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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

#951

Post by tmp10423288442 »

2Gkashmiri wrote: post #911
Jimega36 wrote: post #854

Switzerland has the system closest to the US in my experience, but with universal coverage. As individual, you buy basic insurance costing roughly $500/month with a $2500 yearly deductible (LAMal/KVG). Applicants must be accepted even with pre-existing conditions. Post-deductible, you pay 10% co-insurance capped at roughly $800/year (no medical bankruptcy). Insurers operate basic plans as non-profit. They make their…

Thats too much trouble. In India, there is a new scheme of "ayushman bharat" 500K inr which is quite a lot of money, per family. No co-pay, you show the card in supported hospitals or government hospitals and you are in. There are "problems" but overall it has had a net benefit with poor people who could not afford medical treatment just get it. If you are having an emergency, they just do whatever is needed and you…

What I've read about government hospitals in India is that they're extremely overcrowded, with people crowding the hallways and waiting rooms to be seen while bleeding out or dying from illness, without even air conditioning in a lot of places. On the other hand, this was reported by a young Indian doctor that wanted to get to the UK ASAP, so not sure how representative his accounts are.

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

#952

Post by starkparker »

thorncorona wrote: post #804
tptacek wrote: post #729

Earlier quoted context omitted.

No, that's not why. Doctors also make drastically more than the median wage. Doctors make so much in the US because we have artificial scarcity of doctors.

i mean sure, but all skilled labor is trending towards 200-300K wages in the us. if a "senior" software engineer can make half a mil, and an electrician can make 200k, of course doctor pay are high. who is going to take 10-15 years of school and debt otherwise?

"Gen Z electricians making $240-280k in data centers" was a viral ploy by Mike Rowe on a podcast to promote his trades-training hustle.

> "The electricians that I interviewed and met two months ago in a data center in Plano, Texas, all under 30 years old, all making $240,000 to $280,000 a year, all with as much overtime as they want, none with any debt, all three of whom were poached three times in the prior 18 months," Rowe said ...

Google AI summaries then pick up wealth/finance grifter social media clickbait about it and parrots it as a fact.

There are contract data-center electrical jobs paying $55-65/hr (some with signing bonuses, per-diems, and benefits on top), but they only come close to $200,000 takehome by working 12/7 with generous overtime. And these are 5+ years of experience, OSHA 30, journeyman license, bring-your-own-tools. They're also exceptional; most are still $25-40/hr.

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

#953

Post by matteoraso »

onraglanroad wrote: post #941
matteoraso wrote: post #828

Earlier quoted context omitted.

>With Universal Healthcare the government just provides the funding. And what makes you think that they fund everything? I support universal healthcare as well (I'm literally Canadian), but I can accept that there are tradeoffs associated with it.

They don't fund everything. They don't fund anything in particular. They provide the funding and the medical professionals decide how best to allocate that funding for the best results. It's a bit different in Canada to my situation in Scotland since there is also the choice of private healthcare here if you want to pay more to skip queues etc.

Huh? NICE sets a cost-effectiveness threshold of about £20,000-30,000 per QALY gained from a drug[0]. There was even a controversy where a drug for pancreatic cancer was denied funding for this very reason[1].

[0]https://web.archive.org/web/20110925050527/http://www.nice.o...

[1]https://web.archive.org/web/20151225115559/http://www.pancre...

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

#954

Post by dang »

solid_fuel wrote: post #463
ButlerianJihad wrote: post #391

Earlier quoted context omitted.

"Saved lives" or "Could Save Lives" is a ridiculous, un-falsifiable, and unprovable claim. First, it involves twisting correlation and causation into an Escher knot. Secondly, it's not even what cited source says. Yes, "reduced mortality along a timeline for a certain demographic" is a good and desirable statistic, but there is no way that it translates into the self-aggrandizing and sensationalistic "ACA/Medicaid sa…

[flagged]

Yikes, can you please stop crossing into personal attack? You've been doing this repeatedly and even egregiously:

https://news.ycombinator.com/item?id=49335212

https://news.ycombinator.com/item?id=49334249

https://news.ycombinator.com/item?id=49324512

https://news.ycombinator.com/item?id=49323758

https://news.ycombinator.com/item?id=49323061

https://news.ycombinator.com/item?id=49322063

We ban accounts that won't stop doing this. I don't want to ban you since you also make good contributions. If you would please review https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.

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

#955

Post by solid_fuel »

dang wrote: post #954
solid_fuel wrote: post #463

Earlier quoted context omitted.

[flagged]

Yikes, can you please stop crossing into personal attack? You've been doing this repeatedly and even egregiously: https://news.ycombinator.com/item?id=49335212 https://news.ycombinator.com/item?id=49334249 https://news.ycombinator.com/item?id=49324512 https://news.ycombinator.com/item?id=49323758 https://news.ycombinator.com/item?id=49323061 https://news.ycombinator.com/item?id=49322063 We ban accounts that won't sto…

Alright, heard, I will be less snarky and aggressive.

However, in this case - https://news.ycombinator.com/item?id=49323758 - if HackerNews guidelines allow for someone to defend torture and call it “life affirming medical care” but don’t allow someone to wish for turnabout, then this site isn’t compatible with my worldview and you should just ban me. Because I do not intend to ignore such heinous things when I see them.

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

#956

Post by westurner »

timbit42 wrote: post #934
westurner wrote: post #353

How many employees trapped in a job for health benefits for their families would universal health coverage free up? Quantify the impact on productivity

What makes you think they would no longer work? They still need money to live. They would either get another job or start their own business.

By "free up", I mean "allow to job hop until they find a comfortable healthy fit" like hermit crabs.

With their health expenditure potential liabilities reduced by universal health coverage, people would be more able to take good risks in developing small businesses for example.

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

#957

Post by matheusmoreira »

breakyerself wrote: post #947
matheusmoreira wrote: post #916

Earlier quoted context omitted.

Alternatively, the government starts relaxing legal requirements on medical schools with the intent to flood the market with doctors. This not only severely depresses their wages, it leads to unemployment and indirectly to charlatanism and quackery as people try to make ends meet. Better hope the future AI doctors are good.

Alternatively alternatively the government could subsidize medical school for doctors and nurses reducing financial barriers and allowing more medical professionals without lowering standards.

Subsidizing existing schools merely makes it easier for existing medical students. It does nothing to increase the number of doctors entering the jobs market per year. You need to make more schools to increase that number.

You can't just conjure up a medical school out of nowhere though. That's extremely hard and expensive. You can do it if you relax your standards. Maybe by making the "hospital" part of the school optional or something. Students won't see patients but what does it matter.

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

#958

Post by bhelkey »

Gareth321 wrote: post #902

I think the evidence is quite clear that universal health care reduces aggregate costs, but the public cost in aggregate is enormous. 1. This means large new taxes for everyone. For those on lower incomes, they might end up better off. For those on middle-upper+ incomes, they will unequivocally end up paying more. 2. The U.S. already has unbelievably high deficits and debt. This would make that worse without signific…

> universal health care reduces aggregate costs, but the public cost in aggregate is enormous. This means large new taxes for everyone.

If the US could spend healthcare dollars as efficiently as the UK, the US could pay for a single payer healthcare system covering every resident using only existing Medicare + Medicaid spending.

Is the US willing to reduce the price of healthcare? I observe a large appetite in congress to increase the visibility into US healthcare spend. I observe rather more limited effort spent to use this data to reduce the aggregate costs (e.g. negotiating drug prices [1]).

The math:

The US spends $2 Trillion dollars on Medicare + Medicaid a year [2][3]. $2 Trillion dollars / a population of 342.7 million [4] = ~$5800 per resident per year.

NHS (UK's universal healthcare system) costs ~£3,500 or ~$4800 per person per year [5].

[1] https://www.kff.org/medicare/key-facts-about-medicare-drug-p...

[2] https://www.cms.gov/data-research/statistics-trends-and-repo...

[3] https://www.kff.org/medicaid/medicaid-financing-the-basics/#...

[4] https://www.census.gov/popclock/

[5] https://www.bbc.com/news/articles/cwy7zvp5xrqo

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

#959

Post by mhb »

timbit42 wrote: post #937
up2isomorphism wrote: post #935

The deep problem is that insurance is a highly profit driven business in the US which basically go against what a good insurance should look like.

Profit-based, dividend paying insurance should be banned. Only non-profit insurance should be permitted.

If you think the solution to the world's ills is to organize businesses as non-profits, you're delusional.

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

#960

Post by chermi »

themantalope wrote: post #850
chermi wrote: post #465

I would like to know if anyone has a method or resource to cover rough calculations on things like: 1) how much cost comes from "friction" like middleman, administrative bloat, shitty digitalization/note sharing, all the time the nurses and doctors have to spend on paperwork... Etc. 2) how much drug development is subsidized by the US patient via higher domestic vs. foreign pricing. Or even how much of the cost total…

I’m a physician in the US. In my experience main cost drivers are administration (documentation is part of it but the way billing works is you basically do the job, document what you did, then submit to the payer. This process can take 6+ months and they often just don’t pay for parts of it). And then ICU/end of life. Way too many Americans don’t ever talk about what will happen when they die and what they do or don’…

Thanks! I half-jokingly want to come up with a mental health/memory + physical health test for myself where if I ever fail it my wish is to not be a burden, don't extend my life.
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