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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

#731

Post by trollbridge »

testing22321 wrote: post #671
trollbridge wrote: post #634

Earlier quoted context omitted.

Yeah, having lived under universal care, the dark side of it was atrociously long waits to see a specialist and having a GP who is obviously overworked and barely spends any time seeing you.

That may be your experience, and I’m sorry to hear it, but that is not the universal experience. I’m in the hospital right now. My two year old had her tonsils and adenoids out this morning. Regular Dr visit lead to an X-ray on the same day, specialist appointment 3 weeks later, surgery 2 months later (would have been one month, but we pushed it back because timing and life). Just talking about how my wife is coming…

In America, anyone who earns $20k a year with with a 2 year old is going to get free medical care, too. I have several kids and my medical care is free up until we make about $55,000 per year. If we had no jobs, same thing.

A close relative of mine (who is single) also had cancer and had 100% of it paid for.

Transportation costs are also paid for, although we never needed overnight accommodation so far.

My prior experience was in Australia was a youngster under a particularly terrible universal care system in the 1989s, and then in the 2000s when I lived in Canada.

I get a little weary of the refrain about how American healthcare is terrible, esp. for poorer people - it’s actually very good.

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

#732

Post by Detrytus »

joering2 wrote: post #728
bentt wrote: post #724

There are a lot of people making a lot of money on the inefficiencies of the US system. They won’t give up their revenue streams without a fight, and they are filthy rich on the backs of sick people. You better believe they will play dirty.

this is a great example. What a horrible human... https://www.miamiherald.com/news/politics-government/article...

This is a top-level example but you do not have to look at the top, really. The whole private insurance system is a scam at every level. I mean: I immigrated to US couple years ago, and I can tell you that any hospital visit, or a diagnostics, such as CT scan or ultrasound are 15-20x more expensive here than in my home country (which is in the EU).

Funny thing is: if you tell the hospital that you do not have an insurance they will charge you a price that actually sounds reasonable, say $700 for a CT scan (which is still like 2x more than in my home country, but then the US is a high cost of living place), but if you do have insurance they will try to extort as much money as possible from your insurer: initial bill will be like $10k, and then they will settle for, say, $6k.

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

#733

Post by NoImmatureAdHom »

1) U.S. healthcare spending subsidizes the rest of the world, much like U.S. defense spending. New drugs wouldn't be developed at the same rate if it wasn't profitable to do so, and it's profitable largely because it's profitable in the U.S.. Some proportion of the high U.S. spending relative to other countries is this. It's pretty stark. In revenue terms, for new drugs 2018-2023: 67.1% of total sales in the USA alone, 15.8% in Europe, 3.9% in Japan, and 13.2% for the entire rest of the world ( https://www.efpia.eu/media/2rxdkn43/the-pharmaceutical-indus... )

2) I believe the U.S. is willing to go to greater lengths to save people. So they will spend obscene amounts of resources keeping a cancer patient alive for an additional six months, or saving a borderline case of a premature baby, etc.

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

#734

Post by danlitt »

bentt wrote: post #724

There are a lot of people making a lot of money on the inefficiencies of the US system. They won’t give up their revenue streams without a fight, and they are filthy rich on the backs of sick people. You better believe they will play dirty.

They are already playing as dirty as possible.

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

#735

Post by margalabargala »

danlitt wrote: post #734
bentt wrote: post #724

There are a lot of people making a lot of money on the inefficiencies of the US system. They won’t give up their revenue streams without a fight, and they are filthy rich on the backs of sick people. You better believe they will play dirty.

They are already playing as dirty as possible.

I assure you that is not true.

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

#737

Post by danlitt »

nickff wrote: post #720
TuringNYC wrote: post #706

Earlier quoted context omitted.

>> Medicare pays 50% less than private insurance. So doing this would require either layoffs, cutting salaries for doctors/nurses/etc, or both. This may well be the right decision for society as a whole--that's a big part of the debate here--but there's no free lunch. You arent considering 1. Hospitals eating the cost of the uninsured, which this would solve 2. Hospital spending tons on administrative duties fighting…

How would this change solve: "Hospitals eating the cost of the uninsured..." ? Wouldn't it just transfer the cost from the hospitals to the universal coverage agency? This would make the financial picture even worse for the proposed system.

>>> Hospitals have an operating margin of 2-5%. Medicare pays 50% less than private insurance.

The hospital can be paid less without reducing their margin if they can remove a cost from their balance sheet. It does not make the system cheaper overall, but it means the hospital does not have to bear those costs directly. They may not have to bear them at all, because hospitals are not the only things in the system.

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

#738

Post by bigcat12345678 »

nickff wrote: post #720
TuringNYC wrote: post #706

Earlier quoted context omitted.

>> Medicare pays 50% less than private insurance. So doing this would require either layoffs, cutting salaries for doctors/nurses/etc, or both. This may well be the right decision for society as a whole--that's a big part of the debate here--but there's no free lunch. You arent considering 1. Hospitals eating the cost of the uninsured, which this would solve 2. Hospital spending tons on administrative duties fighting…

How would this change solve: "Hospitals eating the cost of the uninsured..." ? Wouldn't it just transfer the cost from the hospitals to the universal coverage agency? This would make the financial picture even worse for the proposed system.

Think about corps merging to save cost on back office. Here is the same idea. With AI, it would even cut additional order of magnitude of cost.

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

#739

Post by nradov »

cwmoore wrote: post #714
nradov wrote: post #681

Earlier quoted context omitted.

So what's the solution? Some states have already limited malpractice liability but that hasn't done much to hold down costs. When patients are harmed by preventable medical errors they should be compensated.

The solution is NOT to decide on one problem at a time to all agree on solving by incremental compromise, or trust free market competition driving what is in reality a non-free market. Most patients never file a lawsuit, even if things don't go well, and most injuries that aren't deaths or newsworthy are not worth the trouble to an "overburdened" court system itself imposing a lot of burdens. And the quality life yea…

That's a non answer. The medical profession is already embracing evidence-based medicine as well as specific tools such as checklists and EHRs to reduce preventable errors. But there will always be some providers who are simply sloppy or incompetent or even malicious. Nothing else you proposed is actionable, just vague complaints and hand waving.

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

#740

Post by cwmoore »

tptacek wrote: post #727
cwmoore wrote: post #719

Earlier quoted context omitted.

I think there's also the gamified confusion of over how much goes to the physician versus how much goes to administrating orgs and liability coverage.

We have numbers for this, we don't need to derive them axiomatically. Practitioner compensation is the largest component of health provider spending. Liability coverage is the second largest component of admin spending, which is 25% of provider spending.

“We have numbers” is always refreshing, especially in a shell game. Cost of all licensed medical practitioners? Or overweighting incomes of outlier CEO physicians? 25% is a steep tax on health in any case.
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