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Quote from Obama on single payer. The system is set up quite specifically so certain parties can profit from it. “Everybody who supports single-payer health ca

Quote from Obama on single payer. The system is set up quite specifically so certain parties can profit from it. “Everybody who supports single-payer health care says, ‘Look at all this money we would be saving from insurance and paperwork,’ ” the former President noted. “That represents one million, two million, three million jobs.” https://www.newyorker.com/books/under-review/the-bullshit-job-boom https://www.newyorker.com/books/under-review/the-bullshit-jo...

peteradio 2y ago
Give them a shovel and have them go plant trees somewhere.
RHSeeger 2y ago
It's a reasonable statement, though. There's a LOT of people that think a single payer healthcare system is the right goal. And a LOT of those people also realize that getting from where we are right not to a single payer system is HARD. One reason it's hard is that there are millions of jobs that will go poof when that happens. Those people could be put to work doing something that's actually beneficial to society. But the transition from <working in bullshit job> to <working in useful job> for millions of people is not trivial. The change isn't something where you just pass a law / flip a switch, and everything is better. It's HARD.
- floor2 2y ago
  Maybe this is an upside to the looming AI-taking-jobs issue. I bet a ton of these bureaucratic approve/deny/request-more-information workflows in current EMR systems will be replaced by AI in a few years, putting the people out of work. Once AI eats their jobs, less resistance to changing the system.
  - pixl97 2y ago
    Unemployed people: "Oh wow, now I see why we should shutdown the people eating machine" Trillionaires with killbot armies: "No, I'm not seeing what you're seeing at all"
  - Rinzler89 2y ago
    >I bet a ton of these bureaucratic approve/deny/request-more-information workflows in current EMR systems will be replaced by AI in a few years, putting the people out of work. The EU AI act prevents exactly this scenario.
  - nradov 2y ago
    Most of it doesn't even require AI. The majority of those jobs can be eliminated just by implementing existing interoperability standards between payer and provider organizers, and then writing some simple deterministic rules. I previously worked on projects to do just that. There is a tremendous amount of waste (and associated jobs) that can be eliminated without buying a single GPU.
    - ryandrake 2y ago
      They could also be replaced with even simpler code: bool should_approve_claim(int claim_id) { return false; }
      - nradov 2y ago
        Ha ha, but even single payer or socialized systems have similar mechanisms for preventing payments for treatments that don't meet medical necessity criteria. Blindly approving all claims would only serve to make the system more expensive and overloaded than it already is.
  - enceladus06 2y ago
    Hopefully these jobs go away sooner than later, they are not exactally fufilling work & there are much better jobs out there. I am now buidling an aprove deny API, going to call it dPANEL for deterministicPanel. Also chatGPT seems ungodly enthusiastic to help me build it... Pricing Strategy for Health Insurance Approve || Deny API Pricing Structure Base Subscription Fee: Annual Subscription: $120,000 per year, covering up to 50,000 API calls. Volume-Based Pricing: Beyond the initial 50,000 calls: Tier 1: 50,001 to 100,000 calls at $1.50 per call. Tier 2: 100,001 to 200,000 calls at $1.25 per call. Tier 3: Over 200,001 calls at $1.00 per call. Multi-Year Discounts: 2-Year Contract: 10% discount on the annual subscription fee. 3-Year Contract or more: 15% discount on the annual subscription fee. Additional Services: Custom Integration: $30,000 one-time fee. Premium Support Package: $25,000 per year for dedicated support and quarterly performance reviews. Early Termination Benefits: Early termination within the first year incurs a 50% fee of the remaining contract value. Termination in the second year or later incurs a 25% fee of the remaining contract value. Cost-Saving Benefits Labor Cost Reduction: Automation of approval and denial processes reduces the need for manual labor. Increased Efficiency: Faster processing times improve operational efficiency and customer satisfaction. Error Reduction: Minimized human errors reduce costs related to claim reprocessing and disputes. Scalability: Efficiently manages varying loads without significant staffing changes. Regulatory Compliance: Helps ensure decisions are consistent and compliant, reducing potential fines. Data Insights: Offers valuable analytics that can lead to better risk management and operational adjustments.
alistairSH 2y ago
“That represents one million, two million, three million jobs.” Isn't this a flavor of the "broken window" fallacy? There is more productive work these people can do than the adversarial "deny-fight-ok approve" system we have today.
- acdha 2y ago
  It is, but that doesn’t change the political calculus at all. If you’re the president who does something which cuts millions of jobs, that’s a LOT of people who are now voting for the other guy. Obama won reelection by 5 million votes, so that could be all of his margin when you think about friends and family. I am not saying we shouldn’t try, but you really do need to think carefully about how to phase things in so people have time to adjust.
kjkjadksj 2y ago
Think of all the poor horseshoe makers out of work today lining up for soup
neuronexmachina 2y ago
Full quote for context: https://www.thenation.com/article/archive/mr-obama-goes-washington/ https://www.thenation.com/article/archive/mr-obama-goes-wash... > “I don’t think in ideological terms. I never have,” Obama said, continuing on the healthcare theme. “Everybody who supports single-payer healthcare says, ‘Look at all this money we would be saving from insurance and paperwork.’ That represents 1 million, 2 million, 3 million jobs of people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?”
- threecheese 2y ago
  If Kaiser could figure out how to cut those jobs themselves, it’d be done by next week. When it’s for the good of society, we have a conscience; when it’s for the bottom line, there’s no conscience and that’s celebrated. I have no solutions, only a pervasive anxiety.
  - fragmede 2y ago
    Would they? Internal corporate politics says a team's manager, who's going to best know the value the team provides, is not going to declare their team is redundant and fire them and then quit themselves because what they're doing isn't necessary.

peteradio 2y ago

Give them a shovel and have them go plant trees somewhere.

RHSeeger 2y ago

It's a reasonable statement, though. There's a LOT of people that think a single payer healthcare system is the right goal. And a LOT of those people also realize that getting from where we are right not to a single payer system is HARD. One reason it's hard is that there are millions of jobs that will go poof when that happens. Those people could be put to work doing something that's actually beneficial to society. But the transition from <working in bullshit job> to <working in useful job> for millions of people is not trivial. The change isn't something where you just pass a law / flip a switch, and everything is better. It's HARD.

floor2 2y ago
Maybe this is an upside to the looming AI-taking-jobs issue. I bet a ton of these bureaucratic approve/deny/request-more-information workflows in current EMR systems will be replaced by AI in a few years, putting the people out of work. Once AI eats their jobs, less resistance to changing the system.
- pixl97 2y ago
  Unemployed people: "Oh wow, now I see why we should shutdown the people eating machine" Trillionaires with killbot armies: "No, I'm not seeing what you're seeing at all"
- Rinzler89 2y ago
  >I bet a ton of these bureaucratic approve/deny/request-more-information workflows in current EMR systems will be replaced by AI in a few years, putting the people out of work. The EU AI act prevents exactly this scenario.
- nradov 2y ago
  Most of it doesn't even require AI. The majority of those jobs can be eliminated just by implementing existing interoperability standards between payer and provider organizers, and then writing some simple deterministic rules. I previously worked on projects to do just that. There is a tremendous amount of waste (and associated jobs) that can be eliminated without buying a single GPU.
  - ryandrake 2y ago
    They could also be replaced with even simpler code: bool should_approve_claim(int claim_id) { return false; }
    - nradov 2y ago
      Ha ha, but even single payer or socialized systems have similar mechanisms for preventing payments for treatments that don't meet medical necessity criteria. Blindly approving all claims would only serve to make the system more expensive and overloaded than it already is.
- enceladus06 2y ago
  Hopefully these jobs go away sooner than later, they are not exactally fufilling work & there are much better jobs out there. I am now buidling an aprove deny API, going to call it dPANEL for deterministicPanel. Also chatGPT seems ungodly enthusiastic to help me build it... Pricing Strategy for Health Insurance Approve || Deny API Pricing Structure Base Subscription Fee: Annual Subscription: $120,000 per year, covering up to 50,000 API calls. Volume-Based Pricing: Beyond the initial 50,000 calls: Tier 1: 50,001 to 100,000 calls at $1.50 per call. Tier 2: 100,001 to 200,000 calls at $1.25 per call. Tier 3: Over 200,001 calls at $1.00 per call. Multi-Year Discounts: 2-Year Contract: 10% discount on the annual subscription fee. 3-Year Contract or more: 15% discount on the annual subscription fee. Additional Services: Custom Integration: $30,000 one-time fee. Premium Support Package: $25,000 per year for dedicated support and quarterly performance reviews. Early Termination Benefits: Early termination within the first year incurs a 50% fee of the remaining contract value. Termination in the second year or later incurs a 25% fee of the remaining contract value. Cost-Saving Benefits Labor Cost Reduction: Automation of approval and denial processes reduces the need for manual labor. Increased Efficiency: Faster processing times improve operational efficiency and customer satisfaction. Error Reduction: Minimized human errors reduce costs related to claim reprocessing and disputes. Scalability: Efficiently manages varying loads without significant staffing changes. Regulatory Compliance: Helps ensure decisions are consistent and compliant, reducing potential fines. Data Insights: Offers valuable analytics that can lead to better risk management and operational adjustments.

alistairSH 2y ago

“That represents one million, two million, three million jobs.” Isn't this a flavor of the "broken window" fallacy? There is more productive work these people can do than the adversarial "deny-fight-ok approve" system we have today.

acdha 2y ago
It is, but that doesn’t change the political calculus at all. If you’re the president who does something which cuts millions of jobs, that’s a LOT of people who are now voting for the other guy. Obama won reelection by 5 million votes, so that could be all of his margin when you think about friends and family. I am not saying we shouldn’t try, but you really do need to think carefully about how to phase things in so people have time to adjust.

kjkjadksj 2y ago

Think of all the poor horseshoe makers out of work today lining up for soup

neuronexmachina 2y ago

Full quote for context: https://www.thenation.com/article/archive/mr-obama-goes-washington/ https://www.thenation.com/article/archive/mr-obama-goes-wash... > “I don’t think in ideological terms. I never have,” Obama said, continuing on the healthcare theme. “Everybody who supports single-payer healthcare says, ‘Look at all this money we would be saving from insurance and paperwork.’ That represents 1 million, 2 million, 3 million jobs of people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?”

threecheese 2y ago
If Kaiser could figure out how to cut those jobs themselves, it’d be done by next week. When it’s for the good of society, we have a conscience; when it’s for the bottom line, there’s no conscience and that’s celebrated. I have no solutions, only a pervasive anxiety.
- fragmede 2y ago
  Would they? Internal corporate politics says a team's manager, who's going to best know the value the team provides, is not going to declare their team is redundant and fire them and then quit themselves because what they're doing isn't necessary.