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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

#581
post #479

Earlier quoted context omitted.

We want consumers to consider cost when evaluating what services to buy, though. That's a feature. The medical emergency debt statistic is just the usual thing of people not really understanding how medical insurance works.

When I’m having a heart attack, or when I’m in anaphylactic shock - you know, some of the most expensive procedures that happen - I’ll make sure to confirm the ambulance is in network, the hospital, the specific first ER doctor, the specialist, the surgeon, the lab, the lab techs, the anesthesiologists and so on, while I’m either unconscious or actively dying.

Every insurance plan I've ever had makes exceptions to the in-network requiremnts for emergencies like that.

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

#582
post #574

Earlier quoted context omitted.

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,…

Lots of studies have shown that the US spends a much larger portion of our GDP on healthcare than other countries, there is plenty of money to solve this problem already allocated to healthcare. I am aware that Medicare does aggressively negotiate prices, and our current system is a complex mess of different parts of the system subsidizing other parts to keep hospitals somewhat solvent, but this is largely just to enable all of the useless insurance middlemen to take big chunks of the money for no good reason (and its not all yacht money, its also just bullshit jobs that accomplish nothing productive but are sufficiently complex to require expertise, training and pay decent wages in many cases).

And I do know that you mentioned a real material reason why this isn't pushed harder by either political party despite the nearly inevitable massive savings if we pull it off. Causing an upheaval in the job market by removing a bunch of unnecessary admin work has real short-term impacts that will be hard for any US political party to weather well. That being said, I do think there are very real paths to achieving this and rhetoric about needing to copy-paste big parts from other countries distracts from how achievable it is. 90% of the work is already there with Medicare, and expanding the list of covered drugs and having a price negotiation with hospitals to make Medicare a good customer rather than a burden in some cases is definitely possible with some political will. A public option if it had been included in the ACA would have likely moved us a lot closer to universal coverage, especially if the mandate was still enforced, and likely would have spurred some of these necessary discussions.

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

#583
post #556

Earlier quoted context omitted.

I think this one might not be true anymore. Canada has 432 machines as of ~2023 (340 in 2015) and MA is on the order of ~300 (can't find exact figures). It's still a lot lower per capita (10.8 per million vs 42 per million).

So the new comparison is Canada and Illinois. I can remember that! :) (Thanks for catching this! I had no idea.) This is super weird , isn't it? Some of it is obviously overprescription on the US side, but also: Canada could just get more machines.

It's kinda weird, yeah! Not sure if Canada thinks the rest of the world overuses MRI machines in a cost x diagnostically inefficient way, or what, but I'm sure months-long waiting lists aren't optimal either.

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

#584
post #554

Earlier quoted context omitted.

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.

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

You are incredibly optimistic about a large swath of the population's understanding, unfortunately.

> Nobody is lying

There are plenty of people in this discussion making statements of fact that are false. Call it whatever you want.

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

#585

Earlier quoted context omitted.

Not buying any of this when the world is now full of dark patterns¹ and the ultimate result is that people in charge keep getting richer, faster. ¹ https://en.wikipedia.org/wiki/Hollywood_accounting

many hospitals are run by non-profits or the government (e.g. universities)

How do the salaries of administrators at such hospitals compare to for profit hospitals? How do they compare to non-medical institutions of similar size? Without a lot more information, your statement doesn't mean anything.

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

#587
post #554

Earlier quoted context omitted.

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.

The vast majority of those 8 billion people do not have single payer healthcare. A lot of Americans get confused on this, because we're the only country in the Anglosphere that doesn't do single payer, but it's far from universal globally.

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

#589

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.

On the occasions that I’ve watched a hospital go through the actual process of selling a small amount of inexpensive medication for a large amount of money, there is a ridiculous amount of ceremony involved. I can easily imagine that it costs that hospital 2 cents for the pill, $5 in amortized capital plus operating expense for the facility that stores that pill, plus $25 in labor and IT expenses to get that pill to the patient.

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

#590

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…

A lot of the reason hospitals have to charge so much is that they take massive losses on uninsured people in emergency rooms. Medicare for all means they don't have to treat anyone for free.
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