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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

#961

Post by cwmoore »

nradov wrote: post #928
NoMoreNicksLeft wrote: post #879

Earlier quoted context omitted.

I think instead of my comment being silly, it's just difficult for you to understand because your Overton window only allows people who agree with you but differ on how much compensation should be allowed and the particulars of how that compensation is decided and doled out. I'm used to this though.

No, you just don't understand the basics of how the US legal system works. It's always disappointing to see that level of aggressive ignorance on HN.

It is run by self-motivated humans and it often doesn't work.

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

#962

Post by timr »

breakyerself wrote: post #948
timr wrote: post #890

Earlier quoted context omitted.

You’re blaming it on lack preventative care, but the truth is that there is very little preventative care that is shown to be effective at anything more than burning money. The few things that are effective (e.g. vaccines) are largely inexpensive, and don’t require “insurance” as we know it. Most of the things that are predictable and lead to long-term bad outcomes are behavioral (i.e. diet and exercise; smoking cess…

No ability to prevent cancer? Ever heard of the HPV vaccine? I had polyps removed from my colon 10 years ago. There's a decent chance those would have developed into colon cancer by now. Prevention is a major part of reducing deaths from cancer. See also the effects of increasing taxes on tobacco products or restrictions on the use of asbestos.

Those are the exceptions, not the rule. But also, you're wrong: most polyps would not become cancerous -- only 5%-10% ever do. As a preventative intervention on otherwise healthy people, colonoscopy is one of the most effective things we do, and it's not that effective [1].

You've also included vaccines (which I explicitly mentioned) and "taxes" (which are not medical interventions), so you've completely missed the point.

[1] The NordICC trial found an impact of 0.03% on risk of death from colorectal cancer, which was insignificant. It did find an 18% risk reduction for getting colorectal cancer, but this didn't translate into a survival benefit.

https://www.nejm.org/doi/full/10.1056/NEJMoa2208375

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

#963

Post by ThrowawayTestr »

Barrin92 wrote: post #852
ThrowawayTestr wrote: post #518

Earlier quoted context omitted.

That you actually believe that is so sad. No, the money would come out of the pockets of insurance CEOs.

it would not because the margins in the insurance industry aren't high. The OP is entirely correct, insurers are a source of payment, not a driver of cost. Insurers don't benefit from hospitals charging them high prices, they try to negotiate cost down , that is their service. They don't enjoy paying hospitals more money. What is driving the actual cost is the high expenses hospitals have, and the biggest source of t…

I'm sure the army of middle been between patient and doctor have nothing to do with it.

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

#964

Post by LorenPechtel »

arh5451 wrote: post #908
ggm wrote: post #901

Earlier quoted context omitted.

Is there any reason to believe less healthcare professionals would be employed under a universal system? Insurance claims adjusters and call centre scripted finance deciders, sure. But actual health delivery agents?

The UK has a "universal system" as does Germany and the inevitable reality is that if administration does not limit/deny overuse of the system then it requires setting prices artifically low to limit costs. --> Causes Doctors to earn less wages and be overworked (many med cases). Ultimately, less doctors. =(

Except this process is independent of whether there is overuse. It's always a pressure to lower costs, whether they are appropriate or not.

Medicare, Medicaid and Tricare are all basically universal systems for segments of the population. None work well. And all are subsidized from what people with private insurance pay. And the UHC proponents rely on a stacked deck--UHC is "better" in a system that makes 20% of the score "fairness". That is, UHC. And one of the other yardsticks is life expectancy. Sounds fine--but dig deeper. A big factor in lowering life expectancy is infant mortality. Again, sounds fine--except you see a big difference in infant mortality across the developed world that is not reasonably explained by differences in their medical systems. But you see an inverse relationship between infant mortality and stillbirths. Most of what you're really seeing is whether the doctors consider it a live birth that promptly died, or consider it a stillbirth. (And, yes, we are still an outlier--but by only 1/3 of the amount claimed.)

Show me it's better without your thumb on the scale!

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

#965

Post by LorenPechtel »

timr wrote: post #890
beloch wrote: post #839

Earlier quoted context omitted.

"Healthcare costs have been rising faster than inflation, and a staggering share of that spending is consumed by administrative middlemen, soaring drug prices, and emergency care for conditions that should have been treated earlier and for less" ----- It's a n-tuple-whammy. Co-pays and deductibles discourage early diagnoses by preventing most people from visiting doctors for issues that aren't serious. The painful pr…

You’re blaming it on lack preventative care, but the truth is that there is very little preventative care that is shown to be effective at anything more than burning money. The few things that are effective (e.g. vaccines) are largely inexpensive, and don’t require “insurance” as we know it. Most of the things that are predictable and lead to long-term bad outcomes are behavioral (i.e. diet and exercise; smoking cess…

Lifestyle can help, it's not a cure-all.

I'm one of the 20% with the lipoprotein A gene. Mimics high cholesterol. Diet and exercise still help but that just slows the clogging.

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

#966

Post by LorenPechtel »

nielsbot wrote: post #865
cortesoft wrote: post #823

Earlier quoted context omitted.

> Hospital spending tons on administrative duties fighting with insurers on coverage, which this would reduce Would this go away, though? Instead of fighting with insurers they would be fighting with the government insurer? I am very pro universal healthcare, I just don’t want to pretend there aren’t still going to be fights over what should be paid for. No matter what, there are going to be disagreements on what med…

> Instead of fighting with insurers they would be fighting with the government insurer? 1. I'd rather fight the non profit-motivated entity 2. We can probably compare to VA and Medicare and even other countries to see what the fight will be like. I'm willing to bet it will be a big improvement. > No matter what, there are going to be disagreements on what medical procedures should be paid for and who needs them, as w…

Government has a cost motive. Lower taxes. There is no such thing as non-profit, cost drives all organizations.

And government can just lower the definition of acceptable service rather than provide any accountability for not providing it.

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

#967

Post by Barrin92 »

ThrowawayTestr wrote: post #963
Barrin92 wrote: post #852

Earlier quoted context omitted.

it would not because the margins in the insurance industry aren't high. The OP is entirely correct, insurers are a source of payment, not a driver of cost. Insurers don't benefit from hospitals charging them high prices, they try to negotiate cost down , that is their service. They don't enjoy paying hospitals more money. What is driving the actual cost is the high expenses hospitals have, and the biggest source of t…

I'm sure the army of middle been between patient and doctor have nothing to do with it.

they don't, for the simple reason that if they did all you'd need to do is go to the hospital and pay out of pocket, most US states don't require you to have health insurance. (or switch your insurance provider, as you pointed out there are many).

There's no logic in what you're trying to argue. Healthcare providers charge for their service, insurance companies negotiate that cost down, next to risk management that collective bargain power is the reason you buy insurance in the first place. Again if what you're saying is true all you'd need to do is just buy your healthcare from the hospital directly, if you end up in the ER take a look at the bill and tell me how that went

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

#968

Post by HDBaseT »

DrScientist wrote: post #922
HDBaseT wrote: post #860

Earlier quoted context omitted.

Because the US buys medicine at absurd pricing. Something that should cost dollars, costs hundreds. [0] [0] https://aspe.hhs.gov/reports/comparing-prescription-drugs

Don't believe that - not that the US doesn't pay well over the odds - that's clear - but it's the major cause to overall higher healthcare costs. Typically health care is massively human capital intensive with like 50% on wages, and only 10% on drugs. I suspect the blame lies with a broken market and inflated prices costs across the board ( ie the higher drug prices are a symptom of a wider systemic problem ).

You can believe whatever you want, but the facts are pretty clear.

It's not the entire reason, but when America pays 2-3x more for the same drug, it can blow out.

Reading the source I attached helps. "In 2022, U.S. prices across all drugs (brands and generics) were nearly 2.78 times as high as prices in the comparison countries. U.S. prices for brand drugs were at least 3.22 times as high as prices in the comparison countries, even after adjustments for estimated U.S. rebates."

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

#969

Post by ThrowawayTestr »

Barrin92 wrote: post #967
ThrowawayTestr wrote: post #963

Earlier quoted context omitted.

I'm sure the army of middle been between patient and doctor have nothing to do with it.

they don't, for the simple reason that if they did all you'd need to do is go to the hospital and pay out of pocket, most US states don't require you to have health insurance. (or switch your insurance provider, as you pointed out there are many). There's no logic in what you're trying to argue. Healthcare providers charge for their service, insurance companies negotiate that cost down , next to risk management that…

The doctor's bill the government directly for a set price. You don't need a negotiation on every medical procedure. There is no need for a middleman.

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

#970

Post by Barrin92 »

ThrowawayTestr wrote: post #969
Barrin92 wrote: post #967

Earlier quoted context omitted.

they don't, for the simple reason that if they did all you'd need to do is go to the hospital and pay out of pocket, most US states don't require you to have health insurance. (or switch your insurance provider, as you pointed out there are many). There's no logic in what you're trying to argue. Healthcare providers charge for their service, insurance companies negotiate that cost down , next to risk management that…

The doctor's bill the government directly for a set price. You don't need a negotiation on every medical procedure. There is no need for a middleman.

The United States government does not set prices for doctors bills, what are you talking about? Healthcare providers in the US operate privately and set prices based on market rates. Again, if you want to, you can go and purchase whatever healthcare you like already without a middleman, the point is, it isn't going to be cheaper, which is why people, voluntarily, purchase insurance.
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