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Re:Health insurers just published close to a trillion hospit... by chii on Tuesday September 06, 2022 @09:20PM (#32745298)
But looking from another perspective - if healthcare is 20% of GDP, an awful amount of people are therefore paid directly due to this "waste".

Any improvement in efficiency would mean those people lose out on jobs. A new use for them must be found, or there will be massive unemployment (at least, short-medium term).

Re:Health insurers just published close to a trillion hospit... by smcl on Wednesday September 07, 2022 @01:11AM (#32746575)
This is a peculiar perspective to see on HN. Isn't the entire business model of startups and YC based on ruthlessly "disrupting" industries using efficiency gains achieved through technology, causing the same sort of unemployment? Why should healthcare billing and administration be any different?
Re:Health insurers just published close to a trillion hospit... by granshaw on Wednesday September 07, 2022 @01:37AM (#32746759)
Actual founders are maybe 0.1% of the HN reader base. Most everyone else are tech workers not looking to disrupt anything.
Re:Health insurers just published close to a trillion hospit... by smcl on Wednesday September 07, 2022 @01:57AM (#32746891)
I'm mostly interested why the USA suddenly becomes pro-worker when it comes to this expensive and inefficient healthcare system they have. I swear you could be talking to the most hardline GOP guy who wouldn't spit on a trade unionist if they were on fire ... but if you mention, say, single-payer healthcare they'll start weeping for the all the workers in hospitals' billing departments and in health insurance companies who will lose their jobs.

I mean I don't want anyone suffering either (one would hope you'd have adequate social safety net to take care of these people until they find another job) but it's such a bizarre exemption to carve out

Re:Health insurers just published close to a trillion hospit... by robertlagrant on Wednesday September 07, 2022 @05:24AM (#32748409)
No, they're worried that single-payer would increase healthcare costs and/or decrease quality. They might be wrong, but that's not why they'd be worried.
Re:Health insurers just published close to a trillion hospit... by smcl on Wednesday September 07, 2022 @06:05AM (#32748692)
I've heard that too, but I have heard on multiple occasions that this will cause a lot of people employed in the field to lose their (sometimes quite well paying) jobs working in billing.
Re:Health insurers just published close to a trillion hospit... by granshaw on Wednesday September 07, 2022 @03:27PM (#32755425)
And for some reason it seems like a lot of those jobs are staffed by right leaning people, even if left leaning areas…
Re:Health insurers just published close to a trillion hospit... by robertlagrant on Wednesday September 07, 2022 @05:23PM (#32757135)
What do you mean by left leaning areas?
Re:Health insurers just published close to a trillion hospit... by Vecr on Thursday September 08, 2022 @01:09AM (#32761427)
Probably they mean most cities, look at the voting statistics in various somewhat recent elections. If you don't buy the left/right dem/repub mapping, you can look at the various stances of the actual local officials elected.
Re:Health insurers just published close to a trillion hospit... by Tanoc on Wednesday September 07, 2022 @01:46PM (#32753738)
There's a large web of insurance companies, hardware and chemical companies, provider networks, and universities that benefit too greatly from the current inefficiencies to ever move away from private insurance. Hardware and chemical companies like LifeSys have contracts with insurance companies and provider networks that state the insurance will only pay for things if the tests or treatment are done with that supplier's tools and that the work will only be done if it's within the network.

For a theoretical based on what actually happened where I live, Hospital X is contractually obligated to use a specific kind of infusion pump from supplier Y and order blood tests from specific supplier Z in order to get Blue Cross Blue Shield coverage. Meanwhile the state university pushed out the other hospital in the city and heavily expanded the surviving hospital campus they sponsored to take on the increased capacity and introduce the services they were previously lacking compared to their now dead competitor. So Hospital X is just following the policy of University Network A. All of which is a common practice.

In many states the state university sponsored medical care networks are the or are close to being the biggest employers. The University Of Iowa medical network, the West Virginia University network, and University Of Pittsburgh Medical Center network all have taken over a majority of medical care functions in their states, leaving mostly specialists and those in mental health to independent practices. That exacerbates the issue of insurance and supplier contracts, because these small places that are competing with the university networks often don't bother with insurance unless it's government provided and just prefer patients pay up front instead. They lose too much time and money sorting through the myriad private insurance providers, plans, and coverage obligations without full time staff to handle that for them. Medical billing is a massive industry for a reason.

Now, if everyone wasn't chained to private insurance and juggling all of these providers, coverage limits, and contractual obligations the number of inefficiencies and thus the overall cost would decrease. We have historical examples of this even in the U.S., by comparing what happened between 1960 to 1975 and it's modern equivalent of 2005 to 2020. Healthcare costs were increasing rapidly, doctors were dwindling in number, and there weren't enough medical students for generalist fields in the 1960s just like the 2010s. The major difference is that while quality of care continued to increase through the 1960s and early 1970s, both the efficacy and quality of care has gone down since the 2000s. The several minor differences were that nationwide coverage was rarely available in the 1960s compared to the 2010s, that Medicare was spending more than it was receiving in the early 1970s thanks to how Medicare was funded in the 1960s, and that privatization of entire hospitals was uncommon and frowned upon in the 1960s because of the income impact it had on the doctors. The U.S. barely survived the 1960s medical crunch with enough government intervention, but it is dying under the weight of the 2010s medical crunch because the government can't easily intervene and is lobbied to maintain distance.

So the reason the lead figures in the American right are worried about single payer is because they won't make as much money. And they're very good at convincing people to vote against their own interests because they know those people don't care to look into complex systems too deeply. As a result many of the regular voters and workers are worried because someone told them a lie about where the money is actually being wasted and what the actual history is.

Re:Health insurers just published close to a trillion hospit... by robertlagrant on Saturday September 10, 2022 @03:12PM (#32793693)
> the government can't easily intervene and is lobbied to maintain distance.

Just picking this point out - how can lobbying stop something? As in it's worth too much lobby money to politicians to change it?

Re:Health insurers just published close to a trillion hospit... by richiebful1 on Tuesday September 06, 2022 @09:54PM (#32745518)
My current job depends on the current system being wasteful (healthcare insurance administration). But I'd much rather have to find a new job in a new industry than have the current healthcare system of the United States.
Re:Health insurers just published close to a trillion hospit... by Invictus0 on Tuesday September 06, 2022 @09:40PM (#32745426)
Yes, and we should also think of the blacksmiths and the elevator operators, milkmen and horse carriage drivers, who will unfortunately be out of a job if we make our society more efficient.
Re:Health insurers just published close to a trillion hospit... by cuteboy19 on Wednesday September 07, 2022 @12:29AM (#32746319)
Why not go further still. Smash a window so that window makers can make a living, slash someone's tires so that tire companies can employ more people.
Re:Health insurers just published close to a trillion hospit... by hutzlibu on Wednesday September 07, 2022 @07:19AM (#32749122)
I heard some people in all seriousness explain, that they throw their garbage just on the way and not in a bin, to create cleaning jobs.
Re:Health insurers just published close to a trillion hospit... by JackFr on Wednesday September 07, 2022 @07:20AM (#32749136)
I’ll go one better - pay they rat catchers per rat so they start breeding them.
Re:Health insurers just published close to a trillion hospit... by jkestner on Wednesday September 07, 2022 @10:31AM (#32751134)
Re:Health insurers just published close to a trillion hospit... by cycomanic on Wednesday September 07, 2022 @02:47AM (#32747288)
There was a quote by an opposition politician in Germany to the argument that Germany should buy the Eurofighter (which had huge cost overruns etc.) because it creates jobs. Loosely translated: "We can also build a pyramid for Helmut Kohl [chancellor at the time] if the goal is to create jobs".
Re:Health insurers just published close to a trillion hospit... by trashtester on Wednesday September 07, 2022 @03:45AM (#32747727)
The defence industry is treated like that in every country. Part of the reason why a country wants to retain some military industry domestically, is to ensure production capacity during a security crisis (kind of like for agriculture). It's not just "jobs", but "jobs" with that particular skillset.

For instance, Germany is producing the Leopard 2. They may export most of them during peacetime, but should they need to, they could start pumping out those tanks for the Bundeswehr instead. Furthermore, with the skills available domestically, it would take much less time to repurpose VW/BMW/Audi factories to also produce weapons.

Re:Health insurers just published close to a trillion hospit... by hattmall on Tuesday September 06, 2022 @11:35PM (#32746068)
Most want be unemployed they will just make a lot less. Doctors, Surgeons and administrators are barely breaking 6 figures in many socialized systems, and those come with far higher tax burdens typically.
Re:Health insurers just published close to a trillion hospit... by anon_123g987 on Wednesday September 07, 2022 @07:13AM (#32749077)
Two economists are walking in a forest when they come across a pile of shit.

The first economist says to the other “I’ll pay you $100 to eat that pile of shit.” The second economist takes the $100 and eats the pile of shit.

They continue walking until they come across a second pile of shit. The second economist turns to the first and says “I’ll pay you $100 to eat that pile of shit.” The first economist takes the $100 and eats a pile of shit.

Walking a little more, the first economist looks at the second and says, "You know, I gave you $100 to eat shit, then you gave me back the same $100 to eat shit. I can't help but feel like we both just ate shit for nothing."

"That's not true," responded the second economist. "We increased the GDP by $200!"

Re:Health insurers just published close to a trillion hospit... by chii on Wednesday September 07, 2022 @07:31AM (#32749220)
They did produce $200 worth of value - i'm sure if the first economist didn't enjoy watching the 2nd eat some shit, he wouldn't have paid.

You used a wrong allegory to try to demonstrate a point that noone was making.

Re:Health insurers just published close to a trillion hospit... by specialist on Tuesday September 06, 2022 @11:54PM (#32746146)
Yup. For the (downvoting) peanut gallery: aka "political economy". Obama Admin's compromises wrt ACA reform vs jobs has been written about.

Another example of political economy is two different efforts to address climate crisis, with very different outcomes.

During the Obama Admin, the push was for carbon taxes. Wonks loved it. Logical, concise, moral. Complete nonstarter. Because carbon taxes has no built-in constituency that's willing to advocate and defend it.

Whereas in 2020, progressives pushed "green new deal" themed industrial policy and investment strategy. Made most everyone a benefactor. Millions of jobs. 100s of billions of dollars. Much better political economy.

Re:Health insurers just published close to a trillion hospit... by taneq on Wednesday September 07, 2022 @03:57AM (#32747825)
Or maybe it would mean that more people actually receive quality care? In AU, at least, our waiting periods for pretty much everything are ridiculous.
Re:Health insurers just published close to a trillion hospit... by seandoe on Tuesday September 06, 2022 @11:10PM (#32745943)
Not sure why you're getting down voted so bad. It's a valid point. I recognize that there is waste and inefficiency in the system, but I can guarantee that any effort to "streamline" or cut "waste" will inevitably hurt everyday people... Even outside of job cuts.
Re:Health insurers just published close to a trillion hospit... by cuteboy19 on Wednesday September 07, 2022 @12:39AM (#32746367)
If keeping existing inefficiency protects jobs, perhaps introducing new inefficiency creates jobs? But that would mean that we should force people to do wasteful things in order to stimulate the economy!

Thankfully the economist bastiat solved this absurdity in 1850.

https://en.m.wikipedia.org/wiki/Parable_of_the_broken_window

Re:Health insurers just published close to a trillion hospit... by chii on Wednesday September 07, 2022 @03:54AM (#32747805)
> we should force people to do wasteful things in order to stimulate the economy!

you laugh, but this is exactly what the US gov't does, esp. with military budget allocation. Why do you think all sorts of military products are split into different pieces for manufacturing, separated into different states? It certainly doesn't help efficiency.

I'm not saying that healthcare shouldn't be improved via efficiency increases - it needs improving! But let's not kumbaya and ignore the plight of those whose livelihood would be disrupted (and not of their own fault).