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Comment by nickff | Hacker News Reader

>"In 2022, the British government spent £3.5k ($4.4k) per person per year on healthcare. The US spent $13k per person per year in 2022, of which $6.2k was government (national+state+local)[2]. The UK government spends less per person than the US government on healthcare, even before the amount paid privately."

The difference in medical spending is largely due to wage costs being much higher in the USA than the UK; healthcare insurance companies are not as profitable as it may seem (they're about as profitable as other insurance businesses). Pharmaceutical prices don't explain much of the difference either, because they’re only a single-digit percentage of healthcare spending (in the USA).

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It isn't about the profit margin of the insurance companies it's about their purpose. What value do they add to the healthcare industry?

Aren't healthcare insurance companies intrinsically an inefficiency that could be outright eliminated?

If there is to be some control on healthcare spending, and/or policing of fraud, someone must approve and decline payment for services. This is the function currently fulfilled by the insurance companies. You can eliminate the companies, but anyone performing the service will consume some amount of overhead.

Well whatever is going on in America[0] it just isn't working.

https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_heal...

It isn't intrinsic. In any modern healthcare system, someone has to manage resource allocation and risk pooling. Some countries have government perform those functions, which can be more efficient but isn't necessarily so. In the USA, even the government run Medicare health plan outsources much of the administrative work to for-profit companies.

@nickff shouldn't that be a not-for-profit watchdog capability then? Not a massive money making middleman?

(Can't reply that deep)

Even if that is true, how does that change anything about what I said? The government can evidently do this more effectively, fairly, and efficiently.

That may be true; what are you basing this view on? How do you evaluate those three criteria?

> what are you basing this view on?

Every other developed nation?

It seems that it's not as clear to me, so could you please explain how one should evaluate those criteria?

The most obvious criteria is cost per citizen. The US has, by far, the highest cost per citizen. And also the lowest quality care.

I explained in my original post. The fact the UK government spends less than the US government on healthcare per-capita, despite the fact it gives everyone healthcare rather than just a subset of the population is pretty damning. How can anyone possibly argue the US system is working more efficiently given that?

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