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

ysph.yale.edu

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

#501

Post by scoofy »

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…

There is a ton of ideology baked into naive-level analysis of this stuff.

I am constantly told how much less Europeans pay for better health outcomes and all I can think about was the obesity crisis I grew up around in Texas.

Socializing healthcare isn’t going to get an huge portion of the population out of their cars and get them walking as a primary or secondary mode of transportation. Not when it’s 100° and the grocery store is five miles away.

Americans, in no small part, have worse health outcomes because we have dramatically worse lifestyles. I support German-style universal healthcare, but I’m not going to pretend it will suddenly give us German health outcomes.

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

#502

Post by tptacek »

scoofy wrote: post #501
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…

There is a ton of ideology baked into naive-level analysis of this stuff. I am constantly told how much less Europeans pay for better health outcomes and all I can think about was the obesity crisis I grew up around in Texas. Socializing healthcare isn’t going to get an huge portion of the population out of their cars and get them walking as a primary or secondary mode of transportation. Not when it’s 100° and the gr…

Europeans do pay much less (though: for roughly the same outcomes --- probably the same outcomes if you control for wild SES variance across the US).

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

#503

Post by scoofy »

tptacek wrote: post #502
scoofy wrote: post #501

Earlier quoted context omitted.

There is a ton of ideology baked into naive-level analysis of this stuff. I am constantly told how much less Europeans pay for better health outcomes and all I can think about was the obesity crisis I grew up around in Texas. Socializing healthcare isn’t going to get an huge portion of the population out of their cars and get them walking as a primary or secondary mode of transportation. Not when it’s 100° and the gr…

Europeans do pay much less (though: for roughly the same outcomes --- probably the same outcomes if you control for wild SES variance across the US).

Right… my exact point is that it’s not a like-for-like comparison.

Take Europeans, put them in Kansas. Fund their healthcare as though they were in Europe, and watch their health outcomes take a nosedive because the environment here is non-trivially worse for you health.

Unless I’m wildly misunderstanding these studies, it makes sense that we would need to spend more for the same outcomes because we are starting from a more unhealthy position, so the same results require more resources.

We need to at least be controlling for the 10%+ differences in obesity rates, and the enormous differences in UV index. That’s before even considering weekly exercise minimums that most European get when just walking to a bar.

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

#504

Post by tptacek »

scoofy wrote: post #503
tptacek wrote: post #502

Earlier quoted context omitted.

Europeans do pay much less (though: for roughly the same outcomes --- probably the same outcomes if you control for wild SES variance across the US).

Right… my exact point is that it’s not a like-for-like comparison. Take Europeans, put them in Kansas. Fund their healthcare as though they were in Europe, and watch their health outcomes take a nosedive because the environment here is non-trivially worse for you health. Unless I’m wildly misunderstanding these studies, it makes sense that we would need to spend more for the same outcomes because we are starting from…

I don't think there's a whole lot to understand in this study; it's pretty wildly extrapolated and its savings numbers come from spherical-cow projections of what single-payer would actually do (somehow, it would drastically cut pay to doctors without chasing them all out of the field).

I think the important bit in all these discussions is that "universal health care" and "single payer" aren't synonyms. Single payer is one way to do universal, and most universal systems don't do it. But this article conflates the two.

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

#505

Post by afavour »

poncho_romero wrote: post #23
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,…

In what world is the Republican Party pro entrepreneur/small business enough to make these rhetorical questions meaningful?

As a sibling comment points out, the world of… 1974

https://news.ycombinator.com/item?id=49333468

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

#506

Post by consensus1 »

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.

I would love to know how universal healthcare works in your head

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

#507

Post by avgDev »

robot_jesus wrote: post #469
EA-3167 wrote: post #369

Earlier quoted context omitted.

Ever hear of loss leaders? Some parts of a typical hospital make money while others lose it hand over fist. The overall margin isn’t across the board, it’s after everything hopefully balances out. ER’s for example are money pits, but society really needs them. https://www.definitivehc.com/resources/healthcare-insights/h...

Exactly this. They need to offset the areas where they lose money. And we have federal laws (justifiably so, IMHO) that ERs must provide stabilizing services regardless of insurance and ability to pay. And while that law is obviously humane and reasonable, my only gripe is that the rest of our system is so backwards that it increasingly forces people to leverage that. There was a story about a woman who needed dialys…

But wouldn't nationalized healthcare help with this? The amount of uninsured individuals would drop drastically.

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

#508

Post by avgDev »

stronglikedan wrote: post #454
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.

Universal healthcare brings the cost of private healthcare down.

I would still get private insurance for VIP car but it would cost less than what i am paying now.

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

#509

Post by nradov »

mindslight wrote: post #401
nradov wrote: post #362

Earlier quoted context omitted.

That's all true, but from a practical standpoint providers really have no way to accurately estimate a patient's out-of-pocket financial responsibility in advance. The current HIPAA adopted standard transactions don't allow for sending a prospective claim. So all they can realistically do is perform the procedure, submit a claim to the patient's health plan, wait for it to (maybe) be paid, and then send a bill to the…

One can always craft some excuse, which is how the terrible system continues to perpetuate itself. Doctors cannot even tell you how much they themselves will charge for anything . The problem I'm describing originates completely with them - no escaping blame here. (And " might take years " lol. How about eliminate whatever flagrant regulatory capture is allowing providers to create and enforce post-facto and downrigh…

Feel free to blame doctors if that makes you feel better but the reality is that in most cases they literally have no way to accurately calculate a patient's out-of-pocket cost in advance. Like there's just no technical way to do it.

If you have specific suggestions for fixing the regulatory capture problem then you can submit a petition for rule making under the Administrative Procedures Act.

https://www.govinfo.gov/content/pkg/USCODE-2011-title5/html/...

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

#510

Post by DerArzt »

garbawarb wrote: post #333
karakoram wrote: post #31

Earlier quoted context omitted.

In all seriousness, this would be a massive stimulus to the economy. Americans are consumers at heart. All the money saved on insurance and/or other healthcare related costs would then be spent elsewhere. Cars, clothes, TVs, Labubu dolls. People will use the savings to buy things. In massive quantities.

Some would, but some would just put that money into savings and investments instead.

From a retirement standpoint I keep hearing that not enough Americans are saving for retirement, so this would still be a win for me.
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