Study: When Counting Premiums, US Workers Heavily Taxed

[DarkLight]

And moreover the preventative care is usually a fraction of the cost. So we all end up paying more because some people would rather pay to treat a heart attack ($$$$$) than some pills ($)

I think it’s the fear of being taken advantage of more than anything. Restricting things to people in emergencies means we know they’re not gaming the system.

I have often said we need a voluntary system in which people that work and yet can not get health care can have 12.5% of their check go to medcaid. Other can also have 6% of their checks go into that system to help those who need health care help.

You’d also need to make sure health care people were getting was adequate. I know one big problem is that low wage jobs that do offer insurance have shifted to high deductible models. The practical result is an effective lack of healthcare simply because workers cannot afford the deductible on their wage.

Obamacare did nothing to control costs of healthcare by requiring a very high level of medical services that must be covered by all plans regardless of the health, age, etc., of the individuals consuming health insurance. This extreme inclusiveness and lack of choice increased the cost of premiums substantially and reduced choice. I personally think that we need to allow for people to make decisions as to what procedures and services should be covered under their plans, this would help to lower the costs of premiums.

The worry is that, in practice, this would just mean that the poor would not have effective coverage. Those with preexisting conditions would also not be able to get effective coverage, if they got insurance at all. The fundamental problem with capitalism and health care is that it can often be more profitable (especially in the short term) to let certain people suffer or to let them die. And US charity care tends to focus only on immediate crises, not on those who may need long term help, and especially not on quality of life.

 

[Dan123]

I think it’s the fear of being taken advantage of more than anything. Restricting things to people in emergencies means we know they’re not gaming the system.

Fully agree. I cringe anytime as another example people talk about helping the homeless, and there’s always someone who raises their hand to say “well I guess I’ll just quit my job then and live in a free house!”. Literally what they’re saying is “if you try to help the homeless too much, I’m going to ruin it.”

I agree with the gaming thing, but that’s ironically part of what makes going ‘all in’ on single payer potentially worthwhile. When you limit help to people in very narrow bands, people try to put themselves in those bands to get help. If healthcare at all levels from preventative to emergency is simply part of being here there’s less incentive to game anything. Many of the issues you’d be left with are issues we already have, such as getting narcotics to resell.

 

[phil3]

You’d also need to make sure health care people were getting was adequate. I know one big problem is that low wage jobs that do offer insurance have shifted to high deductible models. The practical result is an effective lack of healthcare simply because workers cannot afford the deductible on their wage.

In the UK they tax 12% above 166.01 from the employee and 13.8% above 166.01 from the employer. 166.01 pounds is 4.15 pounds per hour in a 40 hour week. If according to most progressives the UK system is superior to the US system then some one earning min wage in the US would pay $1,809 a year for health care using the plan I suggested. They would have full access to the medicaid/medicare system. You would have to adjust it for families vs individual or dual earning incomes. But it could be done and done without having to take away my private health care.

 

[JimG]

Again, how can we get everyone to a baseline of coverage?

How do we cover the uninsured? I don’t know, except by providing tax supported health insurance. But ultimately, if care is provided to everyone, there may not be enough physicians, nurses, medicines, clinics, etc, to equally cover everyone. If there aren’t enough doctors, maybe the nation would have to draft students to attend medical school. That’s how we provide for a standing army when needed.

The market is already providing some solutions, though there usefulness is argued. Some advanced practice nurses now act as primary care providers. I know of some RN’s who provide a limited range of medical services in what is essentially their own private practice.

My own experience with Medicare shows that as long as there is a third party paying, demand will increase, and many practitioners will enter the field simply because the supply of customers and income is guaranteed.

When health insurance was first invented, many people were suspicious of it because it was seen as just a method of guaranteed income for doctors. But now it seems to have turned into a bureaucratic nightmare for some doctors.

Medical care is important. So is food, clothing, housing, electricity, transportation. But I’m not sure that government must provide them all. When God led the first parents out of the Garden of Eden, he didn’t promise them a living wage, decent health care, and a guaranteed retirement.

 

[phil3]

You dont really believe the government has the right to tell people they need to become a Dr? How authoritarian do you want the government to become?

 

[phil3]

Again, how can we get everyone to a baseline of coverage?

Right here is a way. In the UK they tax 12% above £166.01 from the employee and 13.8% above £166.01 from the employer. £166.01 pounds is £4.15 per hour in a 40 hour week (which is $5.43 per hour is us dollars). If according to most progressives the UK system is superior to the US system then someone earning min wage in the US would pay $1,809 a year for health care using the plan I suggested. They would have full access to the Medicaid/Medicare system. You would have to adjust it for families vs individual or dual-earning incomes. But it could be done and done without having to take away my private health care. Take the 90 million the US has on public health care then add the 40 million that dont have health care. The is 40% of the us population There is going to be a lot of young healthy people in that number. The US should be able to get great cost saving agreement with doctor and hospitals.

 

[Theo520]

Obama was excellent as president!

Had class that we haven’t seen in a long time

Yes he was photogenic, but his admin made bad decisions

I don’t want a GQ cover model as president.

 

[DarkLight]

The big thing politically is that many people who want to keep their private insurance also don’t want to contribute any money to public insurance. They feel that they’ve already spent money on the insurance premiums so they don’t want to spend more via their taxes.

Medical care is important. So is food, clothing, housing, electricity, transportation. But I’m not sure that government must provide them all. When God led the first parents out of the Garden of Eden, he didn’t promise them a living wage, decent health care, and a guaranteed retirement.

I think the argument is more that society ought to provide some way for all its members to access those things. E.g. with housing we have section 8 vouchers (although it’s horribly underfunded and often landlords don’t want to deal with it). So we’re still providing housing on the private market, but we’re subsidizing those who can’t afford housing on their own.

The big uniqueness of healthcare is how variable expenses can be. One person may have no expenses other than annual checkups and shots and such. Another may cost thousands every year to stay alive and out of the hospital.

 

[Hodos]

The worry is that, in practice, this would just mean that the poor would not have effective coverage. Those with preexisting conditions would also not be able to get effective coverage, if they got insurance at all. The fundamental problem with capitalism and health care is that it can often be more profitable (especially in the short term) to let certain people suffer or to let them die. And US charity care tends to focus only on immediate crises, not on those who may need long term help, and especially not on quality of life.

Which is why there is the ability of Congress to regulate interstate trade and can make laws that restrict shutting people out of the health insurance market due to pre-existing conditions. Capitalists don’t believe there is no place in the free market for regulation, we argue what is the correct role of regulation in the free market. Certainly where there are externalities created that freeze people out of the market, the government has the right to set ground rules to provide an open market place. This is a common mischaracterization of the role of regulation in free market economies that socialists don’t understand.

With regard to quality of life, it is the individual’s role to guarantee their own quality of life by making free decisions in their own best interests, and to react to the consequences of those decisions to improve their condition in a manner that is consistent with their values. The individual has far more ability to advance their own interests than a disinterested third party which may or may not even share the same values.

 

[Socrates92]

You dont really believe the government has the right to tell people they need to become a Dr? How authoritarian do you want the government to become?

That just sounds suicidal. I’d hate to be a brain surgery patient and have to worry about whether my physician is a disgruntled conscriptee

.

 

[Dan123]

You dont really believe the government has the right to tell people they need to become a Dr? How authoritarian do you want the government to become?

I think he was just suggesting one solution. We wouldn’t do that. Most likely we’d provide accelerated pathways to immigration for people in the medical field, or provide tuition assistant or loan forgiveness for people attending school to be doctors/nurses whatever.

 

[blackforest]

Under a private system you also have the option to forego coverage

That’s lovely for your parents, but we live in different times now. This is not an affordable option for most Americans.

My suggestion was to go fully privatized and increase transparency of costs, while allowing for a range of plans that offer various coverage packages.

I hear this a lot from conservatives but see no active movement demanding change. It’s almost as if they’re happy with the current status quo or something . . .

It depends. In Canada, there are countless stories of people traveling to the US

We’ve been hearing this trope since the 80s and 90s, and it was debunked long ago. There’s no queue of Canadians waiting for U.S. health care.

Emergency rooms often get abused under a single-payer. It’s analogous to how car dealerships would be tied up if car insurance covered oil-changes.

Can you provide evidence for this? My understanding is that this is an outdated argument. As we experience a boom of FQHCs, non-profit clinics, and urgent care centers, fewer people need to opt for the long hospital waits.

The worry is that, in practice, this would just mean that the poor would not have effective coverage.

How would you cover the uninsured,

Sadly, I don’t think that concern is even on a lot of peoples’ radars.

Which is why there is the ability of Congress to regulate interstate trade and can make laws that restrict shutting people out of the health insurance market due to pre-existing conditions.

We can’t regulate our way out of the fundamental flaws of profit-based health care. Lots and lots of commodities work well in a free market system, but health care isn’t one of them. Profit-based health care has too many embedded conflicts of interests. It incentivizes costly, unnecessary, and often invasive medical interventions. There’s also no incentive for people to be healthy.

With regard to quality of life, it is the individual’s role to guarantee their own quality of life by making free decisions in their own best interests

There seems to be this resounding narrative that we can diet, exercise, and “non-smoke” our way out of every health woe. But we need to stop assuming that every absolutely every adverse health event is somebody’s fault. People don’t always ask for cancer, car accidents, multiple sclerosis, ALS, babies born with congenital defects, hospital-acquired infections, etc. In fact, we’re finding better health outcomes in countries with single-payer systems.

 

[Theo520]

The big thing politically is that many people who want to keep their private insurance also don’t want to contribute any money to public insurance. They feel that they’ve already spent money on the insurance premiums so they don’t want to spend more via their taxes.

Got any support for this claim? I don’t see people objecting to what they give to support medicare/SS Disability/etc.

 

[DarkLight]

With regard to quality of life, it is the individual’s role to guarantee their own quality of life by making free decisions in their own best interests, and to react to the consequences of those decisions to improve their condition in a manner that is consistent with their values. The individual has far more ability to advance their own interests than a disinterested third party which may or may not even share the same values.

So I meant this specifically with regard to healthcare. A lot of conditions quality of life requires ongoing medical treatment. So we’re talking about, say, ensuring people with chronic pain (such as a friend of mine who has nerve damage from a childhood incident) have access to pain management as best we can manage. She’s not going to die or be seriously injured without it, but having access to treatment to help control the pain means she can actually go out and work and enjoy things. Or another example might be mental health care and ensuring people can access treatment even if they’re not suicidal and are able to hold down a job. For the poor, this sort of ongoing care is often unaffordable.

There are a lot of health problems that aren’t acutely dangerous, but are still debilitating and require long-term care to achieve a decent quality of life. And like @blackforest mentioned, it’s not like we can just make it all better by living healthy. (And in fact many of these conditions can even make “living healthy” impossible - someone with ongoing pain or major depression may not be able to just make themselves exercise, for example.)

Got any support for this claim? I don’t see people objecting to what they give to support medicare/SS Disability/etc.

I was talking here about a system more like the NHS, where everyone pays via taxes into a system that then covers everyone (not just those deemed needy). However people can still purchase private insurance beyond what’s provided by the government. A lot of people in America don’t want to do that because they don’t want to be paying twice for coverage - they’d be paying taxes and in turn covered by public insurance, but also paying premiums for private insurance that they want to keep.

 

[Sarcelle]

A lot of people in America don’t want to do that because they don’t want to be paying twice for coverage - they’d be paying taxes and in turn covered by public insurance, but also paying premiums for private insurance that they want to keep.

You could say the same thing about education.

People pay taxes to fund public education but are free to choose private schools for their own children.

Are there conservatives that are against public education like they are against public healthcare systems?

 

[DarkLight]

Are there conservatives that are against public education like they are against public healthcare systems?

I have actually known some, admittedly. But I think we’ve gotten used to it at this point. I think there’s also an age aspect - people are more willing to provide for children than for adults. (With some sense, admittedly - it would be quite ridiculous to expect an elementary school child to take responsibility for their own education.) You’ll definitely see similar arguments pop up in talks about extending funding for college though.

 

[Sarcelle]

(With some sense, admittedly - it would be quite ridiculous to expect an elementary school child to take responsibility for their own education.)

It’s not so much as the child taking responsibility for their own education but the child’s parents.

I’ve heard people who argue that having a child is a choice so why should they pay for someone else’s decision?

Admittedly these people are rare.

 

[Dan123]

It’s not so much as the child taking responsibility for their own education but the child’s parents.

I’ve heard people who argue that having a child is a choice so why should they pay for someone else’s decision?

Admittedly these people are rare.

There also short-sighted. When we’re all old we want there to be doctors, but most of us don’t have kids who are becoming doctors. It’s other people’s kids becoming the doctors. How much we support that (e.g. full tuition, low interest loans, or nothing at all) is certainly a point of debate, but there’s no question that supporting a system that allows future generations to thrive without undue burden and debt helps us all in the long term.

 

[Hodos]

That’s lovely for your parents, but we live in different times now. This is not an affordable option for most Americans.

We live in different times now? I am trying to figure out how times have drastically changed so much that choosing to have minimal healthcare insurance, or conversely choosing a Cadillac health care plan is different. Please educate me on the specific changes. I agree that not having insurance is not an affordable option for most Americans. I disagree though that somehow this means that we take away all choice over healthcare plans to fix the affordability of health care. That to me seems a rather absurd leap in logic.

I hear this a lot from conservatives but see no active movement demanding change. It’s almost as if they’re happy with the current status quo or something . . .

I would agree that the failure to pass health care reform between 2016 and 2017 was a legislative failure by conservatives. The issue is not that they are good with the status quo though, that would be a false narrative. The issue was over what policy changes would result in the significant decrease in health care costs.

We can’t regulate our way out of the fundamental flaws of profit-based health care. Lots and lots of commodities work well in a free market system, but health care isn’t one of them.

I have yet to see where we have actually implemented a free market system in the area of healthcare. In the areas where health insurance coverage is less regulated and is optional such as dental and vision coverage however, you have actually seen drastic reductions in the cost of actual care because these areas have had to compete in a free market system where there is transparency of cost. That would actually seem to indicate that free market pressures actually do work when actually implemented in the health care industry.

There seems to be this resounding narrative that we can diet, exercise, and “non-smoke” our way out of every health woe

I didn’t mention that at all, but yes, collective better decisions do make a difference in the aggregate cost of healthcare by reducing the demand for service.

But we need to stop assuming that every absolutely every adverse health event is somebody’s fault.

I didn’t even hint at this. I was talking about the choice of health care plans and providers.

In fact, we’re finding better health outcomes in countries with single-payer systems.

I haven’t seen an apples to apples comparison, so I doubt this claim stands up to scrutiny.

 

[Dan123]

I have yet to see where we have actually implemented a free market system in the area of healthcare. In the areas where health insurance coverage is less regulated and is optional such as dental and vision coverage however, you have actually seen drastic reductions in the cost of actual care because these areas have had to compete in a free market system where there is transparency of cost. That would actually seem to indicate that free market pressures actually do work when actually implemented in the health care industry.

Is that the case or are people just forgoing eye exams and dental care? Those costs eventually catch up to you with interest.