r/FluentInFinance • u/The-Lucky-Investor • 11d ago

“Medicare for All” would save the U.S $5.1 Trillion over 10 years Discussion/ Debate

https://www.commondreams.org/news/2018/11/30/easy-pay-something-costs-less-new-study-shows-medicare-all-would-save-us-51-trillion
21.5k Upvotes

92% Upvoted

2.6k comments sorted by

View all comments

Show parent comments

76

u/JDHPH 11d ago

This always seemed so anti-competitive to me. A trained physician should be able to start up their private practice/clinic to compete for patients. Just like any other business model, serving its customer base through transparent competition.

39

u/Bob_Wilkins 11d ago

Transparent competition. What a quaint concept. That era vanished after 1980 and won’t see the light of day again. Certainly healthcare is an expensive mess. The AMA was firmly against socialistic government medicine back when Truman proposed it in the late ‘40s. Medicare in the ‘60s turned out to be a huge money grab. Now that Managed Care has taken over the Medicare, and increasingly Medicaid, markets, healthcare is funded largely by the government, although made more expensive due to Administrative Loss Ratios going to the Managed Care Firms. Medicare is the most efficient payor of healthcare in the US, with all the benefits and few of the drawbacks of private insurance (the energy expended on private insurance appeals is ridiculous).

7

u/Rooboy66 11d ago

My healthcare Econ prof Nancy Wolff said the VA was the most efficient payor if I recall … but, crap, that was 30+ yrs ago. She advised Hillary’s healthcare panel in the 90’s

6

u/Cheap-Combination-13 10d ago

It is still true. And one of these from the power of bargaining on drug prices that the VA receives. Pharma fought this when Medicare part D was passed as they didn't want state programs to collectively negotiate prices. The pricing power is substantial where wholesale in drug x might be $1000, the VA is getting it for $200. This is most but not all drugs

2

u/SmokinJunipers 10d ago

And the rest of the world pays $5. (I have no idea)

1

u/5thtimesthecharmer 10d ago

If you’re insured you’re getting our negotiated price which is almost all the network discount we negotiate on an AWP- basis. Then there is the rebate side, most high WAC drugs come with a ridiculously high rebate due to their high list cost.

1

u/goodolehal 10d ago

The VA is one of the worst administered healthcare programs in the US

1

u/uncle-brucie 8d ago

It it purposefully underfunded, like many government programs, so Republicans can say “look how the car I ran into a wall 20 years isn’t as good as the 2025 bmw free market Timberlake drives stoned around the Hamptons”

2

u/goodolehal 8d ago edited 8d ago

No, government run businesses just arent good for shit in this country. There is no incentive for performance and every incentive to mail it in enough years to collect your pension, and spend money unnecessarily to keep your budget coming in.

The VAs yearly budget is $300 billion and they serve 9 million people. Think about that for a second and then compare to private insurance. Its a pathetic misallocation of resources. Private insurance companies are leaps and bounds more efficient, modern, and technologically advanced than the public sector.