You keep saying unrealistic assumptions to try to disregard literally dozens of studies but can you elaborate on this in any way, like what is unrealistic and what is realisitc

One point would be the generosity of admin costs assumptions, I'll refer to the Lancet study as an example. The study naively assumes that because Medicare has 2.2% of its expenditures being overheads while private insurance has 13%, we can assume M4A will match 2.2%. But Medicare and Private have different costs, Medicare also piggybanks of the social security system, FBI, DOJ etc deflating their costs on paper.

Also the reason why it's 2.2% is partly because healthcare expenditures for those on Medicare are very high, so this reduces the denominator in the division.

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ Though that study doesn’t explicitly state causation, if your brain is larger than an ant you can figure out their lack of medical coverage leads to disproportionately worse outcomes and higher death rates. Even if we disregard that study, the Urban institute has shown through casual analysis that 18,000 uninsured people die annually through lack of healthcare, you cannot deny that

> you can figure out their lack of medical coverage leads to disproportionately worse outcomes and higher death rates.
No you can't just assume that, like I said the treatment can be endogenous - meaning expanding insurance won't reduce mortality as lack of insurance does **not** increase mortality. Another way of saying this is "people with car insurance will drive more recklessly because they don't bear the cost".

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ Regardless of whether one number may be slightly inaccurate, the majority of the studies agree that Medicare for all would reduce admin costs

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ Regardless you can’t deny the Urban institute study

And don’t just say “generous assumptions” be specific

> , the Urban institute has shown through casual analysis that 18,000 uninsured people die annually through lack of healthcare
Same methodology problems as the Harvard one - does not establish causation, another group of other studies find no change in mortality. I.e this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739025/
"*The Institute of Medicine's estimate that lack of insurance leads to 18,000 excess deaths each year is almost certainly incorrect. It is not possible to draw firm causal inferences from the results of observational analyses, but there is little evidence to suggest that extending insurance coverage to all adults would have a large effect on the number of deaths in the United States.*"

> Regardless of whether one number may be slightly inaccurate, the majority of the studies agree that Medicare for all would reduce admin costs
It's VERY inaccurate; almost all studies on M4A agree it will reduce admin costs - but the reduction is more modest than the Lancet one.

I.e The optimistic estimates put Medicare for All achieving rates of 6% on admin costs, but it's probably slightly higher.

Death
risk appears to be 25 percent or higher for people with certain chronic conditions, which led to the IOM esti- mate of some 18,000 extra deaths per year.

🆙 | **Thememelord leveled up!**

That’s from the Urban institute

The study I sent refuted the 18k deaths one, TL;DR it's the same problems as the Harvard one.

There is probably deaths due to lack of insurance, but in the thousands at most - not 40k, 20k etc.

The reason why I'm saying all this is because I see medicare for all as the worst possible solution to a problem out there, comparing to other country's systems too.

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ The UK excellent healthcare and half the costs

The UK does not have Medicare for All, not even close. But even so, the UK in the developed world has one of the largest waiting times; one of the worst outcomes.

And not necessarily 'half the costs', if you're looking at per capita spending by country keep in mind the US will naturally have a disadvantage as: it has much more health problems than the other countries, i.e UK and a higher income.

Higher income causes healthcare expenditures to be higher, not a bad thing.

We can't just have extremely low spending, we need a balance. I believe my system will find the optimal.

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ Wdym, by medicare for all I mean a single payer healthcare system such as is propsed by Bernie Sanders. It’d move the US to a system similar to the UK

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ What is your system

Medicare for all wants to: ban private insurance; remove cost sharing; cover a large amount of things, i.e dentist works and provide insurance to everyone via the government. Many countries do the last one "provide insurance to everyone via the government", but NO countries do all of the 4 and literally near 0 do the first 3.

The UK has nationalised hospitals too, care givers - I wouldn't want to move to that and Sanders' plan doesn't.

But it has not banned private insurance.

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ No the US actuall consums less healthcare it’s that it is much more expensive per capita

Useful comparison

https://international.commonwealthfund.org/stats/annual_physician_visits/

Yep?

That’s misleading, he doesn’t want to eliminate copays, just reduced them

I'm pretty sure he does.

And on the point of Admin costs the US spends around twice as much as Canada

Agree, but it's not comparable

Costs are different, the way admin costs are calculated are also different etc.

We cannot just match them, we won't.

Every nation that has implemented any version of single payer has dramatically lower admin costs. If we adopt the system then there will be a drop in admin costs

We are not every other nation, costs are different. Admin costs will fall but at best to 6%, **at best**.

You can't compare across other countries, especially when the systems are totally different.

You did say this
> What is your system
A full private, market based system.

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ Why

@sɪᴅɪsɴᴏᴛʜᴇʀᴇ Not any gov intervention?