Comment by dematz
3 hours ago
Admin inefficiencies between orgs definitely exist and maybe better interoperability and standards is the solution, but wouldn't there also be less of a problem in the first place if there were fewer different orgs all complicating workflows?
Also not saying you're wrong about many healthcare services being unnecessary or even harmful, and someone has to be the one to say no to patients asking for low value care which is definitely a real hard position to be in and a real problem. At the same time insurance companies aren't making a great case for themselves as the solution imo bring on the government death panels.
Yes, provider organizations waste a lot of resources dealing with differences between health plans. Reducing the number of different payers would certainly reduce that overhead, at least in the short term. Mandating increased health plan transparency and use of open interoperability standards can also help by allowing providers to deal with those health plans in a more consistent way and automating much of the current manual work.
In general though I'm just skeptical that a single payer solution is the best possible long-term approach. US federal and state governments are already under tremendous fiscal pressure. So if we forcibly route all healthcare payments through governments then there's going to be constant pressure to hold down costs through blunt measures. And decisions will inevitably become even more politicized with special favors or punishments given out based on party loyalty. Do we really want to put someone like Xavier Becerra or Robert F. Kennedy Jr. in charge of centrally planning something like a fifth of the US economy?
The current US healthcare system is unnecessarily wasteful and cruel. But on the positive side we produce far more innovation per capita than any other country. Let's find a way to incrementally fix the worst problems without killing the golden goose.