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My hope, perhaps naive, is that 95% of what happens in this Rube Goldberg machine basically amounts to the government paying private insurance companies to pay

My hope, perhaps naive, is that 95% of what happens in this Rube Goldberg machine basically amounts to the government paying private insurance companies to pay doctors, which is inefficient but ultimately straightforward.

potato3732842 1y ago
>which is inefficient but ultimately straightforward. That's an understatement on the order of saying WW2 was a rebalancing of geopolitical power. Healthcare is what? 20% of GPD. Likely half of that is paper pushing compliance checking rubber stamping that likely ought not to exist.
- pjc50 1y ago
  Unfortunately there's a fraud problem, NOT by patients but by various entities claiming for unnecessary or never-performed procedures. https://pubmed.ncbi.nlm.nih.gov/25068880/ https://pubmed.ncbi.nlm.nih.gov/25068880/
- getnormality 1y ago
  I was going to push back against this, but when I googled "what percent of American health care is administrative costs" I got back numbers ranging from 15-34%, which is pretty darn high. Much higher than the last number I heard, which was something like 8%. The factor of two variance is kind of disturbing in itself.
  - zdw 1y ago
    All this means is that for insurance companies to maximize their administrative costs they push up the overall price - from their perspective making 10% of $10M is way better than 10% of $5M.
    - potato3732842 1y ago
      Drives me up the wall that the same people who can correctly identify when nominal nonprofits like rich people's charity organizations universities or even hospitals are pissing away money on officer salaries, perks, facilities, etc. because "nonprofit" think that somehow being a 10% or X% profit capped organization can't do the same thing with whatever expenses they aren't capped on.
  - orwin 1y ago
    In my country, social security and universal healthcare administrative cost are 8-11% depending on the year. Compare that to Swisslife, my previous private healthcare insurance: for every 100€ I gave them, 66-72€ were paid to insure in need while I had them. Of course the mandatory dividends were pretty high before COVID, and reinvestment/marketing/sales has to take a bite of that, so perhaps only half of the 30% they take from customers are admin costs, but still, I'd rather give more to my country national healthcare if I could. Probably the variance you have could be caused by non-admin costs being counted as admin costs.
- dgfitz 1y ago
  According to: https://fiscaldata.treasury.gov/americas-finance-guide/federal-spending/ https://fiscaldata.treasury.gov/americas-finance-guide/feder... 22 % Social Security 14 % Net Interest 14 % Medicare 13 % Health 13 % National Defense 10 % Income Security 5 % Veterans Benefits and Services 2 % Education, Training, Employment, and Social Services 2 % Transportation 1 % Natural Resources and Environment 3 % Other
  - bpt3 1y ago
    That's the budget of the federal government, which thankfully isn't 100% of GDP.

potato3732842 1y ago

>which is inefficient but ultimately straightforward. That's an understatement on the order of saying WW2 was a rebalancing of geopolitical power. Healthcare is what? 20% of GPD. Likely half of that is paper pushing compliance checking rubber stamping that likely ought not to exist.

pjc50 1y ago
Unfortunately there's a fraud problem, NOT by patients but by various entities claiming for unnecessary or never-performed procedures. https://pubmed.ncbi.nlm.nih.gov/25068880/ https://pubmed.ncbi.nlm.nih.gov/25068880/
getnormality 1y ago
I was going to push back against this, but when I googled "what percent of American health care is administrative costs" I got back numbers ranging from 15-34%, which is pretty darn high. Much higher than the last number I heard, which was something like 8%. The factor of two variance is kind of disturbing in itself.
- zdw 1y ago
  All this means is that for insurance companies to maximize their administrative costs they push up the overall price - from their perspective making 10% of $10M is way better than 10% of $5M.
  - potato3732842 1y ago
    Drives me up the wall that the same people who can correctly identify when nominal nonprofits like rich people's charity organizations universities or even hospitals are pissing away money on officer salaries, perks, facilities, etc. because "nonprofit" think that somehow being a 10% or X% profit capped organization can't do the same thing with whatever expenses they aren't capped on.
- orwin 1y ago
  In my country, social security and universal healthcare administrative cost are 8-11% depending on the year. Compare that to Swisslife, my previous private healthcare insurance: for every 100€ I gave them, 66-72€ were paid to insure in need while I had them. Of course the mandatory dividends were pretty high before COVID, and reinvestment/marketing/sales has to take a bite of that, so perhaps only half of the 30% they take from customers are admin costs, but still, I'd rather give more to my country national healthcare if I could. Probably the variance you have could be caused by non-admin costs being counted as admin costs.
dgfitz 1y ago
According to: https://fiscaldata.treasury.gov/americas-finance-guide/federal-spending/ https://fiscaldata.treasury.gov/americas-finance-guide/feder... 22 % Social Security 14 % Net Interest 14 % Medicare 13 % Health 13 % National Defense 10 % Income Security 5 % Veterans Benefits and Services 2 % Education, Training, Employment, and Social Services 2 % Transportation 1 % Natural Resources and Environment 3 % Other
- bpt3 1y ago
  That's the budget of the federal government, which thankfully isn't 100% of GDP.