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.
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.
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.
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.
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.
If private health insurance was allowed, UHC would be stillborn. It only works if providers don't have better options than medicare reimbursement rates.
> 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?
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.
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.
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.
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.
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?
Presumably not; the same national income would just be redistributed from shareholders to insurees (or shareholders of companies that pay for employee health insurance).
$1 trillion more efficient in allocation of resources, freeing up money for consumer spending on everything.
They don't care about this stuff
The non-healthcare sectors of the economy do.
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As long as that does not translate to good short-term profit, the shareholders won't budge
Are you saying the government is an efficient allocator of resources?
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.
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The government does not have the peverse incentive of putting private profit above all other concerns.
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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.
it's that it's 1 Trillion less in incentivized middlemen. A la Graeber.
$1 trillion less middle-men.
Not profit, just income
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.
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.
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.
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.
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.
If private health insurance was allowed, UHC would be stillborn. It only works if providers don't have better options than medicare reimbursement rates.
> 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?
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What are you proposing happens to providers who freely contract with patients at rates above Medicare reimbursement?
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.
Have you ever dared to dream of something that sounds impossible but isn't?
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.
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And overhead of running the insurance company like salary and office, then wasted time for doctors.
That would be a massive hit to our GDP.
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.
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.
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.
Some would, but some would just put that money into savings and investments instead.
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Not necessarily, over the long-term. That's $1 trillion more in disposable income.
Not at all. Reducing a cost means the payer can spend the money on something else
https://en.wikipedia.org/wiki/Parable_of_the_broken_window
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?
Presumably not; the same national income would just be redistributed from shareholders to insurees (or shareholders of companies that pay for employee health insurance).
Think of all the insurance jobs that would be hit, too. Unfortunately we've bloated the healthcare industry to have a lot of employees
Somehow I doubt there would be fewer jobs in healthcare if the government takes it over.