You're still paying the same people the same wages to work for the government.
Or is your solution that we should pay health insurance workers less money?
You originally proposed eliminating all the jobs. Now you've moved all the jobs to the public sector. So unless you're paying them dirt, all that money is still going to people working to make sure healthcare fraud isn't 80% of GDP.
In a perfect world, you have 6% more money to spend on healthcare instead of corporate profits.
That's not going to change the picture that much.
And you're unlikely to arrive in a perfect world.
You'll probably get a 10% more expensive system that's 9% more inefficient and has 0 profits.
Canada isn't hypothetical. It is very easy to compare costs and outcomes.
I live in BC, Canada, and we don't have an entire industry built around claims processing, administration, etc. They still pay health care workers, but they don't have to have phone banks filled with people answering questions about claim denials. I'm not even sure if a claim denial is a thing here, or who I would call. We don't have healthcare insurance CEOs making 23mm per year. We don't have customer service reps, we don't have billing specialists in every medical practice, we don't have medical coding experts. These things kind of exist in a bare minimum way, but not anywhere at the scale that I have seen in the US.
I go to the doctor, they make a medical determination about what my needs are, and we proceed from there. There is almost no fraud because the doctor has no real financial incentive to overtreat me, and since it is a single payer system, malicious patterns get picked up quickly and efficiently.
Keep in mind that each province administers their own medical system, so there is no such thing as the Canadian health insurance system.
> They still pay health care workers, but they don't have to have phone banks filled with people answering questions about claim denials. I'm not even sure if a claim denial is a thing here, or who I would call.
The Canadian system may be much cheaper to administer, but it isn't magical. There is still a need for staff to administer and adjudicate claims, and you still have to ration limited healthcare resources somehow.
Notice how all of the things that you found represent a single department in the provincial government instead of a significant part of national GDP spread across multiple billion dollar conglomerates.
The first link you submitted is actually showing how the automated system processes the huge majority of claims automatically without people in the loop. So not a good argument that BC has phone banks of people answering claims questions.
Yes the claim process exists, and the various appeals parts exist, but that part of MSP is just not the patient's problem. If you read through the reasons for denial that you linked, almost all of them are requests for better paperwork or missing information. The level of administrative overhead just doesn't exist on the scale that I have experienced living in the states.
What I have never had happen, or heard of happening, is a resident getting a bill for seeking medical care (which would happen if a claim was rejected). Or someone not receiving medical care due to inability to pay. Or having to doctor shop for a place that accepts their insurance. In fact, most people I know have never even had to contact MSP.
>The Canadian system may be much cheaper to administer, but it isn't magical. There is still a need for staff to administer and adjudicate claims, and you still have to ration limited healthcare resources somehow.
But it isn't just the Canadian system -- it's every other system too.[0]
There is a unique form of corruption occurring in the American health system and it is absolutely tied to the insurance industry.
This corruption causes the misallocation of resources in ways that are detrimental to the health of American citizens.
Medical bankruptcy and the cost that it has on a person's health isn't really a thing in Canada. Having to choose between paying for medical bills or healthy food isn't really a thing in Canada. People putting off minor medical issues until they grow into major issues because they can't afford routine checkups or treatments isn't really a thing in Canada.
This results in far less rationing of healthcare because people are able to make better choices that prevent the waste of medical resources.
Don't get me wrong, there are issues with Canadian healthcare -- the biggest being corrupt politicians and business people trying to import American healthcare practices for their personal gain but the issues that the average Canadian face in accessing healthcare are nothing compared to those that the average American faces.
> There is almost no fraud because the doctor has no real financial incentive to overtreat me
The vast majority of healthcare fraud does not come from corrupt dentists convincing you to get root canals you don't need.
The largest source is billing for services not rendered.
That is: some provider just makes up that you came to see them and charges the insurance company and you don't even know about it.
This is a non-trivial problem to solve.
Even in the NHS in the UK - where the entire system, including the providers, are public - there is STILL a large billing for services not rendered problem!
This seems trivially solvable. In BC, Canada, I had an old doctor renew a prescription over the phone. This must have triggered a fraud alert because my address was now in a different health management district. They sent me an automatic notice asking me to confirm that I had been helped by that doctor at that time. I believe I can also log onto a provincial portal and see activity related to my medical care.
Seems like a pretty low cost way to ensure that no fraud is happening. Set up triggers for confirmation like doctors treating people who don't live nearby, treating people who are concurrently seeing other doctors, or any number of other known fraud alerts, and follow up.
Since private practice isn't really allowed here, getting removed from the provincial insurance program means a career death sentence, so I think that it just isn't that big of a problem anyway.
I'm not a citizen of the UK so I can only speculate from a poorly informed position but I would imagine that it has to do with the starve the beast tactics that are being used to weaken the NHS to make it more susceptible to privatization.
I've proposed eliminating those jobs because they're bullshit jobs that have a net negative contribution to society because the American medical system is hopelessly inefficient and corrupt.[0]
It is a curious thing watching people defend the undefendable. What makes you so confident in this system that so many Americans loathe and feel betrayed by?
Because (1) most Americans are satisfied with their healthcare and (2) the CBO doesn't think that a public option would decrease costs much if at all: https://www.cbo.gov/publication/57125
You're still paying the same people the same wages to work for the government.
Or is your solution that we should pay health insurance workers less money?
You originally proposed eliminating all the jobs. Now you've moved all the jobs to the public sector. So unless you're paying them dirt, all that money is still going to people working to make sure healthcare fraud isn't 80% of GDP.
In a perfect world, you have 6% more money to spend on healthcare instead of corporate profits.
That's not going to change the picture that much.
And you're unlikely to arrive in a perfect world.
You'll probably get a 10% more expensive system that's 9% more inefficient and has 0 profits.