A New Study Shows Why Obamacare Should Have Been Single-Payer

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Last summer, with Obamacare's initial troubles fading from view, The New Republic's Brian Beutler noted that certain problems with the healthcare overhaul won't ever go away because they're inherent to its architecture...

... The main problem, Beutler wrote, was that you have to re-enroll every year—and there's no guarantee that you can keep your plan, that rates won't go up, or that the government subsidy won't go down.

But a new study by a group of physicians and health-policy researchers in BMC Health Services Research highlights another problem with our complex healthcare system.

In 2012, billing and insurance-related administrative costs—bureaucratic paperwork and red tape, essentially—cost the U.S. economy around $471 billion, and 80 percent of that was due to inefficiencies in our multi-payer system.

That's how much administrative waste is embedded in our fragmented, dysfunctional system of paying for care,”...

... The study found that the $375 billion saved annually with a single-payer system could be used to cover all of the nation's uninsured and upgrade coverage for millions of under-insured citizens...

Study: Single-Payer Healthcare Would Save U.S. $375 Billion | The New Republic

allnurses Guide

herring_RN, ASN, BSN

3,651 Posts

Specializes in Critical care, tele, Medical-Surgical.

Billing and insurance-related administrative costs in United States health care: synthesis of micro-costing evidence

A simplified financing system in the U.S. could result in cost savings exceeding $350 billion annually, nearly 15% of health care spending.

http://www.biomedcentral.com/content/pdf/s12913-014-0556-7.pdf

lovinglife2015

292 Posts

And whom would pay for it? This is not Cuba or England.

MunoRN, RN

8,058 Posts

Specializes in Critical Care.
And whom would pay for it? This is not Cuba or England.

Are you under the impression we're not paying for healthcare now? How would we need to figure out who would pay for something that costs us less than we're already paying?

lovinglife2015

292 Posts

Of course, 'we' pay now, those that work. Under single payer whom do you think would be paying for all? I also believe nothing from partisan rags like New Republic, fyi. Try to find an unbiased source next time.

Specializes in Geriatrics, Home Health.

Who pays for endless war?

Tenebrae, BSN, RN

1,951 Posts

Specializes in Mental Health, Gerontology, Palliative.
Of course, 'we' pay now, those that work. Under single payer whom do you think would be paying for all? I also believe nothing from partisan rags like New Republic, fyi. Try to find an unbiased source next time.

I get it, none of you want to be paying taxes and having to fund healthcare for those dead beats who dont work.

Reality is, when one looks at what you pay monthly in health insurance premiums versus our tax rate which are fairly comparable, we still get a better deal and should I get struck down with a terminal illness or end up having an accident, I can rest easy in the knowledge that I wont have to declare bankruptcy just to pay the deductible.

I'll never forget meeting a US woman who had become a naturalised NZ citizen. When she was struck down with cancer, she made the decision to die in NZ, because to return home to the US would have been leaving her loved ones a legacy of debt.

Or another friend from the US whose husband was denied a bone marrow transplant for his particular type of cancer because the insurance company deemed that a bone marrow transplant was an 'experimental proceedure' despite the countless evidence that states a bone marrow transplant was the best course of action for his type of cancer

Hes now dead.

allnurses Guide

herring_RN, ASN, BSN

3,651 Posts

Specializes in Critical care, tele, Medical-Surgical.
Of course, 'we' pay now, those that work. Under single payer whom do you think would be paying for all? I also believe nothing from partisan rags like New Republic, fyi. Try to find an unbiased source next time.
Please let me explain my posts.

Here is the research:

Abstract

Background:

The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs.

Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012.

Methods:

We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies

settings, so extrapolated from known sectors.

We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated added” BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses.

Results:

BIR costs in the U.S. health care system totaled approximately $471 ($330–$597) billion in 2012. This includes $70 ($54–$76) billion in physician practices, $74 ($58–$94) billion in hospitals, an estimated $94 ($47–$141) billion in settings providing other health services and supplies, $198 ($154–$233) billion in private insurers, and $35 ($17–$52) billion in public insurers.

Compared to simplified financing, $375 ($254–$507) billion, or 80%, represents the added BIR costs of the current multi-payer system.

Conclusions:

A simplified financing system in the U.S. could result in cost savings exceeding $350 billion annually, nearly 15% of health care spending.

http://www.biomedcentral.com/content/pdf/s12913-014-0556-7.pdf

lovinglife2015

292 Posts

@Tenebrae, BSN, RN But, I thought Obamacare was going to solve all that? What happened?

You folks do realize that the USA has a population of well over 300 million. Our population is significantly larger than that of any of other country offering single payer. As it is in England care is substandard( research it) and people with money pay out of pocket for quality care, so as not to wait 10 months for surgery.

As I said, who's going to pay for it and how do you as a healthcare provider expect to be paid under single payer?

lovinglife2015

292 Posts

Everyone(Republicans, Libertarians, Independents, etc...) that opposed the ACA bill said that administrative costs were too high. ACA is exactly what big govt bureaucracy is all about and what the Dems and those that wrote the bill intended.

Obamacare architect: We passed law due to ‘stupidity of the American voter'

Obamacare architect: We passed law due to 'stupidity of the American voter' - Washington Times

lovinglife2015

292 Posts

Oh, I forgot to add the part about the bill not really being about healthcare at all, but being a tax and penalty (hence the administrative cost) on people that don't buy health insurance. Controlling people is what it's been about all along.

MunoRN, RN

8,058 Posts

Specializes in Critical Care.
Of course, 'we' pay now, those that work. Under single payer whom do you think would be paying for all? I also believe nothing from partisan rags like New Republic, fyi. Try to find an unbiased source next time.

One of the main reasons for healthcare insurance reform was that we were seeing the beginning of a health insurance "death spiral", which is when fewer and fewer people pay into the overall costs of healthcare, which we do mainly through insurance, which increases the costs for those still paying for insurance, which causes the number of people and employers dropping insurance coverage to increase, which again raises the costs for those still paying, and on and on. In 2007, about 200,000 people per week were losing their employer-provided health insurance and that number was steadily increasing over time.

The problem is that just because fewer people have health insurance, the overall cost of our healthcare system doesn't really go down. The vast majority of healthcare costs are legally required to be provided to anyone whether or not they have insurance. So what going to single payer means is basically that the cost doesn't really change (except what we save in reduced overhead costs), but everyone capable of paying and contributing to their potential healthcare costs does so, rather than just leaving it to those who continue to have health insurance and are stuck paying the costs of more and more people who should be paying for themselves.

So what you seem to be saying is that you prefer paying for everyone else's healthcare, even if they are just as capable of contributing as you are.

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