Are there no efficiencies to be had in the remaining costs of private health care?
The $1,644 - $177 billion ?
No efficiencies to be had in these, the other cost buckets?
As you say, private insurance is only a small part of the total cost of US health care.
No costs savings to be had in the other few trillions?
I wouldn’t be able to provide an itemized solution, but having participated in “the system” for some time, and seeing how large enterprises can be quite inefficient, and how everyone can take a handful from a pot of money with poor transparency, surely we could make progress (if the will is there, a large challenge I admit) along the lines of:
Many “Private” health care pools are company funded.
The SKIM is in the HC plan administration fees.
Plan administrator (United Health Care)
Company Director (Employee cost - overhead)
Customer service (UHC pool with a cost/call or ticket)
Peer reviews (UHC employee pharmacist or specialist with a cost/ticket charge)
Pharmacy benefit manager (cost per annum, fee per script OVHD)
“Fitness perks” included, but certainly built into company annual fees
“Fitness tracker” included, but subsidized by company annual fees
Delay, deny, Reformulate - fee, fee, fee,… prevent expenses… fee for reduction in annual expenses.
Private (self funded) health care is fully part of the skim as well. And this is for a plan FUNDED FULLY by the employer and heavily pulled from pre tax salary payments/company contributions.
Sure. But that doesn’t mean that if you switch from one system to the other, the savings from the switch are larger than the costs incurred by the switch. I’m not saying that the savings don’t exist - I’m saying they’re not big enough relative to the costs of switching for the switch to be politically viable. So while saving “millions” might be very relevant in some contexts for some purposes, it’s utterly irrelevant in trying to get the political support needed to move towards single-payer.
In general? Yes, there are efficiencies to be had. Efficiencies to be had by switching? No, not really. The thing about U.S. health care is that we’re just as absurdly more expensive in the public systems as the private ones. It’s been a while since I linked to it, and I’ll see if I can find it later, but proportionately we spend the same absurd amount on our seniors relative to what other countries do on their seniors as we do overall. The same “roughly double” the national average of comparison countries.
So while there are undoubtedly savings to be had, the mere act of switching private insureds into a public program are not going to create them. And all the same political pressures and interest group obstacles that prevent us from realizing those savings in the public programs today are still going to be there when there are more people in the public programs. Perhaps even worse. You think Big Doctor and Big Hospital lobby hard now for their interests? Wait until all their income comes from the federal government and no one else…..
Right. Hence my example of the taxes folks in the UK pay. They enjoy the NHS - though complain about it incessantly - and enjoy the taxes that go with it. And it still isn’t enough - they have deficit spending and rising debt too!
The ACA increases can’t continue as they have. This year our premium without subsidy for a family of 5, Bronze level, is over $40k. I’m not going to pay that much, you taxpayers will help me out, while I pay next to nothing in federal income tax. So thank you, but obviously this can’t continue.
We also are on ACA. We have a bronze plan that really is only good if something major happens. Deductible is $10.6K per individual. Which is also the OOP max. The plan retailed for something like $1900 per month (2 people), but tax credits (and income control!) bring that down to a manageable level.
As long as nothing goes wrong this year, we’ll be paying 100% OOP because the deductible is so high. The only benefit to insurance is the “contracted discount” for in-network providers, and mandatory free wellness of the ACA.
A NATO summit in The Hague this year agreed that allies will reach a new spending target of 5% of GDP by 2035. The target is made up of 3.5% in the defence budget, and another 1.5% of defence-related spending.
No one is spending as much as they did in the early- to mid-20th. The U.S. barely spends 3.5% of GDP on defense - and we’ve got the largest military on the planet by a huge margin.
The concern isn’t whether their militaries are large relative to historic levels, but whether they have militaries that are capable of operating independently from NATO in a way that they could effectively wage war against their neighbors. Modest militaries designed to only be part of a larger fighting force have less of a risk than going back to the days where everyone had a military that could, in theory, be called out to invade one or more neighbords.
The Danish PM called a snap election this week, but Greenland wasn’t enough of an issue.
Denmark’s Prime Minister Mette Frederiksen suffered an election setback as her left-leaning bloc appeared to have fallen short of winning enough votes to form a government. It sets the stage for tough coalition talks over the coming weeks…
Frederiksen’s Social Democrats received the most votes and were seen winning 38 seats in Denmark’s 179-seat parliament, results published early Wednesday showed, compared with 50 seats four years earlier. It reportedly marks the party’s worst election result since 1903.
With 12 parties, it is difficult to read the tea leaves, so to speak. Looks like both major parties were out of favor. Also from your link:
The Social Democrats’ main right-wing rival, the Liberal party Venstre, also had its worst showing for a century, with just 10.1%, falling behind the Green Left SF.
…
Frederiksen, 48, called the vote months earlier than expected, gambling that her boosted poll numbers over her handling of US President Donald Trump’s threat to annex Greenland would help hand her a third term.
However it was domestic, rather than geopolitical concerns, that dominated the campaign trail. These included the cost of living, the state of the economy and welfare concerns, though the high level of pesticides in drinking water – because of pig farming – and the climate footprint of agriculture have also become a concern for voters.
