Study says single-payer health system would save $450B and 68,000 lives annually

[Anya Ristow]

America's resistance to free healthcare is one of the world's greatest mysteries.

David Doel, the Rational National guy on youtube, is Canadian. He mentions this often. He says healthcare isn't something he ever thinks about. Taken for granted, easy to deal with when he needs it, free at the point of care, hardly any paper work, never a surprise bill.

But it's no mystery. Wendell Potter, former insurance exec, says the talking points used to propagandize Americans, by the media, Republicans and Democrats, comes from the insurance industry. He used to write these talking points.

 

[Anya Ristow]

America's had 60 years of runaway physician's income inflation for the high end doctors and they will revolt I bet.

Possibly, but note that while it is said that Canada spends 1/2 per capita on health care as the USA, the cost projection of adopting the Canadian system is much more modest. Possibly because it assumes health care will still be more expensive in the USA for various Americanisms, like the preference for specialization in doctors, and high legal costs.

 

[GoblinCampFollower]

Doctor income is nearly meaningless to what you pay. Say every single doctor you see makes 300k a year, which I doubt. Given they hardly put in standard 40 hr weeks the cost after whatever increases the hospital uses is around 100 per hour. The average person probably spends an hour or so with a dr per year as most of your time in an office is with lower paid peeps or just waiting. That is with no health care system at all.

Not your fault for missing it, it is a common stats problem. People automatically focus on the single outliers rather than the relevant averages.

You are badly misrepresenting what I said. I didn't say every single doctor makes that much. PCP's in particular make a lot less on average, But as a matter of fact, the average doctor is up to 313k a year ( Complete List of Average Doctor Salaries by Specialty [Updated!] - Nomad Health ) . Some fields make less, and some make a lot more than that. You had better believe that's a major factor in overall healthcare costs. It's not the only driver, but you are overstating your case saying 300k a year is "nearly meaningless."

I also never said that was the only driver of massive healthcare costs. What we pay for equipment and drugs is also a major issue that I also mentioned in my post.

...I wasn't trying to say Doctor pay was the main driver of healthcare costs, just a driver, but holy cow, check out that link. They make more than I even thought they did when I made that post.

 

[Veritable Quandry]

It is also a major reason we can't have nice things. The US has a large number of specialists and a shortage of PCPs. Our healthcare system is designed on the assumption that not everyone has access, and that is reflected in the way medical students chose specializations. We would need to retrain specialists for lower paying positions, increase enrollment in medical schools that are frankly a crap system for training doctors the way residencies work in the US (long shifts for low wages), and bring in a bunch of doctors from other countries until we can train more.

 

[Kamilah Hauptmann]

Possibly, but note that while it is said that Canada spends 1/2 per capita on health care as the USA, the cost projection of adopting the Canadian system is much more modest. Possibly because it assumes health care will still be more expensive in the USA for various Americanisms, like the preference for specialization in doctors, and high legal costs.

They'll need to be or you'll have the revolt I mentioned in the same post. You might still have that revolt.

Also in the same post I mentioned Canadian doctors run to the USA for Money, dead Presidents, moolah, wampum. I didn't mention research opportunities but that too. What regulating it into a central billing system and fee schedule will do is slow the inflation of medical fees paid.

But the topic is the extra layers of bureaucracy in the American system. And holy shit some of those numbers.

nb: I worked ten years in Canadian third party medical insurance.

 

[Kamilah Hauptmann]

Oh hey a thing.

When Medical Debt Collectors Decide Who Gets Arrested

Welcome to Coffeyville, Kansas, where the judge has no law degree, debt collectors get a cut of the bail, and Americans are watching their lives — and liberty — disappear in the pursuit of medical debt collection.

features.propublica.org

 

[Brenda Archer]

I just hope M4A will include basic dental without imposing a cost that puts it out of reach for the poor. People forget that bad dental health can lead to serious medical problems like heart disease.

 

[Zaida Gearbox]

Keeping in mind that I'm extremely biased because I work for a medicare supplement company, but Advantage plans (medicare C) seem like a big fucking scam to me. Most of them are HMO's meaning you have to deal with networks and shit, and if you happen to be a person who likes to or needs to travel - well, fuck you. Plus, you cannot have a supplement if you have an advantage plan. Medicare supplements supplement traditional Medicare A & B only. The only good thing about then that I can see is having your drug and health coverage with the same company and maybe the glasses/dental/hearing coverage that traditional medicare does not offer. But, since you can now buy stand alone vision and dental...… I mean I meant to sign up for stand alone vision insurance this year because the vision coverage I have through work is a fucking joke.

Brenda said:
I just hope M4A will include basic dental without imposing a cost that puts it out of reach for the poor. People forget that bad dental health can lead to serious medical problems like heart disease.

Traditional medicare does not cover dental. Many of the advantage plans do, but I've had an awful lot of insured's switch from us to an Advantage plan then switch back as soon as they were able because they found the advantage plan to be a giant pain in the ass. It's so common that it's now a law that if someone switches from traditional medicare and a supplement to an advantage plan and then realizes they fucked up within 12 months - we have to take them back.

 

[Rose Karuna]

America's resistance to free healthcare is one of the world's greatest mysteries.

I think it's because debt collectors, attorneys, court systems, insurance companies and other scammers invest heavily in misleading advertising because they are making money hand over fist on peoples suffering.

I wanted to throw something across the room when I read this: When Medical Debt Collectors Decide Who Gets Arrested

And it's not just in Kansas.

The article is a long but worthy read. A snippet:

Before she had taken this position, during her second pregnancy, her right breast had developed a chronic infection. In 2008, she was uninsured, needed surgery to remove the swollen abscess and ran up a $2,514 bill. More than a decade later, she was still chipping away at a balance that, because of interest and court fees, had more than doubled to $5,736. She had fallen behind on her monthly payment plan and now worried that her booking photo would be on Mugshot Monday, a Facebook album run by the Police Department. She imagined what she would tell her boss: I went to jail … because I missed a court date … for medical bills. It sounded absurd.

Debt collection is an $11 billion industry, involving nearly 8,000 firms across the country. Medical debt makes up almost half of what’s collected each year. Today, millions of debt collection suits are overwhelming state courts. The practice is considered a “race of the diligent,” where every creditor is rushing to the courthouse, hustling to get the first judgment, in order to be the first to collect on a debtor’s assets. In Hassenplug’s view, though, this work is not the rich taking from the poor. He laughed at how locals spread rumors, saying that he seized wheelchairs or Christmas trees. Once, he confessed, he took a man’s Rolex, only to find out it was a fake. Some months, he said, even his law office could not make ends meet.

They are parasites sucking people dry. They put them in situations that they will never be able to recover from financially no matter how many jobs they work. It is beyond disgusting.

 

[Brenda Archer]

Keeping in mind that I'm extremely biased because I work for a medicare supplement company, but Advantage plans (medicare C) seem like a big fucking scam to me. Most of them are HMO's meaning you have to deal with networks and shit, and if you happen to be a person who likes to or needs to travel - well, fuck you. Plus, you cannot have a supplement if you have an advantage plan. Medicare supplements supplement traditional Medicare A & B only. The only good thing about then that I can see is having your drug and health coverage with the same company and maybe the glasses/dental/hearing coverage that traditional medicare does not offer. But, since you can now buy stand alone vision and dental...… I mean I meant to sign up for stand alone vision insurance this year because the vision coverage I have through work is a fucking joke.

Brenda said:
I just hope M4A will include basic dental without imposing a cost that puts it out of reach for the poor. People forget that bad dental health can lead to serious medical problems like heart disease.

Traditional medicare does not cover dental. Many of the advantage plans do, but I've had an awful lot of insured's switch from us to an Advantage plan then switch back as soon as they were able because they found the advantage plan to be a giant pain in the ass. It's so common that it's now a law that if someone switches from traditional medicare and a supplement to an advantage plan and then realizes they fucked up within 12 months - we have to take them back.

It’s very unlikely M4A is going to look just exactly like the kinds of plans we have now.

Going from good corporate-job insurance to Medicare would seem like a step down, but you have to be able to pay a higher level of cost sharing with the insurance from employment.

I’m going this spring from Medicaid to Medicare and Medicare Advantage, so this will be an improvement for me. I don’t expect to be traveling.

Not many people have that good corporate job related insurance. A lot of people are blocked from care by high deductibles and cost sharing, or they’re in the gap between Medicaid and a decent ACA plan and have nothing. Medicare 4 All can help these people. It’s really unlikely that supplemental insurance for extras (like travel) for those who can still afford it, will be banned. Certainly if you can afford entertainment or business travel you can afford a supplemental insurance.

 

[Zaida Gearbox]

I have "good corporate job related insurance" as you put it, and switching to just straight Medicare would be a big step up - especially if we still have the option to purchase a supplement - and guess what? It wouldn't be any more than what we pay now anyway.

 

[Beebo Brink]

They are parasites sucking people dry. They put them in situations that they will never be able to recover from financially no matter how many jobs they work. It is beyond disgusting.

Beyond the immorality of preying on people who have nothing left to give, we end up creating even more problems. People who lose their houses and become homeless are putting yet more strain on our systems. Far better for the country to keep people housed in the first place, often working at a job. Not to mention the stress of medical debt increasing the health problems they already have.

 

[Kamilah Hauptmann]

I just hope M4A will include basic dental without imposing a cost that puts it out of reach for the poor. People forget that bad dental health can lead to serious medical problems like heart disease.

I'd like that here. Having a mouthful of teeth is a (smaller) wealth marker.

 

[Aeon Jiminy]

I just hope M4A will include basic dental without imposing a cost that puts it out of reach for the poor. People forget that bad dental health can lead to serious medical problems like heart disease.

Amen. This is also something affects younger people. It's easy to let those dental check-ups slide when you are young and without much disposable income. You never get that time back. Teeth and gums are very unforgiving. It's interesting how the health insurance companies decided that eyes and teeth were second class parts of the human body. I wonder why they just didn't decide to exclude the entire head?

 

[danielravennest]

You are badly misrepresenting what I said. I didn't say every single doctor makes that much. PCP's in particular make a lot less on average, But as a matter of fact, the average doctor is up to 313k a year ( Complete List of Average Doctor Salaries by Specialty [Updated!] - Nomad Health ) . Some fields make less, and some make a lot more than that. You had better believe that's a major factor in overall healthcare costs.

There are about 860,000 active doctors in the US. Times the average income you mentioned, that comes to $269 billion/year. Total health care spending is about $3.9 trillion. So doctors account for 7%. Most of the cost is elsewhere.

 

[Brenda Archer]

Amen. This is also something affects younger people. It's easy to let those dental check-ups slide when you are young and without much disposable income. You never get that time back. Teeth and gums are very unforgiving. It's interesting how the health insurance companies decided that eyes and teeth were second class parts of the human body. I wonder why they just didn't decide to exclude the entire head?

Until the recent push to equally insure mental health, one could say that they did. It’s still not equal in practice, all at the same time that neuroscience is proving the physical nature of many brain problems. This is a particular threat to the religious grifters who make mental illness a religious problem, or the authoritarians who make it a character problem.

 

[Brenda Archer]

I'd like that here. Having a mouthful of teeth is a (smaller) wealth marker.

This must have an effect on people who would like to take jobs that require a customer facing appearance, or office jobs that require a dress code or just fitting in with middle class people.

 

[Anya Ristow]

 

[GoblinCampFollower]

There are about 860,000 active doctors in the US. Times the average income you mentioned, that comes to $269 billion/year. Total health care spending is about $3.9 trillion. So doctors account for 7%. Most of the cost is elsewhere.

I never said inflated doctor salaries were a majority of costs, but do admit I was overestimating it's portion of the total. Though 7% isn't trivial... Real cost cutting measures would cut into that, and all sorts of other things of course.

 

[Chin Rey]

USA spends about 10,000 USD a year per capita on health care.
Norway spends about 7,000 USD a year per capita on health care.
The Norwegian health care system is vastly superior to the US since it offers top quality service to everybody, not just the rich few.

I think that says it all.