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| ▲ | dsr_ a day ago | parent | next [-] | | $1 trillion more efficient in allocation of resources, freeing up money for consumer spending on everything. | | |
| ▲ | timcobb a day ago | parent | next [-] | | They don't care about this stuff | | |
| ▲ | hx8 a day ago | parent [-] | | The non-healthcare sectors of the economy do. | | |
| ▲ | timcobb a day ago | parent [-] | | I dunno my perspective is they seem to almost entirely place value on profits today. |
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| ▲ | bean469 a day ago | parent | prev | next [-] | | As long as that does not translate to good short-term profit, the shareholders won't budge | |
| ▲ | johndevor a day ago | parent | prev [-] | | Are you saying the government is an efficient allocator of resources? | | |
| ▲ | no-name-here a day ago | parent | next [-] | | Per the study we are discussing -- as well as the results from every single other developed country I believe? -- more efficient when it comes to healthcare, yes. | | |
| ▲ | johndevor a day ago | parent [-] | | If the government is so efficient, why don't we just have them run all our industries? | | |
| ▲ | no-name-here 19 hours ago | parent [-] | | Because both studies and real-world results from every other developed country show gov is more efficient at healthcare, is your argument that means gov is more efficient in every field? |
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| ▲ | GolfPopper a day ago | parent | prev | next [-] | | The government does not have the peverse incentive of putting private profit above all other concerns. | | |
| ▲ | consensus1 a day ago | parent | next [-] | | The perverse incentive of the politician / general / bureaucrat to favor their personal interest over the public interest is identical to the perverse incentive of the CEO to favor his personal interest over the same. I would argue the government case is actually much worse because at least the CEO has the feedback mechanism of revenue because the company <> customer relationship is entirely voluntary on both sides. The public vote is supposed to restrain the government in the same way, but in practice it seems to be much less effective in restraining politicians than the customer is at restraining companies. | |
| ▲ | johndevor a day ago | parent | prev [-] | | The government is just corrupt politicians and lobbyists. You're fighting to give them more money and power. | | |
| ▲ | jkestner a day ago | parent | next [-] | | The government is more directly accountable to me. The only way I have to influence what insurance companies do is through the government. | | |
| ▲ | johndevor a day ago | parent [-] | | You can switch insurance companies, no? | | |
| ▲ | kentm 3 hours ago | parent | next [-] | | In many cases, no. | |
| ▲ | bcrosby95 a day ago | parent | prev | next [-] | | I can if I want to switch jobs too. Probably not a good idea given the current economic conditions. I'd be all for forcing a decoupling of these things, but I don't see that anywhere on the table, and it would probably run afoul of politics anyways. | |
| ▲ | preg_match 6 hours ago | parent | prev [-] | | No, you can’t. |
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| ▲ | bean469 a day ago | parent | prev [-] | | Sounds like a Ron Swanson quote |
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| ▲ | grim_io a day ago | parent | prev | next [-] | | If that wasn't the case, DOGE would have found any waste worth looking at. It was not for a lack of motivation or a lack of cut-throat pursuit, consequences be damned. | |
| ▲ | bobson381 a day ago | parent | prev | next [-] | | it's that it's 1 Trillion less in incentivized middlemen. A la Graeber. | |
| ▲ | a day ago | parent | prev | next [-] | | [deleted] | |
| ▲ | a day ago | parent | prev [-] | | [deleted] |
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| ▲ | RajT88 a day ago | parent | prev | next [-] | | $1 trillion less middle-men. | |
| ▲ | ovi256 a day ago | parent | prev | next [-] | | Not profit, just income | | |
| ▲ | secabeen a day ago | parent [-] | | And most of that income is salaries to existing healthcare administrators. Quickly ending the employment of the people working those jobs would be a significant shock. |
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| ▲ | cityofdelusion a day ago | parent | prev | next [-] | | Not really. Private health insurance would still exist alongside for the more wealthy (including nearly everyone on HN) that doesn’t want to wait a year for their public system MRI. Same thing that plays out in other countries. The U.S. already has a form of this in so-called concierge / premium providers too. Lots of profit to be made. | | |
| ▲ | intuitionist a day ago | parent | next [-] | | This isn’t true of the Medicare for All Act, for what it’s worth. That would ban private insurance altogether. Personally I think that’s a bug, not a feature, but if you’re very concerned with fairness then you probably think the opposite. | |
| ▲ | kennywinker a day ago | parent | prev | next [-] | | Having the machine capacity to get non-urgent MRIs in hours is part of why US healthcare is so expensive. Anyway, the average (again for non-urgent MRIs) where I live in canada is 9 weeks, which is i am sure skewed due to the rural population. In the city it’s like half that. | | |
| ▲ | strictnein a day ago | parent [-] | | Yep, in the US my wife had to wait a day. She could have gotten it the same day, had her injury been a little worse. There's this idea that there are no upsides to the American system, only downsides. |
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| ▲ | loeg a day ago | parent | prev | next [-] | | If private health insurance was allowed, UHC would be stillborn. It only works if providers don't have better options than medicare reimbursement rates. | | |
| ▲ | no-name-here a day ago | parent | next [-] | | > It only works if providers don't have better options than medicare reimbursement rates. 1. A number of other developed countries have UHC while also allowing a private system as well - what is unique about the US that other countries' existing approach couldn't work here? 2. Less importantly, in this world where everyone has medicare, but a smaller fraction have private coverage, your argument is that the existing healthcare providers would choose to give up most of their (medicare) patients? If so, why wouldn't providers choose to stop serving medicare patients under the pre-2026 system, where giving up medicare patients would be a far smaller loss than in a world where everyone has medicare? | | |
| ▲ | maxlybbert a day ago | parent [-] | | > 1. A number of other developed countries have UHC while also allowing a private system as well - what is unique about the US that other countries' existing approach couldn't work here? Mainly, expectations. I understand that UHC in European countries doesn’t cover all the things Americans assume it does. Japan apparently keeps costs down by not using cutting-edge drugs. That’s not going to happen in the US. The US Congress just isn’t good at keeping costs down. > 2. ... why wouldn't providers choose to stop serving medicare patients under the pre-2026 system, where giving up medicare patients would be a far smaller loss than in a world where everyone has medicare? They absolutely do. Many providers don’t accept Medicare. Very few providers accept Medicaid. The payments just aren’t high enough. | | |
| ▲ | no-name-here 16 hours ago | parent [-] | | The US is dead last in terms of health outcomes among every developed country (despite spending far more), but you believe expectations will cause every other developed country's system to fail here? I guess your argument is that the propaganda machine pushing the idea that America's healthcare is not the worst in terms of outcomes (while also being about the most expensive), would prevent Americans from accepting no longer having the worst results and the highest costs? > Many providers don’t accept Medicare. Very few providers accept Medicaid. 1. About the same percent accept Medicare as private insurance (85-90%, while ~70% accept Medicaid - is that "very few"?). 2. "Medicare for all" is one of the primary proposals being discussed. 3. Previous smaller expansions of government healthcare resulted in expanded provider capacity to handle them, not less, but your argument is that we'd see the opposite results from further expansion? 4. And in this new world where everyone had Medicare or similar, your argument is that providers would choose to ignore most patients, where they don't under the existing system where government-sponsored healthcare makes up a significantly smaller portion of the customer base? 5. And your argument is that if the government finds that healthcare providers contract to the point that outcomes remain the worst among every developed country, as they are today, that the government would be unwilling to make any changes (such as reimbursement rates) to address this? | | |
| ▲ | SpicyLemonZest 3 hours ago | parent [-] | | > The US is dead last in terms of health outcomes among every developed country (despite spending far more), but you believe expectations will cause every other developed country's system to fail here? I guess your argument is that the propaganda machine pushing the idea that America's healthcare is not the worst in terms of outcomes (while also being about the most expensive), would prevent Americans from accepting no longer having the worst results and the highest costs? The argument is that the US system has a much lower floor, which leads to the bad health outcomes, but also generates a lot of people who expect and demand more than most universal healthcare systems would give them. An Uber driver with the cheapest marketplace plan he could find would benefit greatly from any universal healthcare system; a guy with really bad ulcerative colitis (https://www.propublica.org/article/unitedhealth-healthcare-i...) would likely not be able to get a prescription for a cocktail of drugs at non-FDA-approved doses costing $2M/year. |
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| ▲ | a-posteriori a day ago | parent | prev [-] | | What are you proposing happens to providers who freely contract with patients at rates above Medicare reimbursement? |
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| ▲ | a day ago | parent | prev [-] | | [deleted] |
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| ▲ | consensus1 a day ago | parent | prev | next [-] | | Total profits for US health insurance companies in 2025 were $50 billion. The other $950 billion has got to come from cutting: 1. money to providers 2. overall healthcare consumption 3. bureaucratic redundancy and waste 1 is going to piss off medical providers. 2 is going to piss of the general public. 3 is going to piss off the 20 million healthcare industry workers who are not direct care providers. So pick your poison. This is why it will never pass. | | |
| ▲ | Hikikomori a day ago | parent | next [-] | | And overhead of running the insurance company like salary and office, then wasted time for doctors. | |
| ▲ | chaps a day ago | parent | prev [-] | | Have you ever dared to dream of something that sounds impossible but isn't? | | |
| ▲ | gadflyinyoureye a day ago | parent [-] | | The average Georgian plumber has higher purchasing power than the average German doctor. In order for the United States to balance its medical books, doctors will have to be paid dramatically less than they are at present. Perhaps there’s a deal to be made where doctors take the hit, but all of their debt is paid off by the state. Going forward medical school is free, but like in Germany you have to qualify, I mean really qualify to even get your foot in the college door. That’s an expectation change for the United States population on all fronts. We don’t do well with expectation changes. | | |
| ▲ | chaps a day ago | parent [-] | | Yeah, a lot of these issues are felt in other fields too so it feels like there's a need for a larger, wider schism. Like I would love to go to law school but I can't afford it. So many possible but inherently unattainable futures. We'll get there. | | |
| ▲ | nradov 20 minutes ago | parent [-] | | You can afford to go to law school if you're willing to prioritize it and make some sacrifices. There are plenty of law schools that have part time night or online options. Take one class at a time and you'll eventually get through. |
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| ▲ | garbawarb a day ago | parent | prev [-] | | That would be a massive hit to our GDP. | | |
| ▲ | bensyverson a day ago | parent | next [-] | | Just think about the boost to our GDP by having healthier consumers who live longer, don't go into medical bankruptcy, and continue to buy stuff. | |
| ▲ | karakoram a day ago | parent | prev | next [-] | | In all seriousness, this would be a massive stimulus to the economy. Americans are consumers at heart. All the money saved on insurance and/or other healthcare related costs would then be spent elsewhere. Cars, clothes, TVs, Labubu dolls. People will use the savings to buy things. In massive quantities. | | |
| ▲ | arkh a day ago | parent | next [-] | | There is also some indirect bonus: if people's healthcare is not tied to their employer then it's easier to look for a new one. Also if the system is done well, then many companies would lose the incentives they currently have for not giving full-time employment. | |
| ▲ | garbawarb a day ago | parent | prev [-] | | Some would, but some would just put that money into savings and investments instead. | | |
| ▲ | DerArzt a day ago | parent [-] | | From a retirement standpoint I keep hearing that not enough Americans are saving for retirement, so this would still be a win for me. |
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| ▲ | triceratops a day ago | parent | prev | next [-] | | Not necessarily, over the long-term. That's $1 trillion more in disposable income. | |
| ▲ | ovi256 a day ago | parent | prev | next [-] | | Not at all. Reducing a cost means the payer can spend the money on something else | |
| ▲ | oa335 a day ago | parent | prev | next [-] | | https://en.wikipedia.org/wiki/Parable_of_the_broken_window | |
| ▲ | dgellow a day ago | parent | prev | next [-] | | Are you implying you would decide to sacrifice citizens health for a few GDP points, a somewhat useful but oversimplified metric that doesn’t reflect anything tangible? | |
| ▲ | brainwad a day ago | parent | prev | next [-] | | Presumably not; the same national income would just be redistributed from shareholders to insurees (or shareholders of companies that pay for employee health insurance). | |
| ▲ | nemomarx a day ago | parent | prev [-] | | Think of all the insurance jobs that would be hit, too. Unfortunately we've bloated the healthcare industry to have a lot of employees | | |
| ▲ | panzagl a day ago | parent [-] | | Somehow I doubt there would be fewer jobs in healthcare if the government takes it over. |
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