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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

#811

Post by goodmythical »

Detrytus wrote: post #732
joering2 wrote: post #728

Earlier quoted context omitted.

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 insu…

>The whole private insurance system is a scam at every level.

All for profit insurance must by definition bring in more than it pays out. From cars to homes to health to pets.

If instead of paying all your premiums, you'd be far more likely to be able to afford the services that the insurers are supposedly paying for. Like, yeah, there's a chance you need a new engine, and a small chance that all of your monthly car insurance totals up to less than the cost of the engine, but the entire point of the company is that they know that it is far more likely that you will end up paying more for their service than you'd have actually payed for turns out the only thing that ever went wrong was a small crack in your windshield.

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

#812

Post by NoMoreNicksLeft »

nradov wrote: post #681
cwmoore wrote: post #648

Earlier quoted context omitted.

A lot of the rest of the reasons are carrying the deadweight of administering regulation, and dancing with the existing and prospective malpractice suits that randomly benefit the system sometimes, but always cost everybody, and warp the practice of medicine and patient healthcare experiences.

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.

When patients are harmed by quacks, it is a true problem and those quacks should be incarcerated and never allowed near medicine again. If there are too many quacks, then this is a systemic problem that needs to be addressed completely separately from malpractice and professional insurance.

When patients are harmed by medical errors caused by non-quacks, that's just tough luck. Not everyone can be saved. Creating a gigantic medical malpractice insurance industry so that a few hundred surviving families per year can have lottery jackpot settlements isn't a solution in any way, and has done very little to incentivize fewer errors.

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

#813

Post by clove »

flenserboy wrote: post #643

impose universal health coverage & the jockeying will commence to see who is in charge of it. medical & diet fundamentalists will rejoice at the opportunity to seize control & force everyone to take certain drugs, eat or not eat certain foods or types of foods, exercise a particular way, surrender their organs at a particular age, or whatever else their hearts desire for everyone else. there have been so many rabbit…

I don't have a dog in this fight (I live in Japan), but I'm a bit disappointed to see the responses here refusing to engage with the assertion.

reply1: "The alternative is bad, and Trump is evil" reply2: "Uhhh, source for that? /reddit" reply2a: "I bet he subscribes to the wrong politics" reply3: "Americans are idiots" reply4: "I bet you have a personality disorder" reply5: "You're dumb but I'm not going to expound" reply6: "WTF dude" (proceeds to uphold a murderer as an example)

Can no one explain why the ideas the OP fears will not come to fruition? Can anyone explain the safeguards of the UHC system? Or do discussions about policy now all fall under the teamsport known as modern politics?

Is this what hackernews has become? It wasn't like this a decade ago.

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

#814

Post by NoMoreNicksLeft »

HEmanZ wrote: post #406
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.

You can search for more reports, because they do vary based on methodology. But the median hospital in the US makes between -1% (yes, negative, they lose money, because a huge percentage are non profits) and 4% depending on the source. When the hospital charges you $37 for an aspirin, that singular pill might have a crazy profit margin in isolation. But your entire treatment could very well be losing the hospital mon…

The old saw about the engineer who says that the $100,000 bill was $1 for the bolt, and $99,999 for knowing which bolt it was... that's just funny AND true!

But if it's a team of nurses, doctors, and other healthcare specialists rushing around doing checklist work to make sure you get that aspirin, that's just evil.

The principle is only applicable to our industry and closely adjacent industries.

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

#815

Post by King-Aaron »

andrehacker wrote: post #777
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.

Right.... but it is also an industry that provides an insane amount of (often well paying) jobs to a large amount of people to do "make work", admin tasks. Reliable details are hard to come by, but some estimations are that more people in the industry are doing admin tasks than instead of providing care, admin tasks that will be reduced drastically once the industry is streamlined. Once we get affordable care there w…

> Once we get affordable care there will be less people who can... afford.

This just plainly isn't true. The US is unique in the way it doesn't have affordable public healthcare, but the rest of the western world doesn't have an affordability problem because of less bean counters scamming patients.

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

#816

Post by Aunche »

jaltekruse wrote: post #582
Aunche wrote: post #574

Earlier quoted context omitted.

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 en…

> rhetoric about needing to copy-paste big parts from other countries distracts from how achievable it is

When have you ever heard "rhetoric" that actually brings up the details of how universal healthcare would actually implemented in practice? If you have an idea at work and a coworker brings up a caveat that you missed, do you dismiss it as rhetoric? If you are to be worried about rhetoric, it should be about how the general public talks about policy like it's sports whereas corporations talk about policy like it's work.

It would fine if it were just internet comments. However, this article is talking about a paper from one of the most prestigious university in the world and yet it's devoid of meaningful analysis. It literally does the "copy-pasting" that I'm talking about.

> Hospital and clinical fees are paid at Medicare reimbursement rates, which are below the rates paid by commercial insurers and above those paid by Medicaid.

https://www.medrxiv.org/content/10.64898/2026.07.22.26358689...

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

#817

Post by sghiassy »

devilsdata wrote: post #789
sghiassy wrote: post #786

Earlier quoted context omitted.

If people voted for universal healthcare we could get it done. The issue is that there’s a sizable, significant voting population that votes against it

My question is why a sizeable portion of the American (and greater Western) public seemingly votes against their interests?

- Dogma - us vs them mentality - we’re not that smart

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

#818

Post by netsharc »

andrehacker wrote: post #777
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.

Right.... but it is also an industry that provides an insane amount of (often well paying) jobs to a large amount of people to do "make work", admin tasks. Reliable details are hard to come by, but some estimations are that more people in the industry are doing admin tasks than instead of providing care, admin tasks that will be reduced drastically once the industry is streamlined. Once we get affordable care there w…

So is that a defense of the broken system?

Feels like their job is mostly to enrich the corporations profiteering from these inefficiencies, they're doing admin fighting the sick and dying who also gained the job of admin of fighting them (a job thrown at them to - in a lot of cases - literally save their lives, financially and physically).

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

#819

Post by sghiassy »

lebuffon wrote: post #801
sghiassy wrote: post #786

Earlier quoted context omitted.

If people voted for universal healthcare we could get it done. The issue is that there’s a sizable, significant voting population that votes against it

I have wondered if an option would be to have a state make it law that every 4 or 5 years they open the bidding for a health care insurance provider for the entire state. A state committee then takes the bid with best premiums to services ratio and they do the job for the contract term. There would still be the option of people and businesses to buy 3rd party "extras" like private hospital rooms, vision care etc. on…

You’re proposing a rational option on an issue where irrational dogma has taken hold

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

#820

Post by cortesoft »

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.

No, because that cost is included in the $300 billion increase in spending that is part of the calculation they do.
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