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

[u/The-Lucky-Investor]

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

[u/Old_Height_8351]

In summary, the ACA had an effect of reducing the % increase on insurance spending for employer sponsored plans. I think I’m interpreting that correctly.

Do you think the individual has an increased out of pocket expense? Such as coinsurance and copayment

[u/GeekShallInherit → u/Old_Height_8351]

Do you think the individual has an increased out of pocket expense?

Deductibles have increased more slowly as well.

In 2003, the average employer provided single PPO plan was $3,505, with a deductible of $275. That's $5,771 and $453 adjusted for inflation.

In 2013, the average employer provided single PPO plan was $6,031 with a deductible of $799. That's $7,835 and $1,038 adjusted for inflation.

At the same rate of increase, the single PPO would have cost $10,636 in 2023 with a deductible of $2378.

In actually in 2023, the average employer provided single PPO plan was $8,096 with a deductible of $1,281. From 2003 to 2013 saw an average of 5.58% in premiums and 8.65% in deductibles after accounting for inflation. 2013 to 2023 saw an average increase of 1.30% and 2.13%.

And everything, including out of pocket spending, is included in the total spending I addressed above.

[u/Old_Height_8351 → u/GeekShallInherit]

Those numbers are factoring in coinsurance or copays, but that could be only a small amount to add to those totals

[u/GeekShallInherit → u/Old_Height_8351]

If anything, additions such as max out of pocket and increased coverage for preventative care should have reduced such costs. Feel free to provide a single shred of evidence otherwise.

I can tell you total household spending on healthcare accounted for an average of 29.6% of healthcare spending in the decade before the ACA went into effect; 28% since.

[u/Old_Height_8351 → u/GeekShallInherit]

If you hit your deductible, it doesn’t mean your out of pocket expenses are 0 now. You could still have a coinsurance.

We can both agree we spend a lot on healthcare. The point of the article was to highlight how getting rid of insurance can reduce expenses. Maybe that’s true long term. I’m all for insurance companies not creating the barriers they do and increasing the price of healthcare. I also don’t think we’ll ever have Medicare for all so this is just an interesting thought experiment

[u/GeekShallInherit → u/Old_Height_8351]

If you hit your deductible, it doesn’t mean your out of pocket expenses are 0 now. You could still have a coinsurance.

And you could before, too, it just started at a lower level and went to a higher level. Again, feel free to provide a single shred of evidence it's increased. Especially given we know total healthcare spending is lower than it would have been by historical norms; we know the total proportion of costs paid by households has gone down.

[u/Old_Height_8351 → u/GeekShallInherit]

I’m not disagreeing with you there, chill lol.

I see the data you provided and assume it’s accurate. But there’s also the fact that medical bankruptcies are about the same before and after the ACA (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366487/). And healthcare is still rising every year as a % of GDP.

[u/GeekShallInherit → u/Old_Height_8351]

Nobody said that the ACA was the end all, be all of healthcare reform, and in fact there is still a tremendous amount that should be done.

The argument is just that things are better than they would have been if nothing had been done. If insurance costs were higher, deductibles were higher, total spending was higher, fewer preventative services were required to be provided with no copay, lifetime spending caps still existed, exclusions for pre-existing conditions didn't exist, tax advantaged HSAs didn't exist, etc..

[u/Old_Height_8351 → u/GeekShallInherit]

I agree with you there. Lots needs to be done.

My personal opinion is that people need to be in charge of their own health and really work towards a healthy lifestyle. If that doesn’t happen I doubt costs ever go down. Demand keeps rising because Americans are extremely unhealthy

[u/GeekShallInherit → u/Old_Height_8351]

eople need to be in charge of their own health and really work towards a healthy lifestyle. If that doesn’t happen I doubt costs ever go down.

I mean, people being healthier is great, but that's not likely to reduce costs.

The UK recently did a study and they found that from the three biggest healthcare risks; obesity, smoking, and alcohol, they realize a net savings of £22.8 billion (£342/$474 per person) per year. This is due primarily to people with health risks not living as long (healthcare for the elderly is exceptionally expensive), as well as reduced spending on pensions, income from sin taxes, etc..

Demand keeps rising because Americans are extremely unhealthy

Yeah... not why costs are rising in the US. In fact, we're not really receiving more healthcare for any reason than our peers, we're just wildly overpaying for it.

https://jamanetwork.com/journals/jama/article-abstract/2674671?redirect=true

[u/Old_Height_8351 → u/GeekShallInherit]

Very interesting article thanks for sharing. The article mentioned administrative costs as being a large burden in the US. If there is less patient demand, maybe admin costs go down? Maybe not a lot of juice there but the reason admin overhead is so high is because of insurance companies and govt policies.

They mentioned higher testing of MRIs. My take is that it is higher in the US because we’re litigious and doctors want to cover their asses from malpractice suits.

There are myriad reasons we’re overpaying. We also receive phenomenal quality. The saying goes you pay for quality. We’re certainly getting diminished returns there