[roenxi]

Typical US profit margins are somewhere in the area of 8%. If dropping healthcare costs by 8% is what people are arguing over then I've been badly mislead about the problems with the US healthcare system.

There is a real issue with regulatory capture. Making the system purely public is not going to result in the regulators suddenly purging their souls of all corruption. It'll still be a disaster just without any pretence of an alternative. There are literally people on HN every day who would happily improve on the US healthcare system's costs and outcomes if well meaning busybodies hadn't banned them from doing so by overregulating.

[foolswisdom]

That's nominal profit margins. It doesn't take into account the way that different parts of these conglomerates take money from one pocket and put it in the other (e.g. insurance and Healthcare providers), which means it doesn't show up in the profits for your first pocket. This is why the fact that Healthcare platforms are vertical monopolies (not just horizontal monopies) is important to this conversation.

(separately, profit capping rules means that once a monopoly is cemented, once a company has moved as much as it can from one pocket to the other, there's an internal incentive to spend money on bureaucracy).

[roenxi]

Because the regulations encourage vertical monopolies. Replacing that with a state mandated vertical monopoly unconstrained by market forces isn't going to help. In fact it'll probably make the situation worse. There is no reason for there to be monopolies in healthcare and if they are emerging that strongly suggests misregulation. Giving the regulators more power in that sort of situation is the opposite of helping.

[ThePowerOfFuet]

Are you seriously arguing against single-payer healthcare?

[roenxi]

Which part of the argument strikes you as frivolous?

[ThePowerOfFuet]

Not frivolous, but outright incorrect.

[roenxi]

So far it's beating your argument pretty handily. I'm not sure why you think it is worth writing that without including one; but my advice would be if your going to post a comment disagreeing with someone you should include some actual arguments or evidence. It helps keep the threads from rambling on.

[lotsofpulp]

>That's nominal profit margins. It doesn't take into account the way that different parts of these conglomerates take money from one pocket and put it in the other (e.g. insurance and Healthcare providers), which means it doesn't show up in the profits for your first pocket.

This is nonsense. UNH’s profit margin is all net income divided by all revenue.

https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-g...

Same with Elevance, CVS, Cigna, Humana, Centene, and Molina. There is a reason all these businesses aren’t at the top of the market cap rankings. Not even in the top 100.

UNH is up there due to sheer size and the fact that they sell high profit margin software and healthcare. Otherwise, you will not get rich starting a managed care organization. Even Warren Buffet, Jeff Bezos, and Jamie Dimon ran away with their tail between their legs:

https://en.wikipedia.org/wiki/Haven_Healthcare

[rqtwteye]

The profit margins are not the only thing. There are tens or hundreds of thousands of people working on billing jobs at doctors and insurances that shouldn’t exist.

[Auracle]

And you think a government run system would be more efficient? It’s still going to have people in each side verifying claims, preauthorizing stuff, etc. To do otherwise invites massive fraud.

[ljf]

Government run systems are alot cheaper all across Europe. So yes.

Unless you are saying there is something exception about the US and profit extractions?

[Auracle]

They're cheaper because of price controls on medications and salaries.

That's just straight up not going to happen in the US. We could have easily tackled medication prices by tying them to an average of some select other countries, but we haven't.

People would throw an absolute fit if our government tried to lower the salaries of doctors, and especially nurses.

The US is also just a very large country, population-wise. German has around 84 million people, so barely more than twice the population of California. I'd be a lot more likely to support government run healthcare if it was done by the states. The larger a system gets, the more inefficiencies sneak in - and, as a bonus, people could move to other states if the healthcare in their own wasn't up to par.

[rqtwteye]

Government run is not the only alternative. We should start at standardizing and simplifying things. Less variations in insurance plans. Standard data exchange. Same pricing for same procedures. Price transparency. It doesn't make any sense that a drug or procedure costs less in cash than through insurance.

[ForTheKidz]

> There are literally people on HN every day who would happily improve on the US healthcare system's costs and outcomes if well meaning busybodies hadn't banned them from doing so by overregulating.

I trust the market to provide healthcare about as much as I expect america to suddenly blast off to join the moon. And i trust vc/finance a hell of a lot less than that.

[roenxi]

Do you feel the Trump & Musk dynamic duo are going to do a better job of handling it? They're cut from similar cloth.

[ForTheKidz]

No, of course not, this is just more extreme of the same behavior.

[slt2021]

high cost of healthcare can be solved overnight: just mandate insurance companies to pay for healthcare for foreign hospitals (at rates not exceeding US rates).

so that Americans could travel overseas and get healthcare expenses reimbursed over there.

watch prices drop...

[rickydroll]

Does that include airfare and living expenses? I figured out that if I needed two crowns, it would be cheaper to fly to Estonia and use my friend's dentist than to go to a US dentist.

On prescriptions, reimbursement for drugs bought from cost plus would also help drive down pharma prices