4 ms·

The last time I checked, 33% of US healthcare dollars went to paying people at the insurance company and people at the healthcare provider to negotiate with eac

by hedora 3y ago

The last time I checked, 33% of US healthcare dollars went to paying people at the insurance company and people at the healthcare provider to negotiate with each other. One way to avoid this in the US is to go with an HMO, since they can be wildly profitable and still be much more efficient than an insurance company + independent providers. Of course, the problem with that is that non-emergency care from third-party doctors isn't covered by the HMO. A better way to solve the problem is to go with a single-payer healthcare system, such as the one the progressives was proposing during the Obamacare negotiations. (As every other first-world country has done at this point.)

codegeek 3y ago
And don't forget the cost of health Insurance for the actual consumers including Premiums, Deductible, Co-Pays, Co-Insurance and all the other nonsense.
scythe 3y ago
>As every other first-world country has done at this point. This is simply not true, and there is another option that deserves to at least be mentioned: http://en.wikipedia.org/wiki/All-payer_rate_setting http://en.wikipedia.org/wiki/All-payer_rate_setting
anonuser123456 3y ago
>A better way to solve the problem is to go with a single-payer healthcare system Better for who, and under what circumstances?
jewayne 3y ago
Not every first world country has a true single-payer healthcare system. There are many variations that work better than what we have. The difference is that in the US we have accepted profit maximization as the legitimate primary goal in the healthcare system.
- qwytw 3y ago
  I think the majority of Western European countries don't even have it? Most seem to have mixed systems or no single payer at all like Switzerland (where healthcare is privatized to an even higher degree than in the US).
  - dv_dt 3y ago
    Switzerland is also the closest in per capita healthcare cost to the US. Though it is a significant amount lower - I think one could draw a graph of percentage private operators in the health system vs per capital healthcare costs and have a pretty straightforward correlation.
    - qwytw 3y ago
      > pretty straightforward correlation. I'm not sure. Switzerland seems to spend about the same as Germany in the last couple of years (of course the German system is also privatized to a significant degree) but Swiss GDP per capita is much higher. If we look at spending as % of GDP Switzerland is actually below both Germany and France and about on par with Britain (~11%) while US spend more than 16.5%. Netherlands where IIRC the system is also almost entirely private just with heavily regulated pricing is even a bit lower than all of the countries I mentioned. Then again Switzerland and the Netherlands has a quite a bit younger population than Germany (median is lower by about 5 years) which must also play a part. *https://data.oecd.org/chart/79Ye https://data.oecd.org/chart/79Ye
      - dv_dt 3y ago
        In terms of total expenditure per capita the picture is a little different, https://ourworldindata.org/grapher/annual-healthcare-expenditure-per-capita?tab=chart&country=CHE~DEU~FRA~GBR~USA https://ourworldindata.org/grapher/annual-healthcare-expendi... I wouldn’t dismiss a comparison vs percentage GDP, but it is a little different than absolute expenditure and abstracts the some aspects out differently. Absolute per capita expenditures if nothing else seems a little less volatile.
qwytw 3y ago
> A better way to solve the problem is to go with a single-payer healthcare system Possibly. But there are countries in Europe where healthcare is primarily or to a large degree (or even entirely like in Switzerland, they don't even have any Medicare/Medicaid equivalents) financed through private insurance systems. Yet they manage to keep prices from spiraling through effective regulation.
- nobodyandproud 3y ago
  Yes, but Switzerland also subsidizes premiums if your income is too low relative to the premium; and healthcare coverage is mandated by law. I don't know Swiss politics but I also assume there isn't a bickering back-and-forth by party lines that end up distorting/underfunding any sort of healthcare.
  - qwytw 3y ago
    > but Switzerland also subsidizes premiums True, however US spends huge amounts on MedicAid which sort of tries to do the same just seemingly way less efficiently and also less equitably. Capping insurance premiums at 10%(?) of income seems like a better idea than having a byzantine style system which discourages people from ever trying increase their incomes. > I don't know Swiss politics but I also assume there isn't a bickering back-and-forth by party lines Yeah, of course that's the real problem since we already know that any system ranging from fully private (with government subsidies) to single payer can work with proper regulation.
    - dv_dt 3y ago
      US Medicaid is intentionally hobbled though. For instance it is not allowed to negotiate drug costs (or maybe with recent legislation it can a with a handful over a decade amid a catalog of tens of thousands of frequently used drugs.
DennisP 3y ago
Single-payer is not actually that common, it just seems that way because Canada is next to us. The UK goes beyond that to single-provider. France, Germany, and Japan have multiple private insurance companies and get fantastic results without spending too much, but they also have a national price list for medical services, no claim denials allowed for anything on the list, and a national digital medical records system. Source: The Healing of America by T.R. Reid.
awongh 3y ago
wow 33%, I haven’t heard that specific statistic before. Any source for that where I can learn more?

by hedora 3y ago

codegeek 3y ago

And don't forget the cost of health Insurance for the actual consumers including Premiums, Deductible, Co-Pays, Co-Insurance and all the other nonsense.

scythe 3y ago

>As every other first-world country has done at this point. This is simply not true, and there is another option that deserves to at least be mentioned: http://en.wikipedia.org/wiki/All-payer_rate_setting http://en.wikipedia.org/wiki/All-payer_rate_setting

anonuser123456 3y ago

>A better way to solve the problem is to go with a single-payer healthcare system Better for who, and under what circumstances?

jewayne 3y ago

Not every first world country has a true single-payer healthcare system. There are many variations that work better than what we have. The difference is that in the US we have accepted profit maximization as the legitimate primary goal in the healthcare system.

qwytw 3y ago
I think the majority of Western European countries don't even have it? Most seem to have mixed systems or no single payer at all like Switzerland (where healthcare is privatized to an even higher degree than in the US).
- dv_dt 3y ago
  Switzerland is also the closest in per capita healthcare cost to the US. Though it is a significant amount lower - I think one could draw a graph of percentage private operators in the health system vs per capital healthcare costs and have a pretty straightforward correlation.
  - qwytw 3y ago
    > pretty straightforward correlation. I'm not sure. Switzerland seems to spend about the same as Germany in the last couple of years (of course the German system is also privatized to a significant degree) but Swiss GDP per capita is much higher. If we look at spending as % of GDP Switzerland is actually below both Germany and France and about on par with Britain (~11%) while US spend more than 16.5%. Netherlands where IIRC the system is also almost entirely private just with heavily regulated pricing is even a bit lower than all of the countries I mentioned. Then again Switzerland and the Netherlands has a quite a bit younger population than Germany (median is lower by about 5 years) which must also play a part. *https://data.oecd.org/chart/79Ye https://data.oecd.org/chart/79Ye
    - dv_dt 3y ago
      In terms of total expenditure per capita the picture is a little different, https://ourworldindata.org/grapher/annual-healthcare-expenditure-per-capita?tab=chart&country=CHE~DEU~FRA~GBR~USA https://ourworldindata.org/grapher/annual-healthcare-expendi... I wouldn’t dismiss a comparison vs percentage GDP, but it is a little different than absolute expenditure and abstracts the some aspects out differently. Absolute per capita expenditures if nothing else seems a little less volatile.

qwytw 3y ago

> A better way to solve the problem is to go with a single-payer healthcare system Possibly. But there are countries in Europe where healthcare is primarily or to a large degree (or even entirely like in Switzerland, they don't even have any Medicare/Medicaid equivalents) financed through private insurance systems. Yet they manage to keep prices from spiraling through effective regulation.

nobodyandproud 3y ago
Yes, but Switzerland also subsidizes premiums if your income is too low relative to the premium; and healthcare coverage is mandated by law. I don't know Swiss politics but I also assume there isn't a bickering back-and-forth by party lines that end up distorting/underfunding any sort of healthcare.
- qwytw 3y ago
  > but Switzerland also subsidizes premiums True, however US spends huge amounts on MedicAid which sort of tries to do the same just seemingly way less efficiently and also less equitably. Capping insurance premiums at 10%(?) of income seems like a better idea than having a byzantine style system which discourages people from ever trying increase their incomes. > I don't know Swiss politics but I also assume there isn't a bickering back-and-forth by party lines Yeah, of course that's the real problem since we already know that any system ranging from fully private (with government subsidies) to single payer can work with proper regulation.
  - dv_dt 3y ago
    US Medicaid is intentionally hobbled though. For instance it is not allowed to negotiate drug costs (or maybe with recent legislation it can a with a handful over a decade amid a catalog of tens of thousands of frequently used drugs.

DennisP 3y ago

Single-payer is not actually that common, it just seems that way because Canada is next to us. The UK goes beyond that to single-provider. France, Germany, and Japan have multiple private insurance companies and get fantastic results without spending too much, but they also have a national price list for medical services, no claim denials allowed for anything on the list, and a national digital medical records system. Source: The Healing of America by T.R. Reid.

awongh 3y ago

wow 33%, I haven’t heard that specific statistic before. Any source for that where I can learn more?