Study: When Counting Premiums, US Workers Heavily Taxed

[phil3]

For who? I love my health care. Why do you need to reform my health care?

 

[phil3]

so why cant the $60,00 be just as dishonest?

 

[Zzyzx_Road]

Actually, the issue is that you’re claiming that going out-of-pocket is an option for people, as it was for your parents. But given the cost these days, it’s actually not.

For the self employed, it’s a killer. Especially if they have families. I have heard my fellow contractors who are married with children tell me they’ve been quoted at least $1600 per month and that’s just the insurance. The family deductible is another $12k per year. Somewhere around $30k per year out of pocket if they have health conditions. That’s cash a lot of families don’t have especially if they don’t make that much more than the maximum eligible for subsidies. So then those families can’t save for college so their college going kids have to take loans. Vicious circle.

@phil3 It sounds like you get the ACA subsidies or you’re employed by a company that’s picking up a good part of your expense. As I said above, us self-employed types are not so lucky.

 

[Sarcelle]

Good for you.

Others cannot the say the same but as Christians we need to be concerned for others.

Just because you are well off is no reason to ignore poverty and need and especially injustice.

Truth is quality healthcare is out of the reach for way too many people. To me that is an injustice.

I just want more people to have access to affordable quality healthcare.

 

[DarkLight]

And as I’ve commented, those in low-end jobs often are not either. Especially since the ACA allows high-deductible plans to be considered acceptable insurance. The way the law works this means if the company offers a plan where the premiums are under a certain percentage of income, then you’re not eligible for ACA subsidies because you’re considered to have access to affordable insurance through your employer. Even in the case where the deductible isn’t reasonably affordable to someone on that income.

 

[RCIAGraduate]

capitalist free markets,

Maybe not capitalistic free markets but what about oligarchic markets? If people can’t stand up to special interests through liberalization, what if single payer seems like the only feasible way to have the people even out the special interests and how do we know if free markets will work especially for the low income and working class, those groups are already having a tough time with rent and laser eye surgery isn’t exactly within their reach either. So at some point, won’t we need safery nets for those who simply make too little or have too much costs (ideally a well funded high risk pool would make things affordable to the sick but I don’t think that played out too well (instead you had people die on waiting lists I believe))?

 

[RCIAGraduate]

Why not make a payroll tax rate that matches with Social Security (at least on the workers side only), also, how about expanding Universal Catastrophic Coverage by ending the exclusion on employer plans (and using the savings to help fund that), using leverage with a national plan (nationwide bargaining?) as well as save on administrative costs and a premium (payroll tax like matching SS rates)? Also, mayve expand the Medicaid (what about 250% of the poverty line) program for those who can’t save for the deductible like low income and perhaps working class folks (especially with rents in the cities these days).

Regarding your idea, it could work for someone people but won’t their be limits like helping those who need more extensive care like those with rarer conditions?

 

[Sarcelle]

Yes

Truth is, we the people do not have much bargaining power against big pharma and insurance companies.

A free market implies that the consumer is on equal footing with the supplier but in the case of the US, the market is anything but free. We all know large corporations are in charge.

Actually the US is getting to be more and more like medieval Europe with the the corporations as the nobility and we the people the serfs.

 

[Zzyzx_Road]

Maybe not capitalistic free markets but what about oligarchic markets? If people can’t stand up to special interests through liberalization, what if single payer seems like the only feasible way to have the people even out the special interests and how do we know if free markets will work especially for the low income and working class, those groups are already having a tough time with rent and laser eye surgery isn’t exactly within their reach either. So at some point, won’t we need safery nets for those who simply make too little or have too much costs (ideally a well funded high risk pool would make things affordable to the sick but I don’t think that played out too well (instead you had people die on waiting lists I believe))?

Not sure if you read my entire post: I said the current health industry is based on “corporate cronyism”. I would add it has been this way at least since the early 1990’s. I suppose one could use the term “oligarchic markets”, but really this is not a market, it’s more like a minimum security prison on an island run by the company store. But you seem to think they are actual markets, hence markets are evil and must be replaced by government pays for all, when it is far, far from the case that these are actual markets.

There is a lot that can be done. But I’m not optimistic that anything will happen before the entire system collapses as the industry hold on Congress is going to be very difficult to break.

 

[phil3]

Medieval Europe had about 95% of the people were peasant and the rest were nobility or within the church. Your hyperbolic is well over the top.

 

[Sarcelle]

Medieval Europe had about 95% of the people were peasant and the rest were nobility or within the church. Your hyperbolic is well over the top.

You’re right and I hope you’re right.

But the way things are going we might end up there.

The poor are getting poorer and the rich are getting fewer but even richer.

The middle class? Under siege.

 

[RCIAGraduate]

entire post: I said the current health industry is based on “corporate cronyism”. I would add it has been this way at least since the early 1990’s. I suppose one could use the term “oligarchic markets”, but really this is not a market, it’s more like a minimum security prison on an island run by the company store. But you seem to think they are actual markets, hence markets are evil and must be replaced by government pays for all, when it is far, far from the case that these are actual markets.

There is a lot that can be done. But I’m not optimistic that anything will happen before the entire system collapses as

Might I ask what your game plan would be int he public policy realm? At some point, isn’t a safety net needed though?

 

[Zzyzx_Road]

Might I ask what your game plan would be int he public policy realm? At some point, isn’t a safety net needed though?

There are a fair number of prescriptions to fix the cost issues and still have space for the poor and the pre-existing conditions. But any and all such prescriptions are or will be very vigorously opposed by the industry which likes our captivity just fine.

If we can’t even get the federal or the state governments to prosecute health care insurers, device makers and providers under the Sherman Antitrust Act and the Robinson Patman Act, then nothing else useful to the bulk of us consumers will ever get done. That prosecution can be done right now, today without going to Congress to change the ACA. But no, never going to happen.

 

[Theo520]

Regarding your idea, it could work for someone people but won’t their be limits like helping those who need more extensive care like those with rarer conditions?

Resources are not unlimited, far better to give primary care to all, where it will do the most good.

 

[DarkLight]

There are a fair number of prescriptions to fix the cost issues and still have space for the poor and the pre-existing conditions. But any and all such prescriptions are or will be very vigorously opposed by the industry which likes our captivity just fine.

I think you’d also be running into the issue I mentioned above, that people are in our culture often terrified of being taken advantage of. We end up setting up so many rules to make people prove they need help that we weed out people who genuinely need help. And we often have this attitude that those in need should be grateful for whatever scraps we choose to throw them.

I think that’s one of the other motivations people have for universal health care. One, we wouldn’t have to worry about the “donut hole” effect where people make too much for help but not enough to manage on their own. Two, people would be more motivated to invest in the system if they benefit as well than if it’s just some needy person.

 

[RCIAGraduate]

There are a fair number of prescriptions to fix the cost issues and still have space for the poor and the pre-existing conditions.

Working class too? Paycheck to paycheck may be more challenging with things like rent these days.

@Theo520, what about countries who seem to provide a strong baseline of care for their people, not that I’m informed but if Germany, France and the Netherlands can do it, Switzerland too (apparently ACA is based off the Swiss model), why not us? What about working class folks already struggling with paying the bills? That being said, why not pursue something like a high risk pool to help create a safety net for those with rarer but more expensive issues?

 

[Zzyzx_Road]

Those countries that have seemingly working single payer systems can’t do it without very high tax rates. The highest tax rates in the world almost all in Europe. The single payer proponents here either sidestep that issue or put out very rosy projections. Netherlands has the highest tax rates of all and France is not far behind. The people are at their limits in France, maybe close it in Netherlands. If health costs continue to expand, those governments are stuck, they’re not raising taxes without a lot of blowback as is happening in France.

I lived in London for a year; tax rates are very high there too. Biggest problem the NHS has is the lack of accountability for cost control. I think this is inherent in every system in which the consumer has no direct responsibility to watch the expenses. Only general complaints about taxes with no real understanding of the connection between the taxes they’re paying and the services they’re getting.

 

[Dan123]

The single payer proponents here either sidestep that issue or put out very rosy projections.

Similar to how people arguing against it like to focus only on tax rates and not total cost by including premiums. Which ironically brings us full circle to the topic of the discussion.

 

[whatistrue]

Which ironically brings us full circle to the topic of the discussion.

Which is also a good opportunity to reiterate that premiums are voluntary while taxes are not, and that premiums for one family may be entirely different for another family based on a variety of factors such as which company carries the policy, what exactly is covered vs. what is not, deductibles, and even what state the family lives in while national level taxes should be relatively even on a percentage basis, perhaps with differing brackets like US income tax. So it is really difficult to show an accurate reliable equivalence.

 

[DarkLight]

That being said, why not pursue something like a high risk pool to help create a safety net for those with rarer but more expensive issues?

The problem was that in practice it failed because no one wanted to fund it. You ended up with long waiting times and minimal coverage, and often the premiums were high enough that those who were both poor and low-risk could not afford them.

Some states made it work. Maryland I recall did. But in most places they weren’t given sufficient money to meet the needs.