1) We cannot provide the same services with the same mechanisms, processes, and infrastructure at 50% of the current price. The margin simply isn’t that high. Everything from the design of the hospital, to the regulations around the equipment provisioned in each room, to the processes followed by staff throughout a given patient visit need to change, along with the specific tools and techniques used to perform procedures, before we even get into how and what procedures are chosen to treat or manage a given symptom or disease, whether acute or chronic.
2) Even with all of the above, a system that optimizes for price will absolutely have to make trade-offs in other areas to achieve that. Understanding where, when, and how those trade-offs are made and if they are being made fairly and uniformly based on malady, procedure, patient population, etc. is not a minor detail.
These are massive structural, policy, and economic changes which will impact a double-digit percentage of GDP. Why should anyone have any faith that this will be done in any semblance of a sane, reasonable, compassionate, let alone fair, efficient, or effective manner?
If the government has shown it’s entirely incapable of passing effective legislation to manage the cost of healthcare, why should government be granted an order of magnitude greater role in the provisioning of care?
And yet it manages Medicare. Poll Medicare recipients and ask them what they think of it. It also manages Social Security. And provides for the national defense. The government is entirely capable passing effective legislation, or at least half of it is.
In any case, the current system is both unfair and unsustainable. Something has to give.
Just to be clear, Medicare costs are roughly 50% higher again per person than the current average US cost per person. Patient population being a major confounder in that comparison, of course.
US defense spending is by far the highest of any other country in the world, and renowned for its wastefulness.
Social Security is going bust whenever we talk about it, and is merely a program which confiscated money today, in order to hand it out tomorrow, and doesn’t even invest it in the meantime.
And which half of government is it that’s capable of passing legislation again?
>Medicare costs are roughly 50% higher again per person than the current average US cost per person.
The numbers speak for themselves and it is ridiculous the US spends 100% more for half the people (e.g. Medicare) than Germany spends to cover 2x as many people and their entire country.
That said keep in mind Medicare patients are the most expensive patients in that they have the highest rate of chronic diseases of any other demographic. Its not apples to apples, but more importantly a Universal coverage could probably be extremely effective in preventing untold millions of chronic conditions through preventative care. What happens now is millions of people reach Medicare eligibility who had no coverage before and as a result have all these untreated chronic conditions, and then boom Medicare has to cover the tab when they become eligible. Its such a stupid system, there are even cases of heart surgery's and cancer treatments that are delayed until a patient hits medicare age, making the issue worse and more expensive to treat.
It may sound like I am taking a devils advocate position, but I 100% agree with you on governmental waste.
1) We cannot provide the same services with the same mechanisms, processes, and infrastructure at 50% of the current price. The margin simply isn’t that high. Everything from the design of the hospital, to the regulations around the equipment provisioned in each room, to the processes followed by staff throughout a given patient visit need to change, along with the specific tools and techniques used to perform procedures, before we even get into how and what procedures are chosen to treat or manage a given symptom or disease, whether acute or chronic.
2) Even with all of the above, a system that optimizes for price will absolutely have to make trade-offs in other areas to achieve that. Understanding where, when, and how those trade-offs are made and if they are being made fairly and uniformly based on malady, procedure, patient population, etc. is not a minor detail.
These are massive structural, policy, and economic changes which will impact a double-digit percentage of GDP. Why should anyone have any faith that this will be done in any semblance of a sane, reasonable, compassionate, let alone fair, efficient, or effective manner?
If the government has shown it’s entirely incapable of passing effective legislation to manage the cost of healthcare, why should government be granted an order of magnitude greater role in the provisioning of care?