Medicare for All and Administrative Costs

Political talk is getting more and more serious around Medicare for All in the United States. The argument, as usual comes down to costs. One of the advantages that proponents always bring up are the very low administrative costs of Medicare. Are those low costs for real? Would they hold up if everyone was in the system? Healthcare Triage looks at the facts.

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Stan Muller -- Director, Producer
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And the housekeeping:

[tetsubo]

Funny how when you take out marketing and profit from healthcare, the cost goes down.

[minabotieso]

Funny how politicians critical of MFA don’t make arguments anywhere close to as reasonable and correct as this.

[katsnax]

Longtime viewer, first time commenter here. Like, I've been watching since the channel was established and promoted by vlogbros. Love your work, Dr. Carroll.

I work, now, in a pain management clinic. I previously worked for a major private company which offers Medicare advantage plans. In fact I'd say it's one of the industry's leading companies and continues to expand its Medicare offerings and decrease it's commercial plans.

I know Medicare isn't a super entertaining topic to young people because it gives an impression that this only matters for the "elderly" but, knowing what I know in my line of work, it is so important for every American citizen to learn all that we can about Medicare as it operates today. Especially if we eventually hope to push for a single payer system where we are all operating under a "medicare for all" program regardless of age.

I implore you to make more videos breaking down Medicare into digestible pieces. You guys do so well at making things understandable in laymen (sp?) terms and it's a topic we so desperately need to hear more about it!!

Thank you for all you do, HCT!!

[karlclements]

Not an American but the network of doctors thing always seemed odd to me, only being able to go to a doctor on your insurance network seems nuts. Doing away with that and having just Medicare and all doctors accessible to all patients seems more sensible

[Borisb]

So yes... Still no excuse for the excessive healthcare costs in the US. Also, you need to look at the whole picture, not just administrative costs.

[gogeeks]

Care management by a private plan just feels like a cost-saving watchful eye, and a conflict of interest in you receiving the best healthcare

[scott]

HEALTH CARE : Europe vs America
THE USA WHY SO COMPLICATED???

WHATS IN IT FOR THE GOVERNMENTs and THE PATIENTS and why EUROPE WINS
European system costs 11% of GDP against 19% in the USA
The USA (BAD)system is rated at 42nd in the world.

EU HEALTH CARE IS ALL INCLUDED and is the best!

THE REAL ISSUE
1. EU Health is non political, non profit, more efficient and cheaper that the USA system,

2. BETTER in many ways, as the patient is first, and health has no “profit COST”.

3. It reduces the cost to the Government. (11% against the USA 20% per year GDP)

4. Its not fragmented. Its coverage is national, and for all.

5. If you are REGISTERED as a TAX payer, you have no problems.

6. If you are clandestine, then you get some emergency humanitarian services only.

USA life expectancy is 42th in the world on the world ratings.

WHATS IN IT FOR THE EU PATIENT?
If you pay taxes, as an individual, and contribute to the central government “POT” (the community POT of money).
You are covered for all treatment, hospital costs, surgery, drugs, implants, chemo, post op therapies, cost of prescribed drugs, specialist and normal GP doctors bills, specialist bills etc etc.
(There are some small exceptions.)

You dont have to look at the small print of coverage.
Its all included, pocket your credit card.. you dont need it.
You dont have to pay in advance
NO Paperwork just let the system work
The system is rated as better than the American system as nobody is excluded and the system covers 99% of all patient needs.

THE EUROPEAN SYSTEM:
HOW IT WORKS:
All european health systems are government run and are simple systems .
It is a central, run by the govenment covering all healthcare needs for the population and is non profit, universal, and also internationally recognised between all EU countries.
The EU underlying system is through fiscal residency of a person,
Simply put, each person pays into the THE GOVENMENT POT as a % of individual pay packet contributions where you are employed
Importantly even if you are unemployed, but registered, you control illegal immigration. Illegals get no benefits, unless humanitarian emergency.
Importantly you are still covered. you as a patient get equal rights and coverage across Europe.

The EU system is state run, and covers everyone, from birth to death and costs half of the USA system.
Therefore in the USA a % of the health cost is based on profit to be paid out in dividends.

Additionallly not all people in the USA are covered, (approximately 15%)
Its a Bum deal for Americans. It costs 8-9% of GDP more than Europe

HOW IT IS MANAGED:
In America USA, the health system is profit run for the most part and privately handled. Patient care is secondary to profit for 50% of coverage.
The European state (country) is the employer of all health staff, doctors, nurses, etc.

Central government then covers the hospitals costs through a system which keeps the hospitals covered for the expenses of each patient.
If we compare the EU to the USA structure in terms of cost to GDP, Europe average 11% of GDP to the USA 20% of GDP, (2019) with the EU at 99% coverage and with improved life expectancy rate, compared to the USA.
Central Government in each country collects the money through the taxes you pay as a citizen, and redistributes it (generally) to regions, hospitals, and doctors etc which then distributes the funds to the health system used by the patient.

The Government also allows the private sector to operate under the public system, to build hospitals, run them privately.
Each country allows this in different rules, like Germany/UK/France etc. They are then licence them to operate by the government.
But importantly, the patient who pays to the state contributions through his salary, has equal rights to access all hospitals.
10-15 % of the EU health system is private

If you wish to pay an additional supplement to the state system, you are allowed to do this into to the private scheme on top of your mandatory state payments so you get private health care coverage.

But you cannot opt out of the central system or add to it.
Most of people dont have the means or desire to pay private insurance policies. So the state system is better for them.

WHATS THE BENEFIT IN THE EUROPE SYSTEM
Basically the EU system covers 99% of people and costs the half of the USA system.
In addition to this, with the EU system, if you pay contributions to the health system in the UK or France, you can have full medical care in other countries, Germany, Italy, Hungary or any other of the 27 states etc.

If you lose your job, you will still be covered. you just pay less to the system as unemployment reimbusement to you is less, so you pay less, but the more you earn at work, the more you contribute to the central system. Its based on % of earnings.

These European systems are based on the old and original UK system, The National Health Service, abbreviated to NHS, was launched by the then Minister of Health in Attlee's post-war government, Aneurin Bevan, at the Park Hospital in Manchester. Aneurin Bevan, Minister of Health, on the first day of the National Health Service, 5 July 1948 at Park Hospital, Davyhulme, near Manchester.


Thanks for the comments!!!!

[SallyHampton]

This just proves that we must remove private insurance if we hope to lower costs.

[jasonsmith]

We need to figure out how to stop price gouging in healthcare. Something so essential to human life shouldn’t be run like a business

[finalmage]

Keep up the awesome work!

Your videos are criminally under watched given the amazing content they provide!

[danieljensen]

Interesting that you make networks sound like they're supposed to be good when I think they're a major problem with US healthcare... It took my dad 6 months of fighting with insurance about out of network issues before he could get surgery for his pancreatic cancer and know it would be covered.

[theengineer]

Take away private insurance companies, make government the only buyer as an monopsony will make drug / device companies lower their costs for their products and services.

[truecrimelover]

Any politician against Medicare for All should lose theirs. Personally I think they should be tied to each other. They should get the same quality and quantity of the same value as the rest of us Average Joes.

[suresh_elonbro]

if the private part of medicare actually costs a lot to maintain, this is an excellent argument to get rid of private players in medicare for essentials and cover them fully.

[worldcitizenra]

The statement at the 5:24 mark that private plans offer an advantage because they have an out-of-pocket limit and Medicare does not is completely disingenuous. It ignores the fact that up until the Affordable Care Act that conservatives love to hate, private insurance typically did not have an out-of-pocket limit and for those private health care insurance policies that did have a limit, it was much, much higher than it is now. The out-of-pocket limit is not something that the insurance company executives put in place because they are responsible, caring people. They did it because they were forced to.

[reinerwilhelms-tricarico]

At least there is a way to effect the reduction of bureaucracy in Medicare by public oversight and required transparency. That is not the case in the private health care and insurance industry, especially as in many states private health insurance is in the hands of quasi monopolies that the public has no way to control. No transparency - business secrets - and competing bureaucrats in private health insurance vs. required transparency in Medicare administrations - which one do you preference?

[KistenPiper]

Looking at the administrative costs of Medicare for all are interesting, but if such a program were to be created tomorrow, as you've just pointed out that would be a small fraction of total cost. Ever plan on an episode (or maybe there's one already that I missed) going over exactly how much MFA would likely cost if it were to appear? And maybe just as important: for the average american who switched from average private insurance, would their health outcomes likely worsen or improve as a result of switching to MFA?

[AdamKhan-mbmu]

any way to post links to the studies that are referenced in the videos?

[TheRepublicOfUngeria]

The fact is this: Humanity is going to stop growing our population eventually. When that happens, we are going to be living in a society in which the old people to less than old people ratio is going to be really high. Healthcare costs will rise as that ratio rises, because old people are health care whales. It will not get any higher than that, but it will cap off at a high level, and we are going to have either bear the cost of that society, or we are going to have to start letting old people die. Pick one and be honest about the consequences you think society should accept: should we live in a society in which we can live nice long retirements? Or should we just let old people die before or not long after they retire.

[clhand]

Allowing for more sufficient competition between medical insurance companies would certainly help bring down the private administration costs. We don't currently have much of a competitive marketplace.