Why Single-Payer Health Care Saves Money

[applegrove]

By ROBERT H. FRANK at the NY Times

https://www.nytimes.com/2017/07/07/upshot/why-single-payer-health-care-saves-money.html?smid=tw-nytimes&smtyp=cur&_r=0

"SNIP............


Sometimes described as Medicare for all, single-payer is a system in which a public agency handles health care financing while the delivery of care remains largely in private hands.

Discussions of the California measure have stalled, however, in the wake of preliminary estimates pegging the cost of the program as greater than the entire state government budget. Similar cost concerns derailed single-payer proposals in Colorado and Vermont.

Voters need to understand that this cost objection is specious. That’s because, as experience in many countries has demonstrated, the total cost of providing health coverage under the single-payer approach is actually substantially lower than under the current system in the United States. It is a bedrock economic principle that if we can find a way to do something more efficiently, it’s possible for everyone to come out ahead.

By analogy, suppose that your state’s government took over road maintenance from the county governments within it, in the process reducing total maintenance costs by 30 percent. Your state taxes would obviously have to go up under this arrangement.

But if roads would be as well maintained as before, would that be a reason to oppose the move? Clearly not, since the resulting cost savings would reduce your county taxes by more than your state taxes went up. Likewise, it makes no sense to oppose single-payer on the grounds that it would require additional tax revenue. In each case, the resulting gains in efficiency would leave you with greater effective purchasing power than before.

.............SNIP"

[NobodyHere]

1. What we need is a state to prove it

[wasupaloopa]

2. I like single payer but this article does not

give any evidence of savings.

Medicare is not free. We all pay for part A through payroll deductions. The individual insured pays for part B and part D and a suplimental.

So Medicare for all would be the same.

There just isn't enough information out there to have a real discussion of single payer beyond "it saves money" and "other countries have it."

Other countries did not have a massive private insurance system to dismantle. So comparing us to them is not reasonable.

CA said the cost of single payer is the same as we are already paying.


We need real facts

[applegrove]

3. If you take the amount of all healthcare spending by people, government

and charities the US, and divide that by the number of US citizens, and then do the same with other western countries, the US spends a full third more than countries with single payer or universal health care. That is a lot of money. And the US doesn't cover all Americans.

[exboyfil]

6. I have actually seen it approaching 2x

In 2016 the U.S. spent 17.2% of its GDP on healthcare. The other OECD countries were around 10 to 11%.

http://stats.oecd.org/index.aspx?DataSetCode=SHA

[applegrove]

7. Yes. It is a huge difference. Studied public policy economics in school.

We were taught that universal health care is both more equitable, which one would expect, but also more efficient that private healthcare.

[wasupaloopa]

9. That still is not evidence of what single

payer would cost us

You can't start with other countries as a base

You have to take our country's costs and only our country's cost.

You must compare single payer cost with what we now have to determine the savings if any.

To me the best argument for single payer is universal coverage without the profit motive built in.

[MiddleClass]

16. Will then we'll look at that way

You pay insurance companies, every dollar 12 to 15 cents goes to executive salaries.

12 to 15 cents goes to the cost of administration/office space in prime areas/personnel

15 to 20 cents goes to advertising.

15 to 20 cents goes to shareholders.

25 to 35 cents goes to healthcare.

– – – – Let's look at Medicare – – – –

2 percent goes to administration/office space, maintenance (paid for years ago)/personnel/executive salaries.

98 percent goes to providing care.

35 cents versus 98 cents, I wonder which is more preferable

[Voltaire2]

5. Dismantling the private system is not really relevant to the cost of a single payer system.

We can look at other countries to see what their per capita health care costs are and compare those to ours. We can also look at those same countries and see what sort of objective statistics are available to measure outcomes. Uniformly, countries with some form of universal comprehensive system have significantly lower per capita costs and generally better outcomes. We pay much more and our measurable results are below average.

Yes there would be transition costs in the insurance industry, but those costs would over time be insignificant.

The proposals made every session of congress by the progressive caucus are comprehensive and replace all the existing programs - medicare and medicaid with a single program for everyone from birth to death. They do away with all the complications of medicare and replace it with a single plan for everyone that covers all aspects of healthcare.

Funding of course requires an increase in the payroll tax and typically other sources as well.

The current version is here: https://www.congress.gov/bill/115th-congress/house-bill/676

[wasupaloopa]

10. I like what you say except for wanting

to ignore the cost of ending the current system.

If you amortize those costs over time they do seem small on an annual basis but that is an accounting principle.

The costs are real such as paying off share holders or just letting them take the hit.

The displacement of workers is another cost but we can let them take the hit too and just ignore it.

In my formula for calculating the cost to our country for single payer includes those costs.

[MiddleClass]

4. A public option in Obama care that would become what he speaks of

First, allow people to vote with their pocketbooks,

all government subsidies pay only public option,

lower Medicare to 55

. Watch what happens

[J_William_Ryan]

8. A single payer system would save lives even if savings were negligible.

Not that most on the right would care about that, of course.

[dsc]

11. Medicare isn't single payer

significant portions (about 20 percent) of medical bills for Medicare are paid by the insured. It should also be noted that California has a separate problem in that 40 percent of the government budget has to go to education meaning that a single payer system in California would require a huge increase in education spending as well.

[applegrove]

12. Why would spending on single payer increase the education budget?

[dsc]

13. by law out there 40% of the state budget must go to education

thus if the budget increases so must education spending.

[applegrove]

14. Oh. That would have to be adjusted. You could change it to keeping

the state education budget the same per capita as it is presently. That would work.

[dsc]

15. this was one of the reasons the Assembly leader shelved it

apparently the 40% would have to be voted on by the people as it was a Constitutional amendment.

[applegrove]

17. Good to know that was one reason why it was shelved. Frankly I was

a bit worried when it got shelved. Didn't seem to make sense.

[MiddleClass]

19. In single-payer insurance with the 20 percent deductible

Again, that's only 20 percent of the negotiated reduced price, sorry, dictated.

What I say is create a public option that mirrors Medicare, but the premiums are the cost.

Obama care subsidies apply to that,

companies free to join and pay for their peoples premiums if they want

[Xolodno]

18. Simple.

Economies of Scale.

[applegrove]

20. Preventive medicine. Negotiation leverage. Less admin cost. These

things as well.

[MiddleClass]

21. Even simpler, elimination of executive salaries, Midtown Manhattan rentals, shareholders, insurance

That is a huge cost of American healthcare eliminated