Does anyone know of the exact savings of Single-Payer?

[steelmania75]

I know it would save the country tons of money each year, but I'd like to get a good estimate as to how much we would save. The United States spends 16% of its GDP on health care services which is 2.345 trillion dollars. Also, when costs would go down, where would the money go from that 2.345 trillion dollars in health spending?

[Lasher]

1. Here is a link to a CBO single-payer comparison from 1993.

The lack of a more recent CBO study is a sad indictment against Congress, particularly considering the events that led to passage of Obamacare legislation.

http://www.cbo.gov/ftpdocs/64xx/doc6442/93doc171.pdf

[xchrom]

2. +1

[alc]

3. I've seen $10-40 billion/year in paperwork

But it will come down to the details. After congress passes it, there would likely be 10s of thousands of pages of details and regulations written. At these extremes, these regulations could be

1. Provide medical service/prescription
2. Submit paperwork
3. Get paid

or

1. Doctor asks permission to perform service/write prescription
2. Gov't checks patient's history (cut down on fraud, overuse, etc)
3. Gov't needs more details
4. Provider gives details
5. Gov't denies X% of the time. got to step 3.
6. Service/prescription provided
7. Paperwork submitted
8. Paperwork rejected X% of the time (X goes up every year to save money). Go back to 7

The first method is a pretty sure way to save $10-40 billion/year. The second has "potential savings" of $100s billions, (much of it by making things so painful that doctors quit and some hospitals stop providing certain procedures and patient stop going to the doctor for many things).

If you think the government does regulation well, you can expect something like the first method. I expect something more like how we regulated the financial markets and BP (fraud will eat up any savings) or something like the IRS tax code (need a CPA equivalent for anything more than your yearly physical).

Congress can pass the best bill in the world, but it'll be up to the regulators and I don't trust them. We still need to keep pressure on regulators (and Congress) for the current reform. It can succeed or be a disaster depending on those details.

[cbdo2007]

6. How would single payer save $10 Billion/year in paperwork?

I don't see how the amount of paperwork would be less than it is now no matter who is paying/running the system.

Even if it did save $10 Billion/year in paperwork that would probably account for hundreds of thousands of jobs lost.

[ljm2002]

7. There are many competing insurance systems out there...

...and every time a claim is filed, someone has to fill out the right form and send it to the right place and then possibly discuss / fight with the person on the other end about whether this, that or the other thing is covered. Doctor's offices spend lots of $$ to support the office staff to do this. Some doctors simply take direct payments and have their patients deal with their own insurance company to get reimbursed.

With single-payer, doctor's offices would have a much simpler task, and their staff would only have to know one set of rules and one place to call when discussing / arguing with the person on the other end about coverage.

With single payer, employers would no longer have to maintain staff to keep records related to their employees' health claims and to mediate between their employees and the insurance company.

For the individual, we would get the care we needed with minimal paperwork, and would not have to go bankrupt to get it.

I'm not seeing a downside. :-)

[cbdo2007]

8. There will still be a huge bureaucracy (sp?) due to the single payer

plan actually being administered by different companies who are all trying to interpret the laws correctly. Add to that the different state requirements for what is/isn't covered and I still don't see a lessening of paperwork or discussing/arguing.

Even if there were a single payer system, the health insurance companies we all know today will still exist and would be contracted to actually administer the plans in each region/state/city, along with offering their own supplemental plans like they currently do now with BA+ to offer better benefits or different options than the govt. plan.

I'm not arguing with whether or not single payer is the way to go, but I don't think there will be as much change to the administration side of it (including jobs and cost) as people think. With your explanation, I'm still seeing hundreds of thousands of jobs lost which would definitely be a down-side, expecially in our current economic state.

[jmowreader]

4. The efficiency rating of a single-payer system is easier to state

The government's main single-payer system, the VA, is 97 percent efficient--it only has three percent overhead.

Their cost figures won't mesh with a single-payer system geared to treating lifelong civilians because many of the VA's customers are combat-wounded senior citizens.

[Lasher]

5. The VA is socialized medicine, where the government runs the hospitals and clinics.

Medicare is a better example of single payer.

[jmowreader]

9. Medicare is close, but it's not a single-payer plan either

There is a lot of private insurance in the Medicare system (look at Medicare Part C and Medigap), plus there are out-of-pocket expenses for the beneficiaries. And let's not even get into Part D!

Medicaid is closer to single-payer.

And you're right, the VA is socialized medicine--it's also the clearest proof going the teabaggers, who were all positive the government can't run a health system, have no idea what they're talking about--because the government owns the hospitals, employs the doctors (who don't mind the lower pay because they don't have to fuck with insurance companies or worry about malpractice insurance) and maintains pharmacies for which they've negotiated the price of every drug they carry, they get better results for less money.

[Lasher]

10. Yes, that is true, but I was thinking only about traditional Medicare as single payer.

When I think of traditional Medicare, in my mind I exclude all those things you mentioned. When I For the analysis in question, it is important to do just that.

Medicare Advantage (AKA Part C), for example, is certainly not single payer, as you have noted. Thanks to Junior and his Bush league GOP lapdog Congress, the government pays a MA per capita subsidy that is 12% more costly than that furnished for traditional Medicare.

And so, I suggest that traditional Medicare is the best US single payer example - even better than Medicaid, which is run by the states, often through for-profit companies, and with a lower degree of nationwide uniformity.

When I say that the VA offers socialized medicine, I am not being critical. They have a good setup, with advantages and disadvantages over private sector health care/insurance. But their costs are universally low, just as you say.