

The government provides your police force and fire department. Why not?

Look no further than the UK, with 24 month waiting lists, the shunning of experimental treatments (many high profile kill decision cases) and skyrocketing costs. In the UK, a brain surgeon is paid less than the General Manager of a single Buc-ees Gas Station location in the United States. Absolutely diabolical.

I'm British. You're incorrect.