Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

ysph.yale.edu

Post reply on HN
Print view View original

491–500 of 1001 posts

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

#491

Post by gadflyinyoureye »

chaps wrote: post #215
consensus1 wrote: post #200

Earlier quoted context omitted.

Total profits for US health insurance companies in 2025 were $50 billion. The other $950 billion has got to come from cutting: 1. money to providers 2. overall healthcare consumption 3. bureaucratic redundancy and waste 1 is going to piss off medical providers. 2 is going to piss of the general public. 3 is going to piss off the 20 million healthcare industry workers who are not direct care providers. So pick your po…

Have you ever dared to dream of something that sounds impossible but isn't?

The average Georgian plumber has higher purchasing power than the average German doctor. In order for the United States to balance its medical books, doctors will have to be paid dramatically less than they are at present. Perhaps there’s a deal to be made where doctors take the hit, but all of their debt is paid off by the state. Going forward medical school is free, but like in Germany you have to qualify, I mean really qualify to even get your foot in the college door. That’s an expectation change for the United States population on all fronts. We don’t do well with expectation changes.

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

#492

Post by soundwave106 »

caseysoftware wrote: post #411
ryaniscool wrote: post #383

Earlier quoted context omitted.

This is a cherry picked statistic. We still have lower life expectancy, high infant mortality rates, and one of the highest rate of preventable and treatable deaths among developed countries

The unfortunate truth is that if you break life expectancy out by ethnicity, it tells a different story. Generally Asians, Latinos, and Whites are above while Blacks and Native Americans are below and pull down the average: https://pmc.ncbi.nlm.nih.gov/articles/PMC9256789/#S12 If you break the groups out and individually compare against countries of similiar ethnicity, the US is often ahead. For infant mortality spec…

Um... really?

When I Googled life expectancy by ethnic group in the United States, it gave me the following numbers:

Asian: 85.2 years

Hispanic: 81.3 years

White: 78.4 years

Black: 74.0 years

American Indian and Alaska Native (AIAN): 70.1 years

Along with a source. (https://www.kff.org/racial-equity-and-health-policy/racial-d...) (Note: Based on the source, these numbers are for 2023.)

Overall, life expectancy in the United States in the last few years is around 79ish per the sources listed here in this Wiki article: (https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...)

This means that the average life expectancy of white Americans is actually slightly below the average life expectancy of all Americans.

Incidentally, while a lot of developed countries do not track life expectancy by ethnicity, the UK seems to have a few some studies. (https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...) Though the data is very old (2011-2014), and the data is broken out by sex with no summaries, whites actually fare the worst. Black African females came out at the top, with a life expectancy of 88.9. I asked Google's search what the comparable black American female life expectancy was in 2011, and it gave me 78.2, along with a link. (https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6244a8.htm)

Our overall ranking generally is below all "developed countries" that I can see, which range from Germany (~80) to the ~84 of "developed" countries like Japan, Switzerland, and Sweden (along with a few countries still classified as "developing" like Kuwait). It's not completely terrible, but considering how much the United States spends on health care, that's quite a poor value.

There are multiple identified factors for explaining life expectancy, but access to healthcare is identified as a very significant factor. In a system, like America, that is very expensive (likely due to highly inefficient, over-bureaucratic, overly complex, and over-quasi-monopolized systems) and without universal coverage, it follows that those who are poorer may not have the same access to healthcare and may succumb to entirely curable illnesses. So I don't think it's a coincidence that the racial breakdown above almost matches the median ethnic household income (the median white American household earns more than the median Hispanic household, but elsewise it aligns).

On infant mortality, at least one link I found -- https://www.healthsystemtracker.org/chart-collection/infant-... -- which adjusted data due to the reported difference, and still found significantly higher infant mortality in the United States. Though the data is a little old (2016).

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

#493

Post by chermi »

GuB-42 wrote: post #484
chermi wrote: post #468

Earlier quoted context omitted.

I don't understand why we always pay attention to only the jobs side of decisions like this. Why is the main concern always preserving existing jobs? The extreme version of that is obviously silly. The savings is real and lowers prices, increasing social mobility and spending elsewhere. How many people are locked out of moving for a job that matches them better, or taking some training for a better job and so on just…

I am not saying it is a bad thing. What I am saying is that when we are talking about trillions we are talking big changes, and big change doesn't come without suffering, and people don't like suffering. Usually big change doesn't happen without a catastrophic event, like a war, a coup, or an economic crisis, or maybe more optimistically, a technical or scientific breakthrough. So when an article mentions trillions w…

I see. But I think that's kind of the same diffuse vs. visible problem that underlies a lot of impedents to progress. The jobs thing is one example. We focus on one set of workers because we can picture being in their position. We can't internalize and "feel" the diffuse but greater benefit of a more efficient healthcare system, which I'm 100% would be a net positive, just spread out over the whole population.

I don't know the solution, but do you agree that the problem is basically one of individuals not being able to accurately model the tradeoffs in their head?

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

#494

Post by nradov »

onraglanroad wrote: post #433
consensus1 wrote: post #119

Earlier quoted context omitted.

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.

Nonsense. In every nationalized healthcare system there is care rationing performed by government bureaucrats. Regardless of a doctor's opinion on medical necessity, some treatments involve long waiting lists or third-party reviews or are simply unavailable. That might be preferable to our current system in certain ways but let's not pretend that there are no trade-offs.

For example, let's say you're in England and your doctor decides you need Enhertu or proton beam therapy. That decision is meaningless because the NHS won't pay for them.

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

#495

Post by [deleted] »

saghm wrote: post #476
dominotw wrote: post #261

Earlier quoted context omitted.

right. my point is last line of my comment. most of the society doesnt operate in the way that you described.

Most of society also doesn't require paying for indirectly via employer subsidy (driving up the cost to people who are between jobs or have money by other means). If your objection is to a system that operates differently than the rest of society, it's not clear why the hypothetical healthcare system is more of a bugbear than the very real one that doesn't resemble pretty much any other way that things get purchased.…

[deleted]

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

#496

Post by dominotw »

saghm wrote: post #476
dominotw wrote: post #261

Earlier quoted context omitted.

right. my point is last line of my comment. most of the society doesnt operate in the way that you described.

Most of society also doesn't require paying for indirectly via employer subsidy (driving up the cost to people who are between jobs or have money by other means). If your objection is to a system that operates differently than the rest of society, it's not clear why the hypothetical healthcare system is more of a bugbear than the very real one that doesn't resemble pretty much any other way that things get purchased.…

i think you are talking over me with some irrelevant nonsense. did you reflect on why you are being downvoted?

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

#497

Post by tptacek »

soundwave106 wrote: post #492
caseysoftware wrote: post #411

Earlier quoted context omitted.

The unfortunate truth is that if you break life expectancy out by ethnicity, it tells a different story. Generally Asians, Latinos, and Whites are above while Blacks and Native Americans are below and pull down the average: https://pmc.ncbi.nlm.nih.gov/articles/PMC9256789/#S12 If you break the groups out and individually compare against countries of similiar ethnicity, the US is often ahead. For infant mortality spec…

Um... really? When I Googled life expectancy by ethnic group in the United States, it gave me the following numbers: Asian: 85.2 years Hispanic: 81.3 years White: 78.4 years Black: 74.0 years American Indian and Alaska Native (AIAN): 70.1 years Along with a source. ( https://www.kff.org/racial-equity-and-health-policy/racial-d... ) (Note: Based on the source, these numbers are for 2023.) Overall, life expectancy in t…

Cite the source for "access to healthcare" as a "very significant factor" in US life expectancy? We have pretty good numbers on the mortality cause differences between the US and other countries and they don't align with this claim (unless you're doing some bank-shot argument about how access to health care makes our car crashes more lethal or something).

You'd want to be looking for a scholarly source that puts numbers on this. It's been done! As I noted elsewhere on the thread, the study we're commenting on is based on 1990s numbers about differing mortality of the uninsured. But here you're looking breakdowns of all mortality causes and tying them to insurance, a trickier proposition. Will be interested in whatever you come up with.

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

#498

Post by chaps »

gadflyinyoureye wrote: post #491
chaps wrote: post #215

Earlier quoted context omitted.

Have you ever dared to dream of something that sounds impossible but isn't?

The average Georgian plumber has higher purchasing power than the average German doctor. In order for the United States to balance its medical books, doctors will have to be paid dramatically less than they are at present. Perhaps there’s a deal to be made where doctors take the hit, but all of their debt is paid off by the state. Going forward medical school is free, but like in Germany you have to qualify, I mean r…

Yeah, a lot of these issues are felt in other fields too so it feels like there's a need for a larger, wider schism.

Like I would love to go to law school but I can't afford it. So many possible but inherently unattainable futures. We'll get there.

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

#499

Post by ixtli »

nsxwolf wrote: post #89
ixtli wrote: post #35

This doesnt need yet another study. Instead of narrating the problem we should figure out whats actually stopping it. And people saying the ACA was universal health coverage or even an attempt at it should stop intentionally derailing this discussion.

Democracy is the biggest obstacle to universal healthcare in the US. A lot of people do not want it, and you've thus far failed to make them want it.

Cool system.

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

#500

Post by Certhas »

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.

Posts like this truly boggle the mind...

The US is in a class of its own when it comes to health spending. The second highest OECD country (per GDP) is Germany which is 5 points lower than the US (and BTW these figures include public and private spending).

You are clutching at straws to discount clear evidence that shows just how ideologically driven the US System status quo is...

"'No Way to Prevent This,' Says Only Nation Where This Regularly Happens"

https://www.oecd.org/en/publications/health-at-a-glance-2025...

Post reply on HN