Although health care expenditure per capita is higher in the USA than in any other country, more than 37 million Americans do not have health insurance, and 41 million more have inadequate access to care. Efforts are ongoing to repeal the Affordable Care Act which would exacerbate health-care inequities. By contrast, a universal system, such as that proposed in the Medicare for All Act, has the potential to transform the availability and efficiency of American health-care services. Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017). The entire system could be funded with less financial outlay than is incurred by employers and households paying for health-care premiums combined with existing government allocations. This shift to single-payer health care would provide the greatest relief to lower-income households. Furthermore, we estimate that ensuring health-care access for all Americans would save more than 68 000 lives and 1·73 million life-years every year compared with the status quo.
pieman7414 on February 15th, 2020 at 18:47 UTC »
here is the link https://imgur.com/a/du4CTxs
dumbledorito on February 15th, 2020 at 16:57 UTC »
I guess the question is who isn’t going to get paid $450 billion. Is it medical workers, hospitals, insurance companies, etc? I’m genuinely curious, because If hospitals make less money will they lay off workers or pay them less?
MagiKKell on February 15th, 2020 at 15:30 UTC »
Serious question: The study assumes that expanding to single-payer healthcare would work just like medicare. But medicare exists in the context of an insurance market where there is some competition and market pressure to adjust prices. For example, if a hospital started charging a lot more for some procedure than other hospitals they might be dropped from the "network" of some insurance carriers. Hence, the prices medicare pays for procedures is somewhat adjusted by what those same procedures cost on the free market.
However, if we have a single payer system, who decides on the prices? Will healthcare providers be able to charge whatever they want? Or, will the government set the prices and that's what providers get.
In the first case, what prevents a hospital from just milking the system to charge whatever they want? On the second option, what the hospital gets paid is completely unrelated to the quality of service or other investments, so there is never a financial incentive to invent new procedures or upgrade facilities. In fact, the only incentive for a hospital would be to cut costs as much as possible since a flat payment would be paid regardless of whether you have a 1-hour or a 10-hour wait to treat someone in the ER.
Obviously healthcare is far from a perfect market, but without zero market pressures, how will this system prevent terrible inefficiencies?
Edit: Thanks for those awesome replies! The day has come where I get to say RIP my inbox. I read all of it but likely won’t be able to respond. Maybe some time later I can read through the down-thread responses. I’ve learned a lot more about the system and the ideas, but I’m still not sure who is ultimately right.