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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

#971

Post by musicale »

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…

> diet and exercise

GLP-1 drugs do seem to help people change their diet (or at least intake), even in this environment of unhealthy, hyperpalatable foods that we have created.

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

#973

Post by frmersdog »

hammock wrote: post #794
frmersdog wrote: post #754

Earlier quoted context omitted.

If someone shoots some more CEOs, they'll have a change of heart. (A lot of people are going to be very mad at me about this comment, without having the awareness to understand that this is the inevitable conclusion to, "You wanna play rough, ah?!"ing people's access to life-saving treatment. Please grok that we can preclude any more assassinations by cutting profits and letting people get the care they need.)

How do you typically react when right wingers make similar comments about what they see as overreaching government?

I acknowledge their bloviating as I would a tough-talking teenager: with a wariness respectful of their capacity for violence, paired with an understanding that, 9 times out of 10, they're not going to do jack shit.

Probably important to point out here that leftists are looking to see a threat to a corporation's leadership change the behavior of a corporation, whereas right-wingers are looking to see a threat to a government's leadership change everyone's behavior ("overreaching government" in a democracy being the will of voters). They're not the same thing.

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

#974

Post by goatlover »

hammock wrote: post #794
frmersdog wrote: post #754

Earlier quoted context omitted.

If someone shoots some more CEOs, they'll have a change of heart. (A lot of people are going to be very mad at me about this comment, without having the awareness to understand that this is the inevitable conclusion to, "You wanna play rough, ah?!"ing people's access to life-saving treatment. Please grok that we can preclude any more assassinations by cutting profits and letting people get the care they need.)

How do you typically react when right wingers make similar comments about what they see as overreaching government?

They've lost all credibility under Trump with the massive amounts of overreach. It becomes apparent they only care when the other party is seen as overreaching.

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

#975

Post by throw10920 »

cogman10 wrote: post #704
qwytw wrote: post #642

Earlier quoted context omitted.

> All insurance should be non-profit. Aren't their profits regulated regardless? If all insurance companies became non profit and let's say total prices dropped by 3-5% that still wouldn't change the situation dramatically? There are many factors, e.g. amongst other things American doctors are better paid than just about anywhere else in the world.

> Aren't their profits regulated regardless? Yes and no. It's sort of a weird thing where insurance is somewhat regulated nationally but also regulated in a piecemeal fashion state by state. There's a non-government standards body called the NAIC which provided national guidance for insurers. Most (all?) states basically say that "if you follow NAIC standards, you are good". > If all insurance companies became non pr…

> Basically the only organization that's motivated to keep costs as low as possible is the government.

Unfortunately, this isn't true for the government either.

Source: personal experience of me and literally dozens of people that I know. I've briefly worked with my country's government, and in that time I personally experienced and got dozens of stories along the lines of "the government spent tens of thousands of dollars of aggregate government employees' time because a single employee booked a hotel that was less than one dollar above the approved rate while traveling".

There's a good reason for this, of course: bureaucracies' policies are mostly "scar tissue" from high-profile cases where a bad actor did something they shouldn't have but wasn't specifically against policy, and then a policy was written for that case and stands for the rest of time. And, bureaucracies are risk-averse, especially democratic governments, whose leaders are elected based on optics almost as much as policy.

But it doesn't change the facts. Not only are large bureaucracies inefficient, but government bureaucracies specifically are incentivized to optimize for optics and structure rather than improving that inefficiency, and anyone who has actually worked for a large government can tell you that.

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

#977

Post by Auracle »

nickff wrote: post #723
bigmadshoe wrote: post #689

Earlier quoted context omitted.

Why do doctors need to be paid integer multiples more in the US than every other country on earth? This is not rhetorical, I mean it sincerely. And I’m aware that medical debt is a big issue, but it seems like a chicken-or-the-egg type problem. Of course you can charge $500k for a medical degree when the doctor can make it back and then some in 5-10 years.

Nurses are also highly-paid in the USA (relative to other developed countries), and they make up a large part of the wage expenditure in the system. This may not make a difference to your point, but it is important to note that doctors are not the whole problem.

For those that have never looked it up, the median RN salary in the US is about $100k a year. Germany and the UK are more like $60k.

It’s funny, because it’s a career that feels both overpaid and underpaid to me. I went to a college where almost half of the students were going for nursing - and you certainly don’t need to be especially intelligent.

At least to an outsider, some nursing fields seem damned easy. The nurse that sees me before my GP? Pretty easy job.

Other specialties? Like the nurses that needed to clean up my wife after she massively bled during/after a c-section and they had to give her medications that also caused all sorts of other fluids to intermingle with the blood? Or the nurses that had to stand there for 10 minutes squeezing our infant daughter’s heel in the NICU to try to get enough blood out while she screamed as hard as a little baby can?

$100k doesn’t seem like enough. Odd occupation. For $60k I’d rather work at Costco, that’s for certain.

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

#978

Post by Auracle »

analog31 wrote: post #655
pstuart wrote: post #628

Earlier quoted context omitted.

It also means that emergency rooms can be used just for emergencies and ongoing and preventative care can happen in clinics. Cheaper to operate and preventing preventable emergencies lowers the load.

Here's what happens in my locale. If you show up in an ER, they quickly decide whether you need emergency care, or regular urgent care, delivered in the same facility. And medicine is anything if not statistical, so they know the amount of each kind of service that they need to plan for.

In my locale urgent care is only open from like 9am-4pm on weekdays, reduced hours on Saturdays, and closed on Sundays.

I could make observations about who tends to be there at either but that might rustle some jimmies.

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

#979

Post by DrScientist »

HDBaseT wrote: post #968
DrScientist wrote: post #922

Earlier quoted context omitted.

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…

Read my post again.

I accept that the US pays over the odds for drugs. I don't accept that's the driving force behind overall health care costs - as 2.78x cost for something that's only 10% of overall costs doesn't get you to doubling the overall spend. ( If overall cost is 100 - then a 2.78 increase in 10% of that is = (10 * 2.78) + 90 = 117.8

That's a long way from double the cost - ie 200.

My contention is that the higher drug prices are a symptom, not a cause - and that's important to understand if you want a cure. Simply targeting drug pricing alone is an exercise in whack-a-mole.

The problem with insurance systems in markets that aren't operating properly is that it's actually in the insurance companies interests to increases costs.

Why? Because in the absence of proper competition in the market, insurance companies profits scale with the size of the thing they are insuring against as margins are % based.

So I would argue there is indirect collusions between all the parties involved ( insurance companies, doctors, hospitals, middlemen, pharma etc ) to escalate costs to increase the money flow they are all feeding on.

The idea of free markets driving ruthless competition is fine on paper - however in the real world there are all sorts of reasons why they don't happen in practice - so they have to be actively managed or in some cases acknowledge it's just not the best way - but that's a much longer post.

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

#980

Post by ThrowawayTestr »

Barrin92 wrote: post #970
ThrowawayTestr wrote: post #969

Earlier quoted context omitted.

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.

That's how it works in civilized countries.
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