No it's not. There is absolutely no way to get from $360B of insurer admin and net cost of insurance to $2.5T --- two point five trillion --- in practitioner costs on paperwork overhead. That is not a plausible argument.

The numbers here are not close. They're stark.

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ceejayoz 2 hours ago | parent [-]

https://news.cornell.edu/stories/2011/08/us-health-care-cost...

> A new study finds that the extra time and labor physician practices spend on interacting with insurance companies and government entities cost U.S. physicians $82,975 each per year, while doctors in Ontario spent $22,205.

> Canadian physicians follow a single set of rules, but U.S. doctors grapple with different sets of regulations, procedures, requirements, formularies and forms mandated by each health insurance plan or payer. The average U.S. doctor spent 3.4 hours per week interacting with health plans; Ontario doctors spent 2.2 hours. The bureaucratic burden falls heavily on U.S. nurses and medical practice staff, who spent 20.6 hours per physician per week on administrative duties; their Canadian counterparts spent only 2.5 hours on paperwork.

All that falls in your $2.5T bucket. And their cleaners, HR, etc. And insurers have had 15 years of innovation since that study.

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tptacek 2 hours ago | parent [-]

You haven't done the math here. Multiply the numbers out. This is what I'm talking about. How are you supposed to engage with these topics if you're literally recoiling from 7th grade arithmetic? Congratulations, taken on your own terms, you just found 3.6% worth of savings from practitioner costs.

My local grocery store wouldn't even bother issuing a coupon for that small a discount.

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ceejayoz an hour ago | parent [-]

This is one example of an aspect where insurance causes costs that are not directly attributable to the insurer in your numbers.

This isn’t seventh grade math. This is kindergarten level cause and effect.

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tptacek an hour ago | parent [-]

Yes, as I said, if we accept your claim at face value, that every dollar of American practitioner-side insurance overhead --- not the delta from Canada, but every single dollar of it --- is mis-spent, you managed to identify 3.6% of the waste in the system. Congratulations.

I said earlier we'd gone round-and-round on this topic before, and I was a little burned out on it, but I didn't expect you to refute your own argument like this. I'm glad we gave it another run this time! This is a great statistic; I'll be using it elsewhere. Thank you.

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ceejayoz an hour ago | parent [-]

Insurance has more than one way to run the costs up; this is but one of them. Weird rebate deals with drug manufacturers. Vertical integration. Buying practices and paying them higher rates.

> I was a little burned out on it

I just did my taxes and am a little burned out by the $49k in healthcare expenses I got to deduct on them.

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tptacek an hour ago | parent [-]

I look forward to the next 3% you find and put on the table!

later

Fun fact: given your background and field, you probably come out significantly ahead of where you'd be in countries with single-payer health care. That's despite the fact that those countries have significantly healthier systems where doctors don't make 3-5x the G20 average and where overprescription and overdelivery isn't as rampant as it is here.

The numbers really do a number on a lot of the narratives people bring to these discussions.

	▲	ceejayoz an hour ago \| parent [-]
		> Fun fact: given your background and field, you probably come out significantly ahead of where you'd be in countries with single-payer health care. Oh, absolutely not. I’ve done the math on that, for sure. Unfortunately, one family member has a condition that makes emigration infeasible.