Study: When Counting Premiums, US Workers Heavily Taxed

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Netherlands has the highest tax rates of all and France is not far behind.
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Touche, but isn’t there also the fact that our spending outpaces or at the very least is comparable with them, meanwhile their working class is covered while we have millions without coverage (our uninsured pop. is literally the size of a moderately large nation) and that’s not counting uninsured folks (unaffordable deductibles or hyper expensive medications) as well as folks who find their insurance companies not being there for them when they need them most?

France may be struggling (but if I understand if they were successful with pension reform in the 90’s maybe they’d be a better place) but the Dutch (Netherlands) seem to be doing well for themselves, why can’t we be like the Dutch (in respect to policies), the people there seem content and well provided for yet we have so many stories of people having a difficult time so why not be like the Dutch where the people seem (relatively) okay?

Regarding the NHS (speaking of which, did you hear about the Tory win there, are you a GOPer/Conservative, would you wish for the same to happen to America though doesn’t the GOP like the Tories need to moderate, have a platform helping the people), maybe we could structure our Community Health Centers to be like a pseudo-NHS, have an option for those who find themselves without coverage/decent coverage, ya get me? I realize though, we may have structural issues to deal with like we’ll need more doctors and nurses so free medical/nursing schools scaled up, tuition free, free room and board, free books and subsidize some mental health professional (perhaps substance abuse treatment) training programs while we’re at it?

What can be done to reduce the number of struggling here? Also, how can we lower the deductibles, I hate deductibles especially once you have premiums (I’m open to Universal Catastrophic Coverage where we get a generous income based deductible though and after that we’re home free with the government covering the rest). By the way, how are you sir?
 
Zzyzx_Road said:
Netherlands has the highest tax rates of all and France is not far behind.
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Their taxes include good basic healthcare for all. If you want more, and have the money, you can buy it no problem. Though I can’t imagine what one would want beyond what everyone else gets.

Some personal responsibility is expected, for example: preventative dental care requires you go for regular checkups and needed work. If you don’t go and later need work, you must pay to get back to standard before you get on the program again.

Economy of scale makes it possible to cover everyone, including the recent immigration they have experienced. Newcomers are helped to find jobs and are integrated so that they can contribute to the tax pool too.

No one is forced to rely on emergency departments as a substitute for basic care, a tremendous savings to the system in itself.

Heard the saying? “Pay me now, or pay me later.”
It means timely, prudent attention to problems at the start can prevent much bigger and more expensive fixes later on.

Healthy people are better suited to work. Everyone benefits when more people are healthy, and work. Health care for all is good for the economy, and less expensive than the alternative.
 
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I’m having the hardest time trying to find information on other countries percentage of tax on wages for healthcare versus premiums paid by wages in the US. It’s probably my google fu that’s failing. One problem is that some countries have both…Dutch…and most of my google hits want to show me costs compared to GDP…which isn’t what I want.

I’d really like to compare apples to apples as much as is possible! If the US average is say 14% of wages goes to healthcare premiums and Dutch pay 8% premiums plus 6% taxes for healthcare…then it’s a wash. But are there countries that wind up be statistically lower yet provide good healthcare?..and who are they. I’m still looking…
 
You can look for total healthcare spending per capita to determine overall spending. A lot of countries don’t have a specific tax for it it’s just part of income taxes.
 
Dan123 said:
don’t have a specific tax for it it’s just part of income taxes
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Shouldn’t I still be able to find a breakdown in those taxes? Maybe I’m looking for the impossible! Wouldn’t be the first time!😂😂😂

I looked for information via capital spending and I’m still not sure it’s telling me what I want…it doesn’t seem to explain what’s included or excluded in “per capita”. I’m giving up for now. I will add that when looking at per capita spending, the US always seems to be about double everyone else…doctor visits, consultations, hospital stays, drugs, etc.
 
JimR-OCDS said:
Insurance companies made sure it wouldn’t work.
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This was either a disastrous arrangement or brilliant politicking. The people in charge of it were the people with $billions at stake if it were to succeed. Talk about letting the fox guard the hen house.
 
Zzyzx_Road said:
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.
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It is important to note that the higher tax rates are not solely due to funding healthcare. Many European countries use taxes to fund things the US doesn’t, like paid maternity/paternity leave, state funded childcare, higher education, generous pension plans etc.

The US isn’t going to jump to the same tax rate as the Netherlands if they introduce single payer healthcare and none of the other benefits Europeans expect in exchange for their tax rates.
 
Pattylt said:
most of my google hits want to show me costs compared to GDP…which isn’t what I want.

I’d really like to compare apples to apples as much as is possible!
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Costs to GDP is a comparison of the whole basket of apples, rather than pulling out one specific cost that does not necessarily represent the same benefit in a different basket.

My own observation re costs in the US basket that might not be found in other baskets:
  • tv & billboard advertising
  • shareholder profits
  • almost 5x administration costs (per capita)
 
Dan123 said:
I don’t think people realize that just isn’t done almost anywhere else.
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I remember when it first started in the US as well - it is a recent change (well, recent for those of use who were around when dirt was new…).
 
_Ruby said:
The US isn’t going to jump to the same tax rate as the Netherlands if they introduce single payer healthcare and none of the other benefits Europeans expect in exchange for their tax rates.
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Maybe not right away, but remember any legislation will be controlled by the “corporate cronies” to make sure their collective rice bowls aren’t upset. Not to mention there is a big move on by progressives to include the illegal immigrants. For instance, those under 26 are already included in California’s Medicaid programs.

So the costs may shift from this bucket to that bucket, but overall share of GDP will not change materially and outcomes will not improve while options are removed from everyone except the rich. I don’t consider that an improvement over the current state of affairs.

The point being, the control of the industry by the biggest players has to be broken apart and I see no sign of that happening. And every sign that any Medicare For All legislation will be written to protect the big companies first. As the ACA was.
 
Zzyzx_Road said:
Not to mention there is a big move on by progressives to include the illegal immigrants. For instance, those under 26 are already included in California’s Medicaid programs.
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A few posts up, @Crocus referred to the saying “pay me now or pay me later.” With undocumented immigrants, it’s better that they receive affordable, preventative health care rather than showing up later in the emergency room, where EMTALA prohibits their being turned away. So covering this population isn’t as scandalous as it may sound.

I do share your concerns that every time there’s hope of good legislation, corporate lobbyists get their dirty mitts all over it, either to water it down or obliterate it completely.
 
I thought ACA was based of the Michigan model?

Seriously, how it was done was a disaster, it didn’t follow any working models.

The only smart thing it did was expand medicaid.
 
Michigan (please tell me more about this model)? I thought it was Switzerland (mandate and premium subsidies). Actually, didn’t the ACA Exchanges have some promise (other than a rocky online start) and if you tweaked around with it and was more generous then you would have a better deal for people (maybe instead lifting the income cap and lowering the percentage of premiums to 5% of income instead of 10% or make total OOP (premiums/deductibles/copays) be capped at 10% of one’s income, if anything President Trump made a mess of things by canceling the CSR subsidies?

What if, we have $100 to $120 billion to the exchanges, then wouldn’t that help them stabilize, at some point, if we can get premiums low enough, then you might get a flood of customers buying which should ward off adverse selection and further stabilize the pool. Looking it, aren’t the ACA Exchanges actually a pseudo high risk pool especially with pre existing protections (which do seem popular and needed), improving parity for mental health and substance abuse treatment seems like a help to many people too. In fact, instead of a high risk pool, how would you feel about salvaging the exchanges, let’s say the exchanges got $240 billion, couldn’t that help not only stabilize them but promote some pretty good health care plans especially for uninsured folks?

Don’t forget, what about smaller things in ACA that no one might talk about like the Public Health and Prevention Fund (perhaps if given a lot of funding, it could help improve outcomes), perhaps funding increases for our Community Health Centers (in fact, might it be a strong idea to universalize Community Health Centers to make basic medical care like preventative/primary/basic specialty care free and there was this video that said that ACA was meant to improve innovation in health care like promoting bundled payments.
 
Zzyzx_Road said:
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_Ruby:
The US isn’t going to jump to the same tax rate as the Netherlands if they introduce single payer healthcare and none of the other benefits Europeans expect in exchange for their tax rates.
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Maybe not right away, but remember any legislation will be controlled by the “corporate cronies” to make sure their collective rice bowls aren’t upset.

So the costs may shift from this bucket to that bucket, but overall share of GDP will not change materially and outcomes will not improve while options are removed from everyone except the rich. I don’t consider that an improvement over the current state of affairs.
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You mentioned up thread that your taxes when living in London were far higher than what you paid whilst living in the US. Can I ask what the amount difference was?
 
FiveLinden said:
US medicine is the most expensive in the world. Public health provision is cheaper. Therefore if your insurance were replaced by tax, AND public provision you would be better off.
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But the insurance company executives and shareholders who make hundreds of billions of dollars annually denying people healthcare would be worse off, and their vacation homes and yachts are much more important than the health and welfare of the average person.
 
Balto1 said:
But the insurance company executives and shareholders who make hundreds of billions of dollars annually denying people healthcare would be worse off, and their vacation homes and yachts are much more important than the health and welfare of the average person.
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More progressive talking point
 
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