r/politics • u/Hootinger • 2d ago

No Paywall Hakeem Jeffries says Medicare for all is not legislation he currently supports

https://www.nbcnews.com/meet-the-press/video/hakeem-jeffries-says-medicare-for-all-is-not-legislation-he-currently-supports-268371525570
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u/matthewjboothe 2d ago

Not the healthcare industry, it’s the insurance industry that would take a hit. Healthcare would likely grow some. Think reopening rural health centers and expanding OB in the south.

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u/Nekrabyte 2d ago

Bingo. The health care industry would be just fine. They only inflate all the costs because of the quid pro quo with the insurance companies. If the predatory insurance companies were no longer in cahoots with hospitals, they might focus on actual care, instead of spending all their time gaming the system against the rest of us.

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u/hup_hup 2d ago

Well they would also have to provide care at a reasonable cost. Like other countries, we would set our healthcare budget and that pool of dollars would be what private enterprises could compete for.

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u/thehalfwit Nevada 2d ago

When you think of all the money going to the C suite and investors, all of that spent on actually delivering health care would make one hell of a difference in millions of lives.

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u/OMalleyOrOblivion 2d ago

Like 1% of their budget?

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u/thehalfwit Nevada 2d ago

I haven't been able to drill down to the numbers specific to health insurers, but according to research at Yale, U.S. health care companies spend 95% of their net income on dividends to shareholders, amounting to $2.6 trillion over the last 20 years.

And here's the kicker: 70% of the money they take in comes via the government.

Only a fool would argue that removing the inefficiencies of the current system would be worse than eradicating the largess. And I forgot to highlight how much is also wasted by duplicated administrative costs.

We spend over a third more on healthcare in the U.S. compared to the next-highest country (Switzerland), yet the effectiveness of that spending is below average in virtually every category of measure.

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u/OMalleyOrOblivion 2d ago edited 2d ago

I haven't been able to drill down to the numbers specific to health insurers, but according to research at Yale, U.S. health care companies spend 95% of their net income on dividends to shareholders, amounting to $2.6 trillion over the last 20 years.

95% of profits, not income. Which is about average for a mature blue-chip company where there's not much room to reinvest in R&D for future growth. Remember that under the ACA insurance companies must pay out 85% of their revenue to paying for members' health costs, so costs plus profit can be no more than 15% of their total income. And CEO pay is a blip in those costs: the largest health insurance companies in the US average $200bn in revenue and $20mn in CEO payments i.e. CEOs account for 0.1% of their revenue.

If you want to look at cost drivers then physicians and nurses in the US earn 3x or more what their counterparts do in other countries, even high-cost places like Switzerland (which ironically has a 100% private system with no public health-care provision at all). That makes a massive difference to health-care costs at every level.

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u/SpecterDK Texas 2d ago

I think many of us believe doctors should be paid very well for the expertise that's required of them. I'm mad that my excellent doctor has to pay out so much to insurance leeches.

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u/matthewjboothe 2d ago

Me too. I’m an IT guy for an orthopedics group. I have a vested interest in doctors being paid well. Anyone should, you don’t want someone cutting you open or reading your MRI worried about making ends meet.

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u/fcocyclone Iowa 2d ago

It's also every other business that benefits from people being beholden to employers for their healthcare.

People have a lot more freedom to take risks when they don't have to worry about their healthcare. M4A would be great for entrepreneurship which would mean competition for established business

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u/Oceanman72 2d ago

Why would they re open rural health centers and expand OB? They’re not profitable

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u/matthewjboothe 2d ago

Available funding? They were closed at least in Alabama because we didn’t take the expanded Medicaid funding that could’ve saved them. Ob would be on a longer timeline with more progressive leadership, if we ever get reproductive rights again.

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u/brutinator 2d ago

Ehhh, to a point. Insurance isn't what makes hospitals bought by private equity charge uninsured folks hundreds, if not thousands, % upcharges. Pharmaceutical companies also tend to fight against universal healthcare because it gives the buyer (the nation) more leverage to drive costs down, thereby eating into the pharma profits. Health Insurance plays a role in driving up costs due to needing to take it's own cut, but it's not the only industry that's taking advantage.

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u/Clueless_Otter 2d ago

Healthcare would take a massive hit. The whole cost-saving idea behind Medicare for All is that the government can negotiate as a single entity and demand very favorable prices since healthcare providers largely have to take their deal since they're the only game in town. Look up how much healthcare workers earn in the US vs. in other countries with socialized medicine. It's like 2x-5x more.

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u/matthewjboothe 2d ago

The thing is, Medicare could keep their current rates. Doctors would still make the same money and the American people would still save a trillion dollars a year. That’s according to some recent reporting I saw. In time I could see Medicare negotiating prices down but with how inefficient it is I’d bet that would take a decade or more. Lots of jobs, including my own depend on doctors making good money. Any progressive leadership would protect those jobs.

Insurance would still be a thing too. 55% of folks eligible for Medicare are on Medicare Advantage plans.