Universal health coverage could save $1T and 114k lives a year: study • Hacker News Board

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

#981

Post by Gareth321 » Thu, Aug 20, 2026, 12:35 PM UTC

bhelkey wrote: post #958

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 congre…

I think you did not understand my comment, and that is perhaps my fault. To be explicit:

1. Universal health care reduces the total cost of healthcare across the nation. If the bill is $x now, the total cost would be $x-0.2 (or whatever).

2. This is EXTREMELY expensive FOR THE GOVERNMENT. They would need to either raise taxes considerably (broadly and deeply, as in Europe), or deficit spend.

For some people, the increased taxes would be offset by not having to buy health insurance. For some people, they would be spending more.

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

#982

Post by testemailfordg2 » Thu, Aug 20, 2026, 12:56 PM UTC

How will the capitalists survive then, they would go extinct as a species. Healthcare and defense are the two prominent sectors where the options available are kept artificially scarce / high in demand (wars), thereby reaping money unfairly from both taxpayers and individuals.

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

#983

Post by nielsbot » Thu, Aug 20, 2026, 2:46 PM UTC

LorenPechtel wrote: post #966

nielsbot wrote: post #865

Earlier quoted context omitted.

> 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.

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

but why would they? OTOH for-profit companies do this all the time.

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

#984

Post by bhelkey » Thu, Aug 20, 2026, 5:53 PM UTC

Gareth321 wrote: post #981

bhelkey wrote: post #958

Earlier quoted context omitted.

> 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 congre…

I think you did not understand my comment, and that is perhaps my fault. To be explicit: 1. Universal health care reduces the total cost of healthcare across the nation. If the bill is $x now, the total cost would be $x-0.2 (or whatever). 2. This is EXTREMELY expensive FOR THE GOVERNMENT. They would need to either raise taxes considerably (broadly and deeply, as in Europe), or deficit spend. For some people, the incr…

Potentially I am misunderstanding you.

My point is that we already pay $2 Trillion dollars for existing single payer healthcare (Medicare/Medicaid). I think it's fair to call that extremely expensive.

You say that universal single payer healthcare would have a huge price tag, my point is that we are already paying a huge price tag ($2 Trillion) but just not getting universal single payer healthcare as a result of this spending.

My point is that we could have universal single payer healthcare without raising taxes if it cost less than or equal to ~$5800 per person per year.

UK spends ~$4800 per person per year on their single payer healthcare.

Note: This just considers existing taxes spent on existing single payer healthcare. This doesn't consider other healthcare spending. The majority of the US get's their insurance through employment-based plans. Some pretty reasonable percentage buy their plans directly through the marketplace. And some pretty reasonable percentage don't have health insurance.

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

#985

Post by jjav » Fri, Aug 21, 2026, 7:26 AM UTC

shibapuppie wrote: post #560

jjav wrote: post #551

Earlier quoted context omitted.

It is a system where all prices and costs are so far detached from reality for multiple reasons, that looking at any current profit margins is not going to be very realistic either. Really need to step back and start from first principles. When I go to urgent care I get 15 minutes with a doctor who on average makes about $300K and maybe another 15 minutes with a nurse assistant who might be making $100K (or less). So…

How much does insurance, legal representation, a department to argue with insurers, etc cost the hospital?

> a department to argue with insurers, etc cost the hospital?

My surgeon friends routinely complain about the inordinate amount of time they personally need to spend fighting with insurance, in the form of filling endless forms that insurance insists must be filled and signed by the doctor. This is in addition to whatever time/cost the hospital staff wastes fighting with insurance paperwork.

The surgeon time is not cheap, but the insurance companies expect these doctors to do all this paper pushing for free on top of their day job.

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

#986

Post by dominotw » Fri, Aug 21, 2026, 2:18 PM UTC

moate wrote: post #688

dominotw wrote: post #156

Earlier quoted context omitted.

can someone tell me this. Right now level of care is rationed by type of insurance you can afford. eg: northwestern in chicago downtown is inaccesible to ppl below certain income level. In universal everyone has access to every hospital ? Why would someone go to lower level hospital if they can go to northwestern. Now the acess to best hosptials is gated by a queue? I am not saying this is right but ppl who already h…

You're right, it's not just that people opposing it are stupid or brainwashed: Some of them, to your point, are selfish and don't want others to have access to the nice things that they have. Can you explain why those people DESERVE access to better care? Do they have more complex/rare diseases that require specialized treatment? Are there specialists who only work at that hospital? Those feel like warranted needs. B…

> Can you explain why those people DESERVE access to better care?

i dont get why ppl responding to me think i do when i already said this

> I am not saying this is right

i am merely saying that the angle i described should be considered because a big portion of population thinks along those lines ( my guess)

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

#987

Post by dominotw » Fri, Aug 21, 2026, 2:20 PM UTC

saghm wrote: post #530

dominotw wrote: post #496

Earlier quoted context omitted.

i think you are talking over me with some irrelevant nonsense. did you reflect on why you are being downvoted?

From my perspective, what you're saying sounds like nonsense. I'm not sure why you're more concerned with my karma than I am, but since you're curious: no, I did not spend much time thinking about the one singular downvote my comment received. It's pretty common for people to downvote for any number of reasons (downvoting for disagreement in particular is controversial but not against the HN guidelines), so I didn't…

no idea what you are harping on when i clearly said

> I am not saying this is right

in my original comment.

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

#988

Post by onraglanroad » Fri, Aug 21, 2026, 5:04 PM UTC

matteoraso wrote: post #953

onraglanroad wrote: post #941

Earlier quoted context omitted.

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...

NICE is an independent body consisting mainly of medical professionals. It's not made up of MPs.

That's exactly my point. How on earth are you still missing this?

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

#989

Post by _heimdall » Fri, Aug 21, 2026, 7:54 PM UTC

dmschulman wrote: post #667

_heimdall wrote: post #357

Earlier quoted context omitted.

If the ACA was so successful at reducing coats we wouldn't still be having discussions like this about the excessive costs of both care and insurance in the US. We will never know how costs would have changed if we didn't implement the ACA, and cost is not the only metric of success. But it clearly hasn't led us to a place where people feel okay with what the industry costs.

The purpose of the ACA was to get more people to sign up for health insurance by creating plans everyone could access regardless of employment status or income. Solving the healthcare crisis in this country from top to bottom is going to take more than an act of Congress. Also necessary to remember the ACA was only passed because of Democratic support in 2010. Republicans hacked away at the proposal before it became…

Making healthcare more affordable was literally in the name. I agree they also aimed to expand coverage, but cost reduction as a top line item and my point was simply that it didn't land that goal.

At a minimum since we don't know what prices would be today without the ACA, prices have risen dramatically in recent years to a point that I think most agree its unaffordable.

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

#990

Post by _heimdall » Fri, Aug 21, 2026, 8:22 PM UTC

nradov wrote: post #672

_heimdall wrote: post #550

Earlier quoted context omitted.

Nothing stops a doctor or an office from saying "treatment X costs $Y." Doctors can't say how much an insurance provider will cover or what a patient's out of pocket will therefore be, but that is a separate issue further downstream of clear pricing for treatment.

Right, and as I already pointed out below, cash pay patients have the right to demand a Good Faith Estimate (GFE) from providers under federal price transparency rules.

That shouldn't be limited to cash payers though. Insurance companies should not be part of the process of care providers pricing their service, nor should they be able to deny a charge after the fact.

Today's model is great for the insurance company, it should be great for the patient. If one wants to offer an insurance product they should be considering average cost of care based on whatever factors their actuaries come up withz they shouldn't be demanding say into pricing so they can protect their bottom line.