4 ms·

I have good news! If you move it to the public sector, you will effectively pay doctors less money for the same work. That's because the way it works currently

I have good news! If you move it to the public sector, you will effectively pay doctors less money for the same work. That's because the way it works currently is that the doctors have to deal with private insurance bureaucracy. By freeing them from this responsibility, they have more time to take care of patients, which should effectively gets you more medical bang for your buck.

onlyrealcuzzo 2y ago
You're describing the federal system being massively more efficient - which is theoretically possible - but rarely happens in practice.
- dangus 2y ago
  It is already established fact that Medicare is more efficient than private insurance. https://www.healthaffairs.org/do/10.1377/forefront.20110920.013390/ https://www.healthaffairs.org/do/10.1377/forefront.20110920....
  - onlyrealcuzzo 2y ago
    Assuming that your numbers are correct: You eliminate ~1.2% of total healthcare spending on private insurance profits. Then you eliminate ~37% of ~14% of ~27% total healthcare spending on insurance labor costs = ~1.5%. * Article states medicare is ~37% more efficient. * Insurance companies are required to spend AT LEAST 80% of premiums on actual patient care (~6% of the remaining ~20% are profits - already taken out in the previous ~1.2% of total health care spending). * ~27% of total US healthcare spending is on private insurance premiums. You end up with ~2.7% cheaper healthcare in the ABSOLUTE best case. That's not moving the needle.
    - FireBeyond 2y ago
      You are absolutely ignoring the fact that you don't just get cheaper care (and lets also remember that spending is inflated by the bullshit of insurance "negotiation"), but oh, now everyone has healthcare, not just those employed with a decent employer who provides it.
    - dangus 2y ago
      - That literally moves the needle. You don't want your healthcare to cost 2.7% cheaper? If you were buying a TV and Best Buy sold it for $1000 but Costco sold it for $973 you wouldn't buy it from Costco? - Insurance companies being required to spend at least 80% of premiums on patient care logically incentivizes them to keep patient care costs high, because if costs go down then profit goes down. If your MRI costs $1000 then the insurance company is allowed to make $200 in profit. If your MRI costs $2000 then the insurance company doubles their profit to $400. - Removing private insurance would give public healthcare far more negotiating power on costs. While there is a limit to profit margins made by insurance companies, there is no limit to the profit margins made by medical suppliers, pharmaceudicals, etc. - Removing non-paying patients would reduce prices charged by hospitals. Hospitals are essentially sub-prime lenders making loans out where no assets are involved. They have to charge insurance companies more money to cover everyone else who doesn't pay. Moving to healthcare paid for automatically completely removes the issue of unpaid bills, collections, medical bankruptcies (how much do the salaries of bankruptcy courts, judges, lawyers remove from the healthcare system?). - You're arguing against the established fact that all other countries besides the United States spend less on care. If the United States tried anything else it would be likely to reduce costs.
- craigmccaskill 2y ago
  The federal system already runs a much more efficient enterprise as evidenced in medicare and medicade since their establishment in the 60s.
- snailmailstare 2y ago
  It seems to me like centralized governments have had a rise that whether impressive or just typical of an average country, was thought to be impossible for them. Couldn't the past performance be down to the absurd costs of data collection and management in the past and the lack of scaling benefit when centralizing gigaflops of secretaries or the costs of doubling a very small number of bytes of information on every household at that time?

onlyrealcuzzo 2y ago

You're describing the federal system being massively more efficient - which is theoretically possible - but rarely happens in practice.

dangus 2y ago
It is already established fact that Medicare is more efficient than private insurance. https://www.healthaffairs.org/do/10.1377/forefront.20110920.013390/ https://www.healthaffairs.org/do/10.1377/forefront.20110920....
- onlyrealcuzzo 2y ago
  Assuming that your numbers are correct: You eliminate ~1.2% of total healthcare spending on private insurance profits. Then you eliminate ~37% of ~14% of ~27% total healthcare spending on insurance labor costs = ~1.5%. * Article states medicare is ~37% more efficient. * Insurance companies are required to spend AT LEAST 80% of premiums on actual patient care (~6% of the remaining ~20% are profits - already taken out in the previous ~1.2% of total health care spending). * ~27% of total US healthcare spending is on private insurance premiums. You end up with ~2.7% cheaper healthcare in the ABSOLUTE best case. That's not moving the needle.
  - FireBeyond 2y ago
    You are absolutely ignoring the fact that you don't just get cheaper care (and lets also remember that spending is inflated by the bullshit of insurance "negotiation"), but oh, now everyone has healthcare, not just those employed with a decent employer who provides it.
  - dangus 2y ago
    - That literally moves the needle. You don't want your healthcare to cost 2.7% cheaper? If you were buying a TV and Best Buy sold it for $1000 but Costco sold it for $973 you wouldn't buy it from Costco? - Insurance companies being required to spend at least 80% of premiums on patient care logically incentivizes them to keep patient care costs high, because if costs go down then profit goes down. If your MRI costs $1000 then the insurance company is allowed to make $200 in profit. If your MRI costs $2000 then the insurance company doubles their profit to $400. - Removing private insurance would give public healthcare far more negotiating power on costs. While there is a limit to profit margins made by insurance companies, there is no limit to the profit margins made by medical suppliers, pharmaceudicals, etc. - Removing non-paying patients would reduce prices charged by hospitals. Hospitals are essentially sub-prime lenders making loans out where no assets are involved. They have to charge insurance companies more money to cover everyone else who doesn't pay. Moving to healthcare paid for automatically completely removes the issue of unpaid bills, collections, medical bankruptcies (how much do the salaries of bankruptcy courts, judges, lawyers remove from the healthcare system?). - You're arguing against the established fact that all other countries besides the United States spend less on care. If the United States tried anything else it would be likely to reduce costs.
craigmccaskill 2y ago
The federal system already runs a much more efficient enterprise as evidenced in medicare and medicade since their establishment in the 60s.
snailmailstare 2y ago
It seems to me like centralized governments have had a rise that whether impressive or just typical of an average country, was thought to be impossible for them. Couldn't the past performance be down to the absurd costs of data collection and management in the past and the lack of scaling benefit when centralizing gigaflops of secretaries or the costs of doubling a very small number of bytes of information on every household at that time?