I moved to the US from a country with socialised medicine. When you include premiums then taxes in both were roughly similar if not a little higher in the US (ignoring cost of living differences).<p>But even that doesn't include the real sting on the tail of US medicine. You pay a fairly high health insurance premium, but if you actually need health services you then pay again through the nose even with insurance "discounts."<p>For example my under one year old needed to go to the emergency room due to a high fever for several hours, we paid over $300 on top of paying over a thousand in combined employer/employee premiums each month. That's with insurance picking up at least that much.
Like to bring this up when we talk taxes: I think it's totally crazy that we give the feds 25% or more and our states soo soo sooooo much less. I think it should be the other way around:
5% for the feds, and maybe 20% to the states. The reason is that our cities are filled with bums, and have absolutely no money to either give them jobs or make new programs. The feds don't give a shit and are busy making missiles or creating massive social programs that enrich the wrong people. I think the current strategy is broken. The other nice thing about this, is that we'd pay less in taxes AND the states/cities would be able to handle every damn thing it needs. It would be like 2x to 3x the money they are getting right now.
Just a quick note that health insurance premiums do not in fact get plowed directly into rents and administrative redundancies; we pay more than Europe (and Medicare) does in administrative costs, but far-and-away the largest components of health care expenditures in the US are in inpatient and outpatient procedure billings (outpatient by a factor of almost 2x inpatient, itself something like 3-4x all administrative costs).<p>We certainly do seem to pay far too much for health care! But the explanations aren't as simple as evil health insurers. The system appears to be structurally pretty messed up, and alterations to the payer-side alone, without radical changes to the provider side, are unlikely to solve the problem.
The Canadian figures seem insanely low. 11.5% total? When I lived in BC making an approximately average income, my effective tax rate alone was 21% [EDIT: originally put 23%]. I paid pension, health insurance, and unemployment deductions on top of that. And that only counts the employee side of deductions.<p>This example is "married with two kids", so it's possible that there are massive offsets that I didn't have access to as a single person, but 11.5% still seems very low.<p>I would expect Canada to fare favourably in this comparison, though. The taxes are not as bad as most Americans think. Although they do ramp up very quickly for higher earners, which was an incentive for moving to the states as my income increased. Also, pay is higher in the US (by a factor of about 2 or 3) for the same job.
I once considered relocating with the same company to a similar role in London. The base pay in London is lower, and the marginal tax rates are high, but overall cost of living isn't too terribly far off (compared to the SF Bay Area), and doing calculations like these it seemed that while it would be something of a step down total compensation-wise, it wasn't nearly as large of one as it at first seemed. I didn't make the jump, but actually doing the math made it seem a lot more reasonable than it did at the outset.
The article decides to include employer-side payroll taxes in its US calculations as though this is an income tax - but this is not (appears not to be) done for other countries, where payroll taxes are often higher, so it's not a fair comparison.<p>The inevitable Wikipedia link: <a href="https://en.wikipedia.org/wiki/Payroll_tax#/media/File:Payroll_and_income_tax_by_country.png" rel="nofollow">https://en.wikipedia.org/wiki/Payroll_tax#/media/File:Payrol...</a>
So - in the UK you pay national insurance, which ostensibly pays for the NHS and retirement benefits.<p>If you earn £150k a year (top 2% of salaries in the UK) you pay £6,964.16 a year. That's an astounding deal. There are no deductibles, no co pays for hospital stays, GP visits are free, as are any tests and investigations.<p>You do pay £9 for each item on a prescription, but if you get more than 3 items a month you can pay a flat rate of £104 a year for a prepayment certificate.<p>Private health insurance is still a thing - it just gets you a nicer room in a private hospital and quicker treatment for non life-threatening conditions.
Tangential: As a non-native speaker, I find the word PREMIUM highly problematic. You need a lot of contexts to understand that the article is talking about health care costs not covered by health insurance.
>It’s just that they pay it into a private insurance system that wastes large portions of it on rents and administrative redundancy.<p>Would love to see a breakdown of real estate and admin costs for private insurance systems throughout the States to understand how much could be saved by eliminating redundancy.<p>Not seeing this broken out in Anthem's Financials: <a href="https://ir.antheminc.com/static-files/73562e56-886c-4ff5-a365-d4324728524f" rel="nofollow">https://ir.antheminc.com/static-files/73562e56-886c-4ff5-a36...</a>
This does not take into account the fact that in most countries with an universal health care system, you will only contribute to it during your +/- 40 years career while you'll benefit from it during your whole life.
The difference is that your taxes go up as you earn more, but your health insurance premiums don’t. Lower middle class workers are getting screwed, but the top earners are doing great! It’s a feature, not a bug.
The international comparison is a bit eyebrow raising. It has two countries (Canada and the Netherlands), which are on the lower side in terms of overall taxation, on opposite sides of the scale. The Netherlands is listed as the highest tax jurisdiction, at 48%, despite having one of the lower tax burdens in Europe: <a href="https://en.wikipedia.org/wiki/List_of_countries_by_tax_revenue_to_GDP_ratio" rel="nofollow">https://en.wikipedia.org/wiki/List_of_countries_by_tax_reven...</a>. Canada is listed as just 11%.
This article makes some good points up until the end. It criticizes private sector waste without evaluating waste in the public sector. I see how the taxpayer impact could possibly* be a wash, and do see problems in the private sector for sure. But my experiences with just about any US federal system does not cause me to see them as a bastion of efficiency. Without a profit incentive or really any incentive beyond occasional bad press, and with strict salary and firing controls they do not innovate or improve. Look at the VA for an example. Horror stories do exist for British and Canadian systems as well as others I’m sure.<p>* This article also ignores the fact that many of the countries listed also still have private insurance supplementals. Those may need to be added for a fair comparison.<p>In the end I don’t have good solution, but think the traditional arguments in both directions are generally hyperbolic and over simplified. Unless data shows conclusively otherwise, I lean toward free market solutions.
Individual US tax payers pay for most of the world's security. This is one tax of being the global super power, so it's not particularly surprising that when you include all things the US tax payer pays for privately that is taxed in other countries, you arrive at a number higher than other similar countries.<p>In reality, there is no country with which we can fairly compare US tax rates.
My understanding is that in the US there are even companies which can be hired by hospitals and other care centers to "optimize" the codes before the final submission to the insurance. I take this to mean that they can ensure that you're using the right codes and also probably try to maximize the payout.
Markets such as the US health care market, characterized by ineslastic demand and secret prices, should never, ever be tolerated under any circumstances. This arrangement is here to benefit the supply side and screw the demand side and it has to be stopped. The only pathway out of this crisis starts with the federal government replacing private insurers, relegating them to selling supplemental coverage. Such companies also should be legally compelled to run as mutual insurance companies, where any profit deriving from good risk management is sent back to policyholders. It is long past time everybody in the US admitted that markets have completely failed in US health care.
I think I'm privileged to live in Australia where I do not need to pay for my visits to the hospital and for my operation when I had appendicitis. Whereas in the US I've seen it is 30-70k. It's also interesting that there is a range of prices depending on the hospital. Would this be representative of treatment quality? How much one can pay shouldn't be the determinant of the optimal treatment that one deserves to receive.
I actually spoke to someone today who is hiring a guy from a FANG in SV to go and work in Denmark. He told me taxes are high enough over there it isn't all that different.<p>Plus like many Americans he was curious about living in Denmark. Cycling everywhere, laid back lifestyle, that sort of thing.
Misappropriation of funds due to lobbying and regulatory capture.<p>The film 'Vice' on Dick Cheney outlines just how permeable American government is to such non-public interests.<p>It's no wonder tax avoidance is such an interesting topic for those who stand to pay the most if they do nothing.
Not just that, they are also getting nothing in return.<p>The US voters need to realize just how much are they getting fucked over by the military-industrial complex.<p>I’m not against taxes, I’m against taxes that go to pay for wars as opposed to medical insurance, infrastructure and education.
"Fools rush in where angels fear to tread"<p>You can't average averages in this way. You'll get easily manipulated data.<p>He's using a single average data for a married, single income worker, and combining that with the average for health insurance.<p>You can't do that. You need to calculate each individual person's income and share of healthcare costs, and only then average the results.
The only problem with the ‘Medicare for all’ system is that it won’t reduce that insanely high ‘stealth’ taxation - it will just add to it... However, at least with efforts like Oklahoma’s Surgery Center etc one stands a chance to escape the compulsory racket through market efficiency. Potentially.
I never understood why people are against some form of universal healthcare. The idea of "socialism" or "communism" scare many conservatives, but it just doesn't make sense here.<p>How universal healthcare sorta works - we all put money in a pot, and use it to pay for healthcare.<p>How health insurance works - we put money into a company, who uses it to pay for healthcare, while taking a significant cut as it's a private entity.<p>With the correct organization (which the government is notoriously terrible at) it would seem to me that it could only be cheaper to have taxpaid healthcare?