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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

#571

Post by ryathal »

nullocator wrote: post #345
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% Very curious where this comes from and how accurate it is. For example the $37 a provider charges for an Aspirin seems like more than 2-5% margin.

Medicare has been playing a shell game with reimbursements for decades. They cut the base rate for an office visit or hospital stay to below the cost of the actual service, but allow for separate charges for various things that make up the difference so that doctors don't just stop accepting Medicare in mass. That's why you get billed $37 dollars for aspirin, $15 for drug administration, $50 for IV placement, $10/bag for saline drips, $75 for vitals checks, etc. That way the hospital can make up the money lost from the actual visit charge, this also requires more administration overhead, to both keep track of all the additional charges, and to make changes as the rules change.

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

#572

Post by tylervigen »

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…

I think for the math to work you have to consider the bigger bulk of work that could be eliminated by universal healthcare: the payer industry. Insurers, PBMs, and all the smaller sectors that support them. The utility provided to society is fairly low — basically, just selective claims denial.

Any model that gets rid of these frees up a huge swath of capital and work from society, and can use that work elsewhere. Of course, that is easier said than done.

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

#573

Post by soundwave106 »

tptacek wrote: post #497
soundwave106 wrote: post #492

Earlier quoted context omitted.

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 numb…

https://www.ncbi.nlm.nih.gov/books/NBK62376/

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

#574

Post by Aunche »

jaltekruse wrote: post #569
Aunche wrote: post #153

People talk about policies like they're something like can be picked up off the shelf at supermarket. If you could take the policies and Sweden copy-paste them to the US, then sure, we could save $1T and a hundred thousand lives. This would be a very difficult thing to replicate if you're a country without any existing healthcare system. It is impossible in a country with an extremely mature healthcare system, which…

The US already has a national health insurance network that pays the vast majority of all providers, and as far as I know it is widely popular and covers everyone legally present in the US for a portion of their life, Medicare. Old people experience just about every ailment young people do, we can just get rid of the age restriction on Medicare, it's already fully integrated with our medical system. No need to copy-p…

Medicare also isn't something that you can copy paste from covering only old people to everyone. For one, margins from Medicare patients are much lower and often negative for hospitals, and that money has to come from somewhere. Medicare doesn't cover a lot of drugs that people are already used to their private insurance covering like GLP1s for weight loss. Of course, a transition from point a to point B is possible, but there will inevitably be a lot of kinks and bugs to work out, which MFA proponents seem to be unaware of.

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

#575

Post by preg_match »

loeg wrote: post #554
ThrowawayTestr wrote: post #514

Earlier quoted context omitted.

Why is the United States the only country on Earth where free healthcare doesn't work?

The US' healthcare model is not unique, and almost no countries have zero-cost-to-consumer healthcare systems (and none of them are free -- they're just paid by taxpayers instead of consumers). "Free" healthcare is the exception rather than some kind of international norm you incorrectly make it out to be. The first step to reforming US healthcare is actually understanding it, and understanding some international des…

Not a single soul on earth thinks single payer healthcare is free. 8 billion people, not one of them thinks it.

They mean “free to the consumer at time of service”, which it is. Nobody is lying, everyone agrees, it’s just you who doesn’t understand.

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

#576

Post by preg_match »

Aunche wrote: post #315
jgwil2 wrote: post #253

Earlier quoted context omitted.

> thankless job His annual compensation was over $10 million.

That's their point. Congress isn't going to get $10 million from providing universal healthcare (at least for any system that is any good), so they have no incentive to pass it. The year the ACA passed, Democrats suffered one of the worst legislative defeats in history. Nobody wants to be the person to tell millions of people that they can no longer see their chiropractor for free or that their healthcare is not long…

There’s a disconnect between what people say they want, and what people actually want.

People say they don’t like the ACA. But if you try to revoke its grants, it’s political suicide. Which is why republicans don’t even try.

Bring back denying insurance for pre-existing conditions? Lower the age for parent-child plans? Can you even grasp just how wildly unpopular either of those would be? Or what about marketplace plans? Congratulations, you’ve just destroyed every small business and entrepreneur in the country. I’m sure that will go over well.

The ACA is universally loved. Yes, everyone likes it. They won’t say that because they don’t know exactly what it gave them, and they’ve taken it for granted. Many of you would be uninsurable without the ACA.

And that’s why, despite people complaining, the republicans do not dare repeal even parts of the ACA. It’s too popular, whether people know it or not.

I suspect a single payer system would be equivalent. It would be contested hard, but once it’s passed, it’s passed. It would become so unbelievably popular for a majority of the population that suggesting a repeal would immediately end your political career.

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

#577

Post by mejthemage »

myfavoritetings wrote: post #4

How much would it save if you account for the fact that half of congress would sabotage it in to oblivion?

And if not that.. healthcare then becomes monopolized.

Maybe extreme but what prevents that entity from becoming the decider regarding who lives and dies?

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

#578

Post by preg_match »

johndevor wrote: post #254
jkestner wrote: post #236

Earlier quoted context omitted.

The government is more directly accountable to me. The only way I have to influence what insurance companies do is through the government.

You can switch insurance companies, no?

No, you can’t.

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

#579

Post by ses1984 »

jayess wrote: post #112
FireBeyond wrote: post #86

Earlier quoted context omitted.

Hah, even with "platinum" healthcare in the US, urology referral, 4 months. "You should start PT immediately" after a car accident, "we can see you in 5 months". "Oh, your septum is deviated ~90% on the right. Surgery? No, first you need to go on these nasal sprays for a few months so we can decide they didn't reshape the cartilage in your nose before your insurance will decide whether they want to "allow"[1] surgery…

I got my urology referral last week and had an appointment this morning...

It depends on your region, insurance company, and plan.

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

#580

Post by Aurornis »

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.

All healthcare systems have administrative overhead, including completely nationalized systems. The US discourse on health care overestimates the administrative overhead by a large amount. We could remove all insurance company profits and adjust our administrative overhead to be in line with countries with nationalized systems and it wouldn't change health care costs by an appreciable amount.

The discourse also underestimates how much of our health care costs go to our significantly higher salaries throughout the medical system. No politician wants to propose reducing the salaries of doctors, surgeons, or even researchers making new medications. The only acceptable villains are the administrators and insurance companies, but even in this inefficient system that's a much smaller slice of the pie chart than most people imagine.

One of the reasons hospitals operate in this convoluted way and still barely clear a profit is that we require them to treat everyone and attempt to collect payment later. A lot of what you and I pay for health care goes to cover people who can't or won't pay.

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