<story><title>Single-payer healthcare would save $450B and 68k lives a year: study</title><url>https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)33019-3/fulltext</url></story><parent_chain><item><author>bduerst</author><text>I worked in the EMR software industry and have certifications that involve hospital &amp;amp; lab billing, among others.  I&amp;#x27;ve been on site with healthcare providers, and there are entire buildings full of people whose job it is just to code and scrub claims, and cover disputes&amp;#x2F;negotiations with private insurance providers.&lt;p&gt;Consumers do not see it because it&amp;#x27;s typically off-site from the main hospital care facilities, but believe me, the administrative savings potential is real.</text></item><item><author>mgraczyk</author><text>In the study, nearly all the computed savings comes from two sources.&lt;p&gt;1. Decrease in pharmaceutical costs as a result of better bargaining power.&lt;p&gt;2. Decrease in administrative overhead, calculated by extrapolating the overhead in medicare to the entire US healthcare economy.&lt;p&gt;I don&amp;#x27;t have an informed opinion on either of these estimates, but my intuition is that #1 seems reasonable while #2 seems unlikely. The justifications they give include lower executive salaries and decreased fraud. From what I have been told by healthcare professionals, medicare has less incentive to negotiate cost, less incentive to investigate fraud, and therefore lower administrative cost.</text></item></parent_chain><comment><author>mochomocha</author><text>I once worked at a US biotech startup getting paid by insurers where we would build ML models just to reverse-engineer the inconsistencies of CPT coding &amp;amp; claim reimbursement by insurers &amp;amp; hospitals so we could get paid. Basically trying to automate &amp;quot;learn that Karen at insurer X processing claims wiht code Y from hospital Z usually decides to reimburse $XX&amp;quot;. This whole idea of &amp;quot;free market is more efficient for healthcare&amp;quot; has to die. All the incentives are backwards. For example: insurers don&amp;#x27;t want efficient claim processing because that means less revenues for them.</text></comment>
<story><title>Single-payer healthcare would save $450B and 68k lives a year: study</title><url>https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)33019-3/fulltext</url></story><parent_chain><item><author>bduerst</author><text>I worked in the EMR software industry and have certifications that involve hospital &amp;amp; lab billing, among others.  I&amp;#x27;ve been on site with healthcare providers, and there are entire buildings full of people whose job it is just to code and scrub claims, and cover disputes&amp;#x2F;negotiations with private insurance providers.&lt;p&gt;Consumers do not see it because it&amp;#x27;s typically off-site from the main hospital care facilities, but believe me, the administrative savings potential is real.</text></item><item><author>mgraczyk</author><text>In the study, nearly all the computed savings comes from two sources.&lt;p&gt;1. Decrease in pharmaceutical costs as a result of better bargaining power.&lt;p&gt;2. Decrease in administrative overhead, calculated by extrapolating the overhead in medicare to the entire US healthcare economy.&lt;p&gt;I don&amp;#x27;t have an informed opinion on either of these estimates, but my intuition is that #1 seems reasonable while #2 seems unlikely. The justifications they give include lower executive salaries and decreased fraud. From what I have been told by healthcare professionals, medicare has less incentive to negotiate cost, less incentive to investigate fraud, and therefore lower administrative cost.</text></item></parent_chain><comment><author>anonsivalley652</author><text>IIRC, coding is on the order of a million jobs across insurance, hospitals and doctor offices. Then there&amp;#x27;s all the other non-value-add activities of negotiating of prices, authorizing&amp;#x2F;denying treatment, billing and management. Oh and there&amp;#x27;s going through bankruptcy while you have cancer... I forgot that one.</text></comment>