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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

#531

Post by bell-cot »

entropicdrifter wrote: post #529
bell-cot wrote: post #360

Earlier quoted context omitted.

Hand-waving numerous details, but - That $37 isn't the price in the hospital's gift shop. It's n=1 pricing, hand delivered to your bedside by a nurse with a whole hierarchy of higher-level medical & admin staff behind her, and documented out the wazoo. Aspirin could be free & unlimited at the hospital pharmacy's receiving dock, and it wouldn't affect the @bedside price.

... and in other countries, medical administrative costs are far lower because they don't need to build entire divisions around correctly coding the same condition and procedure 11 different times before insurance approves it, because the insurance is universal and self-consistent by comparison to our private fractured mess.

It ain't just the insurance crap that drives up medical overhead costs in the US. Our health care system is treated as a money farm by plenty of other industries and interests.

All of which are willing to fight tooth and nail to preserve "their" fat slices of the obscenely bloated pie.

And on top of that you've got synergies like the horrific cost of housing in the US - which drives up the cost of every employee, no matter how essential they might be to providing actual medical care.

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

#532

Post by tptacek »

fragmede wrote: post #459
sahila wrote: post #410

Earlier quoted context omitted.

> 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.

This is like that thing about about $15,000 toilets at DoD. What's actually happening is a cost allocation function where an agreed-on list price for a whole project is getting distributed pro-rata over as many different line-items as possible.

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

#533

Post by malfist »

fragmede wrote: post #459
sahila wrote: post #410

Earlier quoted context omitted.

> 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.

Sure, it's more expensive, but is it thousands of times more expensive? That $5 bottle probably has 50-100 pills in it. A single dose for $37 is 740X more expensive. And its not just that the apsrin is expensive to cover salaries, EVERYTHING is similarly inflated.

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

#534

Post by scoofy »

AuthAuth wrote: post #527
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…

>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 You would think so but once healthcare cost becomes a government policy issue people complain about its spending and they are forced to try and bring that cost down. One of the ways they did that in my country was to promote biking to work and build bike…

Did I mention the 100° summers or the fact that people usually live 20+ miles from where they work?

I agree with you generally on the incentives, but it took us 70 years to paint ourselves into this corner, and we’re not going to get out of it because of a third-order incentive.

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

#535

Post by 0xy »

dbbk wrote: post #460
0xy wrote: post #382

Earlier quoted context omitted.

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.

On which point? Brain surgeon pay? [1] [2] Waitlisting? [3] [4]

There's literally over 7,000,000 Britons on a NHS waiting list right now.

Please clarify what I'm incorrect about.

[1] https://uk.indeed.com/career/neurosurgeon/salaries

[2] https://finance.yahoo.com/news/buc-ee-offering-275k-salaries...

[3] https://www.bma.org.uk/advice-and-support/nhs-delivery-and-w...

[4] https://old.reddit.com/r/ADHD/comments/1nz7dt2/if_your_in_th...

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

#536

Post by Obscurity4340 »

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…

What do you recommend?

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

#537

Post by mmooss »

nsxwolf wrote: post #105
mmooss wrote: post #76

Earlier quoted context omitted.

There's also a racist element (I know that's a politically incorrect word here, but such things happen). People don't want to fund services to the lazy ______s - fill in one or more of many groups toward whom hate is promoted. When a similar bill was voted down years ago, someone I was with laughed and said, 'no way were we paying for healthcare for the Blacks'. It fits the divide and conquer strategy to divide poore…

Another way of looking at is that some people are concerned about what happens to limited "free" healthcare resources when you simultaneously oppose any controls on immigration.

Can you name any politician or leader, of any signficance, who opposes "any controls on immigration"?

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

#538

Post by secabeen »

SpaceNoodled wrote: post #524
GuB-42 wrote: post #484

Earlier quoted context omitted.

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…

Americans are already suffering under the broken healthcare system. Overall suffering would decrease as a result.

Yes, but it's a different group of Americans, and the ones who are currently thriving in this broken system will fight tooth and nail to preserve their way of life.

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

#540

Post by twoodfin »

chermi wrote: post #447
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.…

It almost seems like obscurity is the goal with the current system. Basically, job security (for admin, insurance) via obfuscation.

It’s more like a politically palatable Rube Goldberg machine for transferring costs to those (well-insured through their jobs, the Federal government, rich supporting institutions and donors) able to pay.
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