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

601–610 of 1001 posts

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

#601

Post by dragonwriter »

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.

It comes from the fact that lots of the charges they bill (both of the patient share billed to insured patients and of all costs billed to uninsured patients) end up written down or off because they are uncollectable.

The margin built into the prices bulled is not the actual margin the hospital ends up with.

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

#602

Post by ryaniscool »

tptacek wrote: post #417
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

Life expectancy differences between the US and other countries are dominated by just a few factors: * Car accidents, because we drive much more and are much more spread out than other countries. * Drug overdoses, though other countries are starting to catch up to us there. * Homicide, because of our gun policy and the universality of firearms (which also bears on our suicide stats). * CVD. That last item sounds like…

I'm sure there are qualifiers and rationalizations when comparing cancer survival statistics as well. As someone already pointed out, uninsured Americans aren't necessarily included. They cited sources, you rebutted without sources.

I believe a single payer system is a matter of when not if. It works just fine in other countries. In our country, the healthcare industry has evolved into extracting as many dollars as it can from the economy. This is because when someone is sick and needs treatment, healthcare providers hold all of the cards.

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

#603

Post by smallmancontrov »

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…

> they simply don't count too premature (under 22 weeks or 500 grams, iirc) and therefore don't consider them in the metrics

Nope, that's not the reason.

> The U.S. infant mortality rate was still higher than for most Europeancountries when births at less than 22 weeks of gestation were excluded.

https://www.cdc.gov/nchs/data/databriefs/db23.pdf

Statistical hustling is common, but the most usual form is that the US excludes uninsured individuals to make itself look like it belongs in the developed country cluster.

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

#604

Post by tptacek »

ryaniscool wrote: post #602
tptacek wrote: post #417

Earlier quoted context omitted.

Life expectancy differences between the US and other countries are dominated by just a few factors: * Car accidents, because we drive much more and are much more spread out than other countries. * Drug overdoses, though other countries are starting to catch up to us there. * Homicide, because of our gun policy and the universality of firearms (which also bears on our suicide stats). * CVD. That last item sounds like…

I'm sure there are qualifiers and rationalizations when comparing cancer survival statistics as well. As someone already pointed out, uninsured Americans aren't necessarily included. They cited sources, you rebutted without sources. I believe a single payer system is a matter of when not if . It works just fine in other countries. In our country, the healthcare industry has evolved into extracting as many dollars as…

Uninsured Americans are in fact universally included in death statistics and in cancer survival outcomes; we have top-tier cancer outcomes.

Europe has several universal coverage systems without single payer. The original sin of the US system isn't private insurance, it's employment-based coverage; that's the thing nobody else has.

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

#605

Post by martythemaniak »

ohlookman wrote: post #597
DataDive wrote: post #588

[flagged]

> The first issue with this is that the gap between the uninsured and insured is not necessarily due to the lack of insurance. It could be due to factors associated with not having insurance, like living on the streets, being schizophrenic, being poor, and so on. Made up perspective to justify his angle. Not having healthcare access for a lot of people is 100% a policy choice. Waved off here by a list that really say…

> random blogger with high school math literacy

He's actually a well-known and widely promoted political activist on X. His niche is using technocratic language and a whiff of 'analysis' to advance MAGA policies.

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

#606

Post by mvdtnz »

amluto wrote: post #589
nullocator wrote: post #345

Earlier quoted context omitted.

> 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…

I, too, can invent numbers from nothing.

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

#608

Post by tomtheelder »

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…

Then compare, say, Massachusetts to high functioning north Europe systems. You will shrink the lifestyle and climate factors down to a pretty minuscule difference, but you will still find that the spending is dramatically higher.

You're not wrong at all that the US has some systematic issues that place additional strain on the healthcare system, but it's a "yes and" situation here. Even accounting for those, we spend far, far too much because our system is extractive.

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

#609

Post by sjsdaiuasgdia »

martythemaniak wrote: post #605
ohlookman wrote: post #597

Earlier quoted context omitted.

> The first issue with this is that the gap between the uninsured and insured is not necessarily due to the lack of insurance. It could be due to factors associated with not having insurance, like living on the streets, being schizophrenic, being poor, and so on. Made up perspective to justify his angle. Not having healthcare access for a lot of people is 100% a policy choice. Waved off here by a list that really say…

> random blogger with high school math literacy He's actually a well-known and widely promoted political activist on X. His niche is using technocratic language and a whiff of 'analysis' to advance MAGA policies.

[dead]

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

#610

Post by Georgelemental »

mirzap wrote: post #595
adgjlsfhk1 wrote: post #590

Earlier quoted context omitted.

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.

They are not taking any losses; they just charge the regular price with a very tiny profit margin. US healthcare costs are heavily inflated. Insurance is a scam that lets the rich get richer. All insurance should be non-profit. We all contribute to the pool at a time when we don't need it so we can use the money when we do, not to make CEOs or stockholders rich. That is how an insurance pool should work. Any excess m…

No. Under EMTALA, hospitals are required to treat anyone who shows up to the ER regardless of ability to pay; this is an unfunded mandate.
Post reply on HN