US Workers Are Highly Taxed If You Count Premiums • Hacker News Board

Re: US Workers Are Highly Taxed If You Count Premiums

#91

Post by dnautics » Mon, Apr 08, 2019, 10:26 PM UTC

arosier wrote: post #12

>It’s just that they pay it into a private insurance system that wastes large portions of it on rents and administrative redundancy. 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. Not seeing this broken out in Anthem's Financials: https://ir.antheminc.com/static-files/73562e56-886c-4ff5-a…

Private healthcare insurance has margins well below most profitable companies, in the us. If anything I'd hazard that the poor treatment of consumers by these entities stems from being barely able to hold the line, not because of greed. Rising medical costs, I think, have the blame elsewhere, but insurance companies sure do make a good Boogeyman for politicians, because they are very poorly understood.

Re: US Workers Are Highly Taxed If You Count Premiums

#92

Post by jakobegger » Mon, Apr 08, 2019, 10:28 PM UTC

Someone1234 wrote: post #19

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). 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 "disc…

As a point of comparison, in Austria:

- taking a kid to the ER costs nothing

- taking a kid to a GP or a pediatrician costs nothing

- staying a night at the hospital costs around 15€

- getting a prescription from the pharmacy costs 5€

Re: US Workers Are Highly Taxed If You Count Premiums

#93

Post by jdmichal » Mon, Apr 08, 2019, 10:28 PM UTC

vonmoltke wrote: post #68

maxxxxx wrote: post #37

Earlier quoted context omitted.

My family in Germany throws a fit when they have to pay 50 Euro for something. In the US you can happy if your cost for seeing a doctor is less than 4 digits.

> In the US you can happy if your cost for seeing a doctor is less than 4 digits. My wife and I have never paid four figures for a doctor visit, despite having two surgeries (one oral), a calf strain, and a dislocated shoulder (with ER visit) between us. The state of medical care in the US is bad enough as it is; you don't need to make up hyperbolic bullshit to make it seem worse.

You walked away from multiple ER visits including surgeries for less than four digits out of pocket? Maybe consider that your experience is the exceptional, not the people you call hyperbolic.

My son had a laceration glued together (dermabond in lieu of one or two stitches) and that was either close to or slightly over four digits after totaling the hospital bill and doctor bill, both in network.

Re: US Workers Are Highly Taxed If You Count Premiums

#94

Post by vore » Mon, Apr 08, 2019, 10:28 PM UTC

patrickg_zill wrote: post #23

penagwin wrote: post #5

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. How universal healthcare sorta works - we all put money in a pot, and use it to pay for healthcare. 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…

I grew up in Canada so I totally understand why people are against universal health care... Check out the wait times for MRI scans that are published by the various Canadian provinces. 90 days' wait is not uncommon. Meanwhile in the US it can be had in 3 days or so in every decent sized suburb or city.

If waiting a little longer doesn't reduce the quality of care (research from 2007: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2801918/), then it doesn't really matter how long you wait.

Re: US Workers Are Highly Taxed If You Count Premiums

#95

Post by btilly » Mon, Apr 08, 2019, 10:29 PM UTC

patrickg_zill wrote: post #23

penagwin wrote: post #5

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. How universal healthcare sorta works - we all put money in a pot, and use it to pay for healthcare. 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…

I grew up in Canada so I totally understand why people are against universal health care... Check out the wait times for MRI scans that are published by the various Canadian provinces. 90 days' wait is not uncommon. Meanwhile in the US it can be had in 3 days or so in every decent sized suburb or city.

As someone who grew up in Canada and actually paid attention, this common line is mostly BS.

If you have an emergency, you essentially have no wait time for an MRI. If you have a condition that can wait, you go into the line and potentially wait for a long time. When the wait times become too long, it becomes a scandal and then improves. Every scandal then gets reported in the USA as stories about how horrible Canadian healthcare is.

Re: US Workers Are Highly Taxed If You Count Premiums

#96

Post by DanBC » Mon, Apr 08, 2019, 10:29 PM UTC

jakobegger wrote: post #77

vonmoltke wrote: post #53

Earlier quoted context omitted.

An emergency room is not a "basic visit".

Taking a kid with fever to the ER is about as basic as you get.

Doesn't the US have out-of-hours pharmacies, or out of hours doctors, or urgent but not emergency treatment centres?

Re: US Workers Are Highly Taxed If You Count Premiums

#97

Post by acdha » Mon, Apr 08, 2019, 10:30 PM UTC

mattkrause wrote: post #82

acdha wrote: post #48

Earlier quoted context omitted.

> how notoriously terrible the government is at organization is a major reason A major propaganda point, not a reason based on data. It’s really hard to find a first-world country which has a medical system which doesn’t compare favorably with American insurance companies on either cost or quality — the baked-in conflicts of interest are too powerful.

Insurance companies are also not exactly....paragons of good customer service themselves. I was camping with a friend when he managed to slice off the tip of his finger. The insurance company fought him tooth and..err...nail to avoid paying out for not having the ER visit “pre-approved”

That was my point: I’ve known a fair number of people from other countries and I’ve never heard any reaction other than stunned disbelief when they experienced the American private insurance system — up to and including giving up jobs here just to avoid the stress of not knowing whether you really will get treated or not.

Re: US Workers Are Highly Taxed If You Count Premiums

#98

Post by kevin_thibedeau » Mon, Apr 08, 2019, 10:31 PM UTC

rhacker wrote: post #87

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…

But then the tax shelter states wouldn't be able to mooch off of federal programs.

Re: US Workers Are Highly Taxed If You Count Premiums

#99

Post by titanomachy » Mon, Apr 08, 2019, 10:31 PM UTC

MichaelBurjack wrote: post #57

titanomachy wrote: post #16

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. This example is "married with two kids", so it's possible that there are massive offsets that I didn't have acce…

You might have a skewed sense of what median Canadian income is. And your job might be further above that median than you realize. Median Canadian individual income is ~$35,000 [0]. In B.C., your average 2019 tax rate would be 13.34% not including non-refundable tax credits (and so the effective rate would likely be a point or two lower). [1] A median tax rate of 11.5% against a median Canadian individual income seem…

It seems you're right. I know I was close to the average for my region, but that's a high cost-of-living city with a much higher median income than 35k. I may have also been conflating household and individual income.

Lessons: 1) I have no concept of the median experience in my country, 2) a single number can't answer the question "does this country have high taxes".

Re: US Workers Are Highly Taxed If You Count Premiums

#100

Post by exodus_de » Mon, Apr 08, 2019, 10:31 PM UTC

mikeash wrote: post #72

vonmoltke wrote: post #68

Earlier quoted context omitted.

> In the US you can happy if your cost for seeing a doctor is less than 4 digits. My wife and I have never paid four figures for a doctor visit, despite having two surgeries (one oral), a calf strain, and a dislocated shoulder (with ER visit) between us. The state of medical care in the US is bad enough as it is; you don't need to make up hyperbolic bullshit to make it seem worse.

I went to the ER thinking I was having a heart attack, and it turned out there was nothing wrong. The doctor who saw me afterwards thought it might have been intestinal spams. I got to pay $6,000 for that bit of entertainment.

Let me guess - your deductible is 6000$?