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Comment by digitaltrees | Hacker News Reader

Single payer Healthcare would flatten that curve by removing the incentive that insurance companies and health providers have to raise prices in coordination. Insurance is only allowed a certain percentage of admin costs (salaries etc) and profit from premiums so their incentive is to raise premiums but they can only do that by showing increased costs. Health providers have an incentive to show their costs aren't fully paid by insurance so they can also justify inflation of expenses.

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> Single payer Healthcare

Have you studied them in other countries? I suggest you inspect your assumptions by looking at what already happens.

Voters want infinite "free" healthcare from their politicians, so healthcare costs continuously increase. You have little recourse to say no to taxes.

In New Zealand ~17% of government expenditure was on health in 2000 and in 2026 it was ~22%.

In NZD it went from ~$10B to ~$40B (inflation and demographics are also an influence).

Privately paid also exists, but only ~1/3 the spending of public health. NZ government ACC spending is also huge.

Government ownership does not fix the problems you wishfully hope it might.

I did. I wrote several papers on it. The OECD spends far less for better outcomes than the US with lower slope of growth. And the growth is in large part due to demographic changes as populations age. Changes in demographics shouldn't be used to say health care doesn't answer cant work. Its ratios of spending across a population as some pay in when they are healthy and some consume as they age. Change the ratio and cost as a ratio also changes.

Let's pick one dimension: hip replacement costs in NZ versus USA. A poor example since fewer of working age.

Looks like surgical costs are similar when adjusted for GDP. The USA system isn't more expensive in comparison with the NZ system.

Replacement is free on the NZ public health system, but I've seen the painful years of waiting, the majority in my experience have to endure. A critical situation like my solo-mum friend who needed hips replaced was grossly delayed: hellish years trying to bring up her young children.

Statistics are very different from outcomes.

Universal SPH would save a net $300B to $1T, reduce paperwork, reduce deaths/improve outcomes, and provide better care. The FUD canards of "rationing", "waiting lists", and "communism" as well as classism and corrupt profiteering are the barriers to less suffering. Just give everyone the same coverage that doesn't have a 20% hole or lifetime limits... and that eliminates Medicare, Medicaid, Tricare, CHIP, ACA, and most private insurance, and most billing coding and prior-auth nonsense. Not doing so wastes money and kills people, just like parts of the BBB coming into effect after the midterms is going to bankrupt and kill thousands of people.

I agree. I own home health care agencies in 14 states. The admin we have to fund is absolutely ridiculous and wasteful. But republicans use clerical errors to scream about waste fraud and abuse because that justifies cutting spending and so the system operates inefficiently and costs keep rising on the public and private side.

Nothing will change in a lasting manner without first leadership addressing political and campaign corruption. Then and only then can SPH and nationalization/re-regulation/nonprofitization happen. For-profit healthcare should be allowed on the periphery but only under a carefully proscribed and uniformly-regulated manner rather than the predatory manner (i.e., private equity) allowed now. Nearly all healthcare should be nonprofit, government, and/or small businesses vaguely similar to the UK NHS or how it worked 50 years ago.

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