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by sigvirt 2855 days ago
Propublica [1][2] has done some investigation into the amount of waste, beginning with a 2012 report by the Institute of Medicine of the National Academies. The unnecessary costs amount to roughly 5% of US GDP. For comparison: the defense budget is about 4.5% of GDP, and Social Security Disability Insurance outlays are about 5% of GDP. NASA's budget is about 0.1% of GDP.

A number of other commenters have castigated politicians on suspicion of being in the pocket of insurance companies or health care companies. Sure such things may happen occasionally. More certainly, politicians and bureaucrates are regularly attentive to the budget and financing of the government.

If medical care was cost efficient, it would 1) reduce GDP and the appearance of economic growth, and 2) wreck the back office math concerning whether the federal government can afford the deficit and the interest on the national debt. Elimination of mass incarceration and criminalization would cause a similar dilema. US economic growth has been 2-3 percent in recent years. If that were negated by substantial reduction of waste-masquerading-as-productivity, then the federal budget could not be financed without massive cuts or dramatic manipulation of interest and inflation rates.

There are others who potentially benefit from denial of treatment or claims beside the insurance company. Beside the doctors, medical institutions, and insurance companies are another set of actors: the benefits management and payment processing companies, who often profit per transaction. Some of the calculus in this camp can be seen in [3]. This part of the system (and others) can benefit when a patient is denied or discouraged from or uninformed of curative treatment and manipulated into some ongoing palliatve therapy - despite the possibility of greater overall long-term cost. The cash-flow gets distributed differently than curative treatment, and there are more smaller on-going transactions enabling a higher percentage of skim.

[1] Sep 2012 - https://www.propublica.org/article/a-costly-equation-medical...

[2] Nov. 2017 - https://www.propublica.org/article/a-hospital-charged-to-pie...?

[3] Nov. 2017 - https://www.bnymellon.com/us/en/what-we-do/business-insights...