Medicare for All and Administrative Costs

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Political talk is getting more and more serious around Medicare for All in the United States. The argument, as usual comes down to costs. One of the advantages that proponents always bring up are the very low administrative costs of Medicare. Are those low costs for real? Would they hold up if everyone was in the system? Healthcare Triage looks at the facts.

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50 thoughts on “Medicare for All and Administrative Costs

  1. Medicare for all is just the tag line. It would be a system mirroring other countries and not the US’s Medicare. Every proponent of Medicare for all is so because of being a great opponent to price gouging private insurance so of course they don’t want it.

    • In the US, you have to be careful about how you say it. You can supply hot buttons for the older, more narrow sighted and entrenched who will champion the big pharma and generally be oppositonal

    • It’s because Medicaid is considered for poor people so it’s got “poor people” image. Medicare is for seniors regardless of income so it doesn’t have that issue.

    • +h7hj59fh3f Canada is single payer. They don’t have one large national health care system so obviously federal government monopolizing Healthcare usnt required to keep costs down. Hence your point of that’s the point of single payer is not correct.

  2. Care management by a private plan just feels like a cost-saving watchful eye, and a conflict of interest in you receiving the best healthcare

  3. Hey this is all very nice, but as a foreigner,
    It would really do me a lot of good if you slowed down and dumbed it down a little bit, like explaining terms etc…
    Thanks for your work!

  4. So basically if you struggle to afford health insurance like 80+% of people, Medicare is cheaper for everyone, including the federal government. If you can afford healthcare, it’s not such a great deal because you make enough money that it is you who is helping pay for everyone else.

    • I mean I love this idea but like… I love quality healthcare facilities that are comfortable and technologically advanced. I think a lot of people that support Medicare for All (which I personally do) think that Medicare equals free healthcare. Most don’t even know the difference between traditional Medicare and Medicare Advantage nor do they understand different parts of Medicare such as supplemental insurance. Urgencies will be covered (part A) but part B (and arguably C) work to control utilization and overall healthcare spending; however, with either Traditional or Advantage, you will never go bankrupt because of medical bills.

    • +Sean We don’t think its free healthcare, everyone knows it is paid by taxes :/ Its just run more efficiently and ethically when you remove the profit motive.

      And no, I didn’t know the difference between the two but I’m British so I don’t really need to. I do watch a lot of American news on youtube tho so it is suprising that I haven’t heard the terms before.

      We have private insurance here in the UK but its for supplimental stuff on top of your essential healthcare; which is entirely free whilst you are in the facility. The fact Americans go bankrupt because of healthcare at all is disgusting to me.

    • +Canine Kitten Part A is paid through taxes but parts B, C and D require at least copayment and typically premiums. Very similar to private insurance.

    • +Canine Kitten But thanks for your perspective! I’m always interested in hearing others thoughts on healthcare and I’ve always loved studying other countries systems! 🙂

    • +Canine Kitten “We don’t think its free healthcare, everyone knows it is paid by taxes :/ Its just run more efficiently and ethically when you remove the profit motive.”

      So explain to me why over 8000 doctors have left the UK 2008 and 2012 and medical school enrollment is down in the UK, of which the primary reason is poor pay and working conditions? Or how about the fact that NHS hospital patients are 45% more likely to die than their American counterparts?

      https://www.investors.com/politics/editorials/why-british-doctors-do-not-want-to-practice-in-own-country/

      http://www.pulsetoday.co.uk/news/gp-topics/education/medical-school-applications-decrease-as-negative-publicity-takes-toll/20030395.article

      https://www.nhs.uk/news/medical-practice/death-rate-much-higher-in-english-than-us-hospitals/

  5. There is no large country with better healthcare performance. Canada, UK etc have subpar scarce care that’s lagging behind years in options. On the other hand regulation has hindered competition from entering the market. Truly the US has one of the most regulated hcare sectors in the world.
    If you’re still in favor of programs like medicare, which doctors are fleeing btw because it doesn’t pay their 100k+ student debt, let it compete freely in the market.

    • Sheesh and Kaden Jacobson, the ranking of the United States depends on which metric you use. If you use something simple like life expectancy, the United States ranks far below many other nations. If you measure it by infant mortality, death due to preventable illnesses, death due to untreated chronic conditions, or quality-life years, the United States ranks poorly. But, if you measure it by research, either dollars spent on research or number of publications, the United States ranks #1. I’m not sure about this, but I think we probably also do a greater number of complex medical procedures per person than any other country. What this amounts to is that the United States has the best healthcare that money can buy, but if you don’t have the money, you might as well live in a third world country as far as healthcare goes.

      Medicare actually pays out quite well. Not as well as private insurances, but enough for doctors to pay their debts. Medicaid, on the other hand, could make loan payments difficult.

    • +rob prop Research is not even remotely related to health care… Compared to European countries, the USA puts out proportionally far fewer PhDs. There will also continue to be fewer researchers and publications if the NIH funding keeps getting hit.

    • David Corbo, sorry, I should have specified healthcare research. And I meant public as well as private funds going into research. Which, granted, is only tangential to health outcomes, but maybe if you’re looking at how much the system can do at it’s best rather than how it performs on average, that is one metric you could consider.

    • rob prop vast majority of people don’t need the experimental or highly cutting edge treatments performed in the United States. You hear about them because it’s interesting but the likelihood of you needing specific care only in the US is rare.

    • darkenergylambda, yes. That is how the US healthcare culture works. Focus on what is interesting, not what is common and needed. Which is part of why we rank highly in medical research but poorly on average outcomes. I’m not saying that’s good, I’m just saying that’s how it is.

  6. Interesting that you make networks sound like they’re supposed to be good when I think they’re a major problem with US healthcare… It took my dad 6 months of fighting with insurance about out of network issues before he could get surgery for his pancreatic cancer and know it would be covered.

    • Yeah I don’t get why people love private bureaucracy but hate public bureaucracy. And private plans are often cheaters. I paid $100/month for about seven years for a plan for my daughter. When she was 17 she accidentally cut a tendon in her thumb trying to open plastic packaging. I looked up the preferred providers in the plan, and chose one. The plan was $2000 deductible, so I paid that. Then after the fact they refused to pay for anesthesia, and when I got the surgeon bill they only paid for 50% instead of the advertised 80% because they said he charged too much. So I ended up paying around $6,000 in addition to the $7,000 I had already paid for insurance. They only ended up paying out about $4,000!

  7. Any politician against Medicare for All should lose theirs. Personally I think they should be tied to each other. They should get the same quality and quantity of the same value as the rest of us Average Joes.

    • Hi I’m all for Medicare for all but please don’t act this way. Everyone is human and has a right to equal access of quality healthcare services regardless of their personal beliefs. Stand up for the core values you are fighting for and don’t let others frame of mind influence those values. Healthcare is a right. For everyone.

    • +Sean All I said was politicians should not have better health care than the rest of us especially since taxes pay the bill. So I don’t understand what you mean by don’t act this way. No one is better than anyone else including the House of Representatives and the Senate. And if they want to vote against the common person then they should have the same health care as the rest of us and see what they think then.

  8. We need to figure out how to stop price gouging in healthcare. Something so essential to human life shouldn’t be run like a business

    • Wrong. Profit belongs in healthcare as well as all other goods and services. There is no “price gouging” in a competitive market. The solution is ending state involvement, not expanding it.

    • Chris Lewis sorry for the late reply. Healthcare is a complicated field, and there’s no clear solution to how broken our system is. I think it’s good to have some competition – for example Europe does have for profit clinics, however we need a minimum standard of care. When people get arrested they have the right to an attorney, when they get sick they should have the right to a doctor. I’ve got zero problem paying higher taxes if it means that everyone is entitled to healthcare, though we do need to deal with the fact that they lobby more than any other group in order to change things. It’s a multi-faceted issue, but in short, I’d rather it be run poorly then have millions of people not get proper healthcare.

    • +Jason Smith Healthcare is not a right, you are not entitled to someone else’s services simply because you deem them as holding intrinsic value. Comparing a right to attorney to having a right to doctors services is comparing apples to oranges, you have a right to a fair trial and thus are entitled to legal representation via an attorney under the sixth amendment, but this does not apply to the attorneys service itself, rather the court is obligated to provide you with legal representation, the lawyer can still say no if they want to.

      While you have a right to a lawyer in certain types of criminal cases, you do not have a right to a specific lawyer. Lawyers are not generally being forced to take on clients they don’t want to due to the right to counsel.

      https://www.quora.com/We-have-the-right-to-have-an-attorney-but-not-to-a-doctor-Can-you-explain-why-that-is

      Also, legally speaking healthcare cannot be constituted as a right, as it does not meet the criteria of being non-rival-able and non-excludeable.

      https://www.mytutor.co.uk/answers/17315/IB/Economics/Why-is-healthcare-not-a-public-good-in-economics/

      “I’ve got zero problem paying higher taxes if it means that everyone is entitled to healthcare.”

      I’m glad you’re okay with paying more in taxes, but I’m not and that’s a big issue. because of this, the only way you’re going to get me to pay into said system is via coercion, aka theft, which is as unethical as you can get. It doesn’t matter what the reasoning behind you taking my money is, stealing is stealing and it is never okay under any circumstances. You’re never going to convince me that forcing people to pay for someone else’s healthcare at gunpoint is somehow ethical.

  9. The fact is this: Humanity is going to stop growing our population eventually. When that happens, we are going to be living in a society in which the old people to less than old people ratio is going to be really high. Healthcare costs will rise as that ratio rises, because old people are health care whales. It will not get any higher than that, but it will cap off at a high level, and we are going to have either bear the cost of that society, or we are going to have to start letting old people die. Pick one and be honest about the consequences you think society should accept: should we live in a society in which we can live nice long retirements? Or should we just let old people die before or not long after they retire.

  10. The argument that private insurance coordinating with in their network doctors to provide better health management to patients is utterly laughable. They do it to control their own costs, no other reason. It’s also unrealistic to compare private and public health care insurance solely based on the benefits of administrative costs. Removing insurance company profits alone would go a long way towards justifying Medicare of All. You’re also not even looking at the benefits of negotiated drug prices and the desire by medical providers to expand the service because for them it’s a win win solution, reducing their expenses as well. So you can’t just compare ONE aspect, you have to look at the solution as a whole.

  11. So yes… Still no excuse for the excessive healthcare costs in the US. Also, you need to look at the whole picture, not just administrative costs.

  12. Not an American but the network of doctors thing always seemed odd to me, only being able to go to a doctor on your insurance network seems nuts. Doing away with that and having just Medicare and all doctors accessible to all patients seems more sensible

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