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Spinaccio t1_je7x4tv wrote

Reply to comment by Jf2611 in ELI5: What is Universal Healthcare by Thegreatcornholio459

But, wouldn’t the new administrator need most of the same people to manage the system?

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Jf2611 t1_je7yn4n wrote

Not even close. There is a whole industry within the industry. Insurance companies have sales teams who are responsible for bringing in new hospitals to be "in network" as well as bringing in new employers and private citizens to use their insurance over someone else's. Then think about every insurance company and the amount of people in leadership roles that would no longer be needed - thousands of C level and VP level executives who "run" the various companies that wouldn't be needed anymore.

Then you have all of the customer service agents who answer questions about coverage to customers. Then you have a whole bunch of folks, like my wife, whose sole job is to verify that your insurance will cover the procedure you just scheduled for yourself.

Then you have all of the various ancillary jobs associated with those roles, admin, IT, etc. Not to mention all of the people that work for drug and equipment companies who "lobby" the insurance companies to cover certain drugs and what the costs would be.

Then you look at how many companies are in the industry to make a profit - drug companies for example. You start dictating to them at the government level how much they can charge for a drug or piece of equipment, suddenly they don't have an incentive to innovate and so people are laid off.

Medicine is a big business machine in the US.

Look up largest employers by state, so many of them are hospital networks. A lot of those jobs are admin related to dealing with the insurance companies.

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Spinaccio t1_je804j3 wrote

That is a lot I didn’t know, thanks for answering. Do the countries with single payer insurance have similar networks?

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Jf2611 t1_je8129c wrote

Not even close to the same scale. Single payer is a type of universal healthcare. In a nutshell, it means that a single entity is contracted to provide healthcare. They would need some admin, but nothing to the scale that the US system has. With a single payer system, there wouldn't be the need to verify insurance coverage, determine costs, etc. It is what it is.

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Spinaccio t1_je81x7r wrote

So, would switching to a single payer system require a whole set of other programs to employ all these talented people? Like a New Deal? Seems like our gornment would have to do a lot of work to plan and administrate something so massive. Like, do their job.

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Jf2611 t1_je82sky wrote

There would be a need for jobs, for sure. But there would be a lot of redundancy if your goal was to give everyone a job in the new system.

Let's say there are 10 insurance companies and we suddenly had to get down to one organization. So that's 10 CEOs down to 1 - what jobs do the other 9 get? The further down the chain of command the more redundancy you get. You could probably run the new administration with the headcount from two of those 10 companies, maybe even less since one system would allow for streamlined optimizations of policy and admin work.

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Manofchalk t1_je8321u wrote

Would it require, no.

Would it be a good political move to do so, probably. Though attempting to cut down the US for-profit health insurance industry with its massive lobbying arm is already unhealthy for a political career so maybe the ire of thousands of unemployed middle managers and cubicle workers wont matter.

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GermaneRiposte101 t1_je84ib3 wrote

A major advantage of Universal Health is that the they can use their size to reduce the cost of medicine, sometimes by several orders of magnitude

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throwawaydanc3rrr t1_je89o91 wrote

Often this is done with rationing the care by wait lists.

In the United States it is (mostly) rationed by price.

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