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What I've come to realize is that bureaucracy costs less than paying patient's medical bills. The idea is this. If you can save US$50M by employing an extra $

by bb88 2y ago

What I've come to realize is that bureaucracy costs less than paying patient's medical bills. The idea is this. If you can save US$50M by employing an extra $1M to increase bureaucracy, why wouldn't you and take the savings as a windfall?

eesmith 2y ago
Except that's not true. The US healthcare system has more bureaucracy and is more expensive, with no overall health benefits and with worse access, than other developed countries. The US pays more per capita for medical care than any other developed country (something like $12,000/person vs. Norway which is next at $8,500/person, https://worldpopulationreview.com/country-rankings/health-care-costs-by-country https://worldpopulationreview.com/country-rankings/health-ca...), but overall health outcomes are not better, and "on the whole it has less access to many health care resources". https://publichealth.jhu.edu/2019/us-health-care-spending-highest-among-developed-countries https://publichealth.jhu.edu/2019/us-health-care-spending-hi... "the United States spends over $1,000 per person on administrative costs — almost five times more than the average of other wealthy countries and more than it spends on long-term healthcare" - https://www.pgpf.org/article/how-does-the-us-healthcare-system-compare-to-other-countries/ https://www.pgpf.org/article/how-does-the-us-healthcare-syst...
- egberts1 2y ago
  It is time to cap the healthcare admin overhead to 10% from supply to patient. Make the middle-man duke 'em out for their own justification to exist.
  - antisthenes 2y ago
    Not this again...Limiting it to a % of something will just make the current system increase costs to the point where 10% becomes enough to continue paying fat checks to all these leeches. It doesn't work.
    - egberts1 2y ago
      Ummm, now that I had time to visualize at macroeconomic level, simple cap at each middleman's transactional behooves the supply chain to conspire on price-fixing just to feed and assist all the middlemen down the line to the patient, as you've asserted. To introduce inter-middleman fighting ensues between favorable price and lower price... Fixing at 1% total for each step along the way doesn't work because one can just add even more middlemen. Fixed 2% price, over entire chain: A competing supplier can easily undercut that downstream conspiratorial bloat.
    - egberts1 2y ago
      Hey. Didn't realize that it was like that child toy that looked like a clear double-lined liquid-gel-filled with sparklers where you squeeze one end and it escapes out bigger at the other end. Thanks! Good catch.
  - eesmith 2y ago
    Okay, but it's under 10% now, at about 8.5%, so that won't change anything. The numbers I gave suggest 2% is what other countries have
- bb88 2y ago
  Right, and where does the money from the bureaucracy go? Administrative costs? Great, you can profit off that too! The more money one can bring in from premiums, and the less they pay out, the more profit. Once they have the money in premiums, it's really hard for the company to let go of them.
  - eesmith 2y ago
    Correct! Hence the need to switch to single-payer healthcare, to get companies out of the system.
piva00 2y ago
Because in healthcare, finance should be just one of the parameters and not the only metric to be accounted for. If you save US$50M from a US$1M bureaucracy which killed 5% more patients, is that worth it in medical terms? Would you be ok if it was one of your loved ones killed by the increased bureaucracy (since inevitably increased bureaucracy creates more chances for people falling into the cracks)? Of course that healthcare as anything else in society needs to find a balanced budget, the outcomes of its failure are the most extreme ones so perhaps it's ok to save less money if it means more lives will be saved, isn't that the whole purpose of living in a society: to live?
- bb88 2y ago
  I'm not arguing against that here. But returning profit to the shareholders is the primary goal of a corporation. Couple that with Upton Sinclair's quote: "It is difficult to get a man to understand something when his salary depends upon his not understanding it", and I think you get to the heart of the problem.

by bb88 2y ago

eesmith 2y ago

Except that's not true. The US healthcare system has more bureaucracy and is more expensive, with no overall health benefits and with worse access, than other developed countries. The US pays more per capita for medical care than any other developed country (something like $12,000/person vs. Norway which is next at $8,500/person, https://worldpopulationreview.com/country-rankings/health-care-costs-by-country https://worldpopulationreview.com/country-rankings/health-ca...), but overall health outcomes are not better, and "on the whole it has less access to many health care resources". https://publichealth.jhu.edu/2019/us-health-care-spending-highest-among-developed-countries https://publichealth.jhu.edu/2019/us-health-care-spending-hi... "the United States spends over $1,000 per person on administrative costs — almost five times more than the average of other wealthy countries and more than it spends on long-term healthcare" - https://www.pgpf.org/article/how-does-the-us-healthcare-system-compare-to-other-countries/ https://www.pgpf.org/article/how-does-the-us-healthcare-syst...

egberts1 2y ago
It is time to cap the healthcare admin overhead to 10% from supply to patient. Make the middle-man duke 'em out for their own justification to exist.
- antisthenes 2y ago
  Not this again...Limiting it to a % of something will just make the current system increase costs to the point where 10% becomes enough to continue paying fat checks to all these leeches. It doesn't work.
  - egberts1 2y ago
    Ummm, now that I had time to visualize at macroeconomic level, simple cap at each middleman's transactional behooves the supply chain to conspire on price-fixing just to feed and assist all the middlemen down the line to the patient, as you've asserted. To introduce inter-middleman fighting ensues between favorable price and lower price... Fixing at 1% total for each step along the way doesn't work because one can just add even more middlemen. Fixed 2% price, over entire chain: A competing supplier can easily undercut that downstream conspiratorial bloat.
  - egberts1 2y ago
    Hey. Didn't realize that it was like that child toy that looked like a clear double-lined liquid-gel-filled with sparklers where you squeeze one end and it escapes out bigger at the other end. Thanks! Good catch.
- eesmith 2y ago
  Okay, but it's under 10% now, at about 8.5%, so that won't change anything. The numbers I gave suggest 2% is what other countries have
bb88 2y ago
Right, and where does the money from the bureaucracy go? Administrative costs? Great, you can profit off that too! The more money one can bring in from premiums, and the less they pay out, the more profit. Once they have the money in premiums, it's really hard for the company to let go of them.
- eesmith 2y ago
  Correct! Hence the need to switch to single-payer healthcare, to get companies out of the system.

piva00 2y ago

Because in healthcare, finance should be just one of the parameters and not the only metric to be accounted for. If you save US$50M from a US$1M bureaucracy which killed 5% more patients, is that worth it in medical terms? Would you be ok if it was one of your loved ones killed by the increased bureaucracy (since inevitably increased bureaucracy creates more chances for people falling into the cracks)? Of course that healthcare as anything else in society needs to find a balanced budget, the outcomes of its failure are the most extreme ones so perhaps it's ok to save less money if it means more lives will be saved, isn't that the whole purpose of living in a society: to live?

bb88 2y ago
I'm not arguing against that here. But returning profit to the shareholders is the primary goal of a corporation. Couple that with Upton Sinclair's quote: "It is difficult to get a man to understand something when his salary depends upon his not understanding it", and I think you get to the heart of the problem.