Comment by craigmccaskill
3 days ago
Medicare administrative costs are around 2% of total program spending [1] compared to typically >10%. While what you're saying on the surface may be true from the numbers you are comparing, the fact of the matter is that healthcare costs are becoming more and more expensive during a time when many are experiencing a cost of living crisis.
The US gets a bum deal on costs and outcomes and while we can argue on which specific changes will move which specific needle I think it's clear that one of the major differences compared to the rest of the world is that running healthcare as a for profit enterprise has failed to deliver on the promise of good outcomes for as affordable a price as possible both on an individual and country wide level.
[1] https://www.politifact.com/factchecks/2017/sep/20/bernie-san...
> While what you're saying on the surface may be true from the numbers you are comparing, the fact of the matter is that healthcare costs are becoming more and more expensive during a time when many are experiencing a cost of living crisis.
Which has almost nothing to do with the amount of profits derived from private health insurance - that's only ~1.2% of spending.
Maybe it used to be ~0.8% - that delta is not moving the needle.
But has everything to do with the need to take a closer look at the entire system and how we can do things better.
I feel like focusing on this part of my comment vs. the bum deal part is disingenuous since non-US countries have figured out how to do it for cheaper with better outcomes without the main focus being the up and to the left drive for profit that our current system mandates.
> But has everything to do with the need to take a closer look at the entire system and how we can do things better.
People do that literally everyday.
If there was a silver bullet, we'd take it.
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I think this is a statistical artifact. Medicare preferentially selects the cohort of customers most likely to demand services from providers (that's the premise of the program). Fixed fees in, floating costs out. If you extended Medicare to 30 year olds, that 2% would, mechanically, soar; the same inputs from customers, but drastically lower service delivery.
The same statistics are similar for Medicaid too but also missing the forest for the trees in that for profit seems to be the main differentiator with the US vs. other parts of the world. There are plenty of models around the world that show this works and it works well.
First it's the government can't do this, then it's the government wouldn't do this because of this reason while ignoring that the US healthcare system is spending more than any other country and missing the mark on outcomes. Every other developed country in the world has figured this out. While not perfect, they're paying less and broadly getting better outcomes.
This is my issue with M4A: it seems clear from the numbers that the problems in our system --- and I think they're grave --- are almost entirely on the provider-side, and Medicare has, if anything, locked us into those cost structures. If anyone's curious why there's a scarcity in physician care hours in the US: Medicare rate limits the number of new doctors allowed into the system every year, through the residency funding system.
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