4 ms·

If they all get jobs with Government Healthcare inc, where are the actual savings coming from? Who is going to be earning less? The profit margins of healthcare

If they all get jobs with Government Healthcare inc, where are the actual savings coming from? Who is going to be earning less? The profit margins of healthcare insurance companies are almost nothing. Look at Humana for instance... 2.5% net margins. Cut that out and every american saves $5 a month.

ok_dad 4y ago
That’s my point, kinda. I expect there to be some savings, but I’m not sure where from and how much. I feel like millions of jobs is a lot though.
- mjevans 4y ago
  Best case: they're not kept on as 'No men' (contrast, 'yes men' for underlings who are just empty enablers), but transferred to scientifically evaluating and seeking the best treatments. Worst case: we go back to what things were before the ACA where if you had a preexisting condition you were screwed.
  - ok_dad 4y ago
    Yea, I'm thinking that there might be a lot of administrative work that could be eliminated by a centralized electronic system for single payer care, but the way I see this going right now is the government adding another layer of administration on top of the current system to operate it (literally privatising it), and then adding a centralized directory of service charges and moving towards eliminating the parts of the system that are unnecessary under this scheme while also working with the same companies as currently exist to merge all EHRs into one common system. I expect most of the cruft of the current system to remain for several decades or more, plus more government cruft, but the upside is that we can eliminate the profit as a goal and probably balance half or more of the government cruft with eliminating inefficiencies. If they privatized pharma and the EHR software companies, too, then that would probably immediately lower prices due to the insane profit motives for investors in those areas, but that would never happen. I think we might save some money right away, but more likely we'll lose a bit, gain the ability for our citizens to not have to worry as much about their jobs being their literal lifeline, and over time we'll save more and more versus the current system due to an increased quality of living due to better health outcomes and longer lives.
noelsusman 4y ago
There wouldn't be much actual savings without massive disruption for providers. Right now Medicare and Medicaid are cheaper per patient largely because they pay below cost for the same services. They are subsidized by private insurance. A move to Medicare for all at current reimbursement rates would require drastic budget cuts at every healthcare provider in the country. That may be what's necessary to fix the broken system, but it would involve a lot of pain.
- rdtwo 4y ago
  Yeah i don’t think Medicare even pays enough to covers the providers wages much less they building overhead and equipment
nn3 4y ago
Margins != overhead. The overhead of insurance is much higher than the margins, and a lot of it is wages and related expenses.
tomrod 4y ago
2021 report: https://humana.gcs-web.com/static-files/78c99040-2eed-4231-89f9-e12b3e9ec333 https://humana.gcs-web.com/static-files/78c99040-2eed-4231-8... Net income: 2.9B USD HOWEVER: 1. They paid 3.6B USD in dividends in 2021 2. They paid 10B in operating costs and receieve ~70B in premiums on top of other streams 3. They increased their interest expense for the KAH acquisition 4. They hold $44B in assets and $28B in liabilities The story they are clearly telling investors is they are seeking to consolidate Payers with Providers to improve efficiencies, which ignores that they they could improve operational efficiencies today.

ok_dad 4y ago

That’s my point, kinda. I expect there to be some savings, but I’m not sure where from and how much. I feel like millions of jobs is a lot though.

mjevans 4y ago
Best case: they're not kept on as 'No men' (contrast, 'yes men' for underlings who are just empty enablers), but transferred to scientifically evaluating and seeking the best treatments. Worst case: we go back to what things were before the ACA where if you had a preexisting condition you were screwed.
- ok_dad 4y ago
  Yea, I'm thinking that there might be a lot of administrative work that could be eliminated by a centralized electronic system for single payer care, but the way I see this going right now is the government adding another layer of administration on top of the current system to operate it (literally privatising it), and then adding a centralized directory of service charges and moving towards eliminating the parts of the system that are unnecessary under this scheme while also working with the same companies as currently exist to merge all EHRs into one common system. I expect most of the cruft of the current system to remain for several decades or more, plus more government cruft, but the upside is that we can eliminate the profit as a goal and probably balance half or more of the government cruft with eliminating inefficiencies. If they privatized pharma and the EHR software companies, too, then that would probably immediately lower prices due to the insane profit motives for investors in those areas, but that would never happen. I think we might save some money right away, but more likely we'll lose a bit, gain the ability for our citizens to not have to worry as much about their jobs being their literal lifeline, and over time we'll save more and more versus the current system due to an increased quality of living due to better health outcomes and longer lives.

noelsusman 4y ago

There wouldn't be much actual savings without massive disruption for providers. Right now Medicare and Medicaid are cheaper per patient largely because they pay below cost for the same services. They are subsidized by private insurance. A move to Medicare for all at current reimbursement rates would require drastic budget cuts at every healthcare provider in the country. That may be what's necessary to fix the broken system, but it would involve a lot of pain.

rdtwo 4y ago
Yeah i don’t think Medicare even pays enough to covers the providers wages much less they building overhead and equipment

nn3 4y ago

Margins != overhead. The overhead of insurance is much higher than the margins, and a lot of it is wages and related expenses.

tomrod 4y ago

2021 report: https://humana.gcs-web.com/static-files/78c99040-2eed-4231-89f9-e12b3e9ec333 https://humana.gcs-web.com/static-files/78c99040-2eed-4231-8... Net income: 2.9B USD HOWEVER: 1. They paid 3.6B USD in dividends in 2021 2. They paid 10B in operating costs and receieve ~70B in premiums on top of other streams 3. They increased their interest expense for the KAH acquisition 4. They hold $44B in assets and $28B in liabilities The story they are clearly telling investors is they are seeking to consolidate Payers with Providers to improve efficiencies, which ignores that they they could improve operational efficiencies today.