3 ms·

What we're really paying for is the armies of data entry and clerical workers that have to back up every doctor in this country because they are in a constant a

What we're really paying for is the armies of data entry and clerical workers that have to back up every doctor in this country because they are in a constant arms race with the insurers about getting every claim paid. Compare any medical practice to just about any tech firm these days. My company has one office administrator taking care of 30 keyboard commandos. A typical medical practice has more than one clerk per doctor. This is not normal. Go to any medical clinic in Europe, and it's no different from the tech sector. One office admin, lots of doctors and nurses. And it's not cheap either.

rayiner 7y ago
Administrative costs are particularly high in the US, but they're high in lots of places: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2013.1327 https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2013.... (Ex. 3) If we cut hospital administration costs to Dutch levels (as a %-age of GDP) we could save about $140 billion per year. It's not nothing, but it's also only about 4% of total U.S. health expenditures. As noted in my response to a sibling post, all profit in the system amounts to another 6%. So even if you cut out all profit,[1] and reduced administrative costs to Dutch levels, you get a 10% cut. It's not nothing, but it doesn't even get you 30% of the way there to cutting our costs to rich-OECD country levels (as a %-age of GDP). You still need to find another $875 billion or so to cut. [1] Which is of course unrealistic, because drug companies in the EU make significant profits too, and most countries like Germany and the Netherlands have private service providers who make profits.
- euroclydon 7y ago
  Profit doesn’t take into account inflated salaries which are tallied as expenses.
  - rayiner 7y ago
    Right, but inflated salaries for who? US nurses typically start out at double what nurses in the UK earn. They can top six figures, which a nurse in the UK won’t touch. If you look at smaller US cities, the hospital is typically the largest employer. Cutting down to European levels of healthcare expenditures will require cutting jobs and cutting salaries for upper middle class people, and there is no political will to do that.
burntoutfire 7y ago
Here in Poland (where we have universal, state-provided health insurance), there are relatively few office admins, but the paperwork still needs to happen (perhaps less than in the US). The health care providers need to diligently fill it out in order to get paid by the state-run insurance. And since the doctors don't get admin help, they have to fill out the paper work themselves, which is a giant misallocation of their skills...

rayiner 7y ago

Administrative costs are particularly high in the US, but they're high in lots of places: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2013.1327 https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2013.... (Ex. 3) If we cut hospital administration costs to Dutch levels (as a %-age of GDP) we could save about $140 billion per year. It's not nothing, but it's also only about 4% of total U.S. health expenditures. As noted in my response to a sibling post, all profit in the system amounts to another 6%. So even if you cut out all profit,[1] and reduced administrative costs to Dutch levels, you get a 10% cut. It's not nothing, but it doesn't even get you 30% of the way there to cutting our costs to rich-OECD country levels (as a %-age of GDP). You still need to find another $875 billion or so to cut. [1] Which is of course unrealistic, because drug companies in the EU make significant profits too, and most countries like Germany and the Netherlands have private service providers who make profits.

euroclydon 7y ago
Profit doesn’t take into account inflated salaries which are tallied as expenses.
- rayiner 7y ago
  Right, but inflated salaries for who? US nurses typically start out at double what nurses in the UK earn. They can top six figures, which a nurse in the UK won’t touch. If you look at smaller US cities, the hospital is typically the largest employer. Cutting down to European levels of healthcare expenditures will require cutting jobs and cutting salaries for upper middle class people, and there is no political will to do that.

burntoutfire 7y ago

Here in Poland (where we have universal, state-provided health insurance), there are relatively few office admins, but the paperwork still needs to happen (perhaps less than in the US). The health care providers need to diligently fill it out in order to get paid by the state-run insurance. And since the doctors don't get admin help, they have to fill out the paper work themselves, which is a giant misallocation of their skills...