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> universal health care reduces aggregate costs, but the public cost in aggregate is enormous. This means large new taxes for everyone. If the US could spend h

by bhelkey 28d ago

> universal health care reduces aggregate costs, but the public cost in aggregate is enormous. This means large new taxes for everyone. If the US could spend healthcare dollars as efficiently as the UK, the US could pay for a single payer healthcare system covering every resident using only existing Medicare + Medicaid spending. Is the US willing to reduce the price of healthcare? I observe a large appetite in congress to increase the visibility into US healthcare spend. I observe rather more limited effort spent to use this data to reduce the aggregate costs (e.g. negotiating drug prices [1]). The math: The US spends $2 Trillion dollars on Medicare + Medicaid a year [2][3]. $2 Trillion dollars / a population of 342.7 million [4] = ~$5800 per resident per year. NHS (UK's universal healthcare system) costs ~£3,500 or ~$4800 per person per year [5]. [1] https://www.kff.org/medicare/key-facts-about-medicare-drug-price-negotiation/ https://www.kff.org/medicare/key-facts-about-medicare-drug-p... [2] https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet https://www.cms.gov/data-research/statistics-trends-and-repo... [3] https://www.kff.org/medicaid/medicaid-financing-the-basics/#870ed126-45c3-4465-8b9a-ae0eea487dcf https://www.kff.org/medicaid/medicaid-financing-the-basics/#... [4] https://www.census.gov/popclock/ https://www.census.gov/popclock/ [5] https://www.bbc.com/news/articles/cwy7zvp5xrqo https://www.bbc.com/news/articles/cwy7zvp5xrqo

Gareth321 27d ago
I think you did not understand my comment, and that is perhaps my fault. To be explicit: 1. Universal health care reduces the total cost of healthcare across the nation. If the bill is $x now, the total cost would be $x-0.2 (or whatever). 2. This is EXTREMELY expensive FOR THE GOVERNMENT. They would need to either raise taxes considerably (broadly and deeply, as in Europe), or deficit spend. For some people, the increased taxes would be offset by not having to buy health insurance. For some people, they would be spending more.
- bhelkey 27d ago
  Potentially I am misunderstanding you. My point is that we already pay $2 Trillion dollars for existing single payer healthcare (Medicare/Medicaid). I think it's fair to call that extremely expensive. You say that universal single payer healthcare would have a huge price tag, my point is that we are already paying a huge price tag ($2 Trillion) but just not getting universal single payer healthcare as a result of this spending. My point is that we could have universal single payer healthcare without raising taxes if it cost less than or equal to ~$5800 per person per year. UK spends ~$4800 per person per year on their single payer healthcare. Note: This just considers existing taxes spent on existing single payer healthcare. This doesn't consider other healthcare spending. The majority of the US get's their insurance through employment-based plans. Some pretty reasonable percentage buy their plans directly through the marketplace. And some pretty reasonable percentage don't have health insurance.

by bhelkey 28d ago

Gareth321 27d ago

I think you did not understand my comment, and that is perhaps my fault. To be explicit: 1. Universal health care reduces the total cost of healthcare across the nation. If the bill is $x now, the total cost would be $x-0.2 (or whatever). 2. This is EXTREMELY expensive FOR THE GOVERNMENT. They would need to either raise taxes considerably (broadly and deeply, as in Europe), or deficit spend. For some people, the increased taxes would be offset by not having to buy health insurance. For some people, they would be spending more.

bhelkey 27d ago
Potentially I am misunderstanding you. My point is that we already pay $2 Trillion dollars for existing single payer healthcare (Medicare/Medicaid). I think it's fair to call that extremely expensive. You say that universal single payer healthcare would have a huge price tag, my point is that we are already paying a huge price tag ($2 Trillion) but just not getting universal single payer healthcare as a result of this spending. My point is that we could have universal single payer healthcare without raising taxes if it cost less than or equal to ~$5800 per person per year. UK spends ~$4800 per person per year on their single payer healthcare. Note: This just considers existing taxes spent on existing single payer healthcare. This doesn't consider other healthcare spending. The majority of the US get's their insurance through employment-based plans. Some pretty reasonable percentage buy their plans directly through the marketplace. And some pretty reasonable percentage don't have health insurance.