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: https://en.wikipedia.org/wiki/List_of_countries_by_tax_reven.... Canada is listed as just 11%.
US Workers Are Highly Taxed If You Count Premiums
231–240 of 534 posts
Re: US Workers Are Highly Taxed If You Count Premiums
#232Earlier quoted context omitted.
> My family in Germany throws a fit when they have to pay 50 Euro for something. Socialized insurance rates in Germany are 15% of income. Unless your family doesn't earn any money, they have been paying far more than 50 Euros. > In the US you can happy if your cost for seeing a doctor is less than 4 digits. That isn't generally true. Every insurance plan is different. Cheap plans have a high deductible. It's similar…
>>Socialized insurance rates in Germany are 15% of income. Unless your family doesn't earn any money, they have been paying far more than 50 Euros. Comments like this always miss the larger point, which is that healthcare overall is cheaper in socialized systems because the government as a large entity negotiates on behalf of citizens and puts strong downward pressure on prices.
I wouldn’t say that the govts of socialized systems negotiate rates down, it’s more of “this is what you will get paid”.
Salaries for doctors are the highest in the US. If we want to move to a single payer system they will have to take significant pay cuts.
Re: US Workers Are Highly Taxed If You Count Premiums
#233Earlier quoted context omitted.
VAT taxes (or sales tax in the US) will tend to more heavily effect lower income workers, which will not be the majority of people on HN. VAT taxes are heavily regressive and, outside of the luxury class of such would be nice to see phased out.
Most sales taxes in the US aren’t applied to staple good like food, blunting the impact on lower income workers. I would disagree it doesn’t impact higher income works because you’re still paying sales tax on luxury items and because of the high prices, the tax is very high. In Canada it’s not uncommon for the HST to be 15%.
> In Canada
And if your income is low enough, you get an HST credit to control for its regressive nature.
Re: US Workers Are Highly Taxed If You Count Premiums
#234Earlier quoted context omitted.
An emergency room is not a "basic visit".
The greatest trick healthcare companies have pulled is convincing Americans that after hours visits for things like high fevers and broken bones isn't basic care. I'm 40, and my Mom was telling me about how my brother cut his head as a child, and the local small town doctor came in after hours to stitch it up. Different era.
That’s what urgent care is for. You shouldn’t be going to the ER for a typical fever or a cut requiring stitches.
Re: US Workers Are Highly Taxed If You Count Premiums
#235I 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…
> 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." That's mostly not true if you have an HMO plan, but your employer may not offer HMO plans if it offers insurance, the HMO may not be a good one if it is available, or it may not cover goo…
> That's mostly not true if you have an HMO plan, but your employer may not offer HMO plans if it offers insurance, the HMO may not be a good one if it is available, or it may not cover good providers in your area.
I think you meant that tongue in cheek, but essentially that means it's true for a significant number of people whose circumstances meet any of those criteria.
Re: US Workers Are Highly Taxed If You Count Premiums
#236The 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…
Is this a Canadian federalism thing? Are social payments pronvincial instead of federal?
For healthcare at least, the federal govt gives grants that cover some of the cost. The provinces are expected to pay the rest.
Re: US Workers Are Highly Taxed If You Count Premiums
#237Earlier quoted context omitted.
Not really. There are non-ER/non-hospital urgent-care centers, but they usually keep to roughly normal business hours. For after-hours care, the ER at a hospital is often your only option.
Depends on where you are. Some places have 24-hour Urgent Care centers that can handle the basic stuff that doesn't need a real ER. But many places don't have any kind of Urgent Care centers, much less one that is open 24 hours a day.
For those from tri-state area: folks, PM Pediatrics is a blessing. They're open till midnight, waiting times are reasonable and they are billed as PCP by the insurance.
Re: US Workers Are Highly Taxed If You Count Premiums
#238Earlier quoted context omitted.
This is actually a huge lever of control for the federal government, and I think has contributed greatly to increase of federal power over the states. The reason being that states can tap into that large federal stream... If they meet the federal criteria. This kind of carrot system is actually how many federal laws that seem to effect the states work. For instance, no state was ever mandated to implement the No Chil…
Yeah, like did you know that 18 is the legal drinking age in the US? That's why 18 year old soldiers can drink alcohol in the military. BUT, if a state increases the drinking age to 21 in their state then they get sweet sweet federal highway funds. For a long time Louisiana was a holdout, so 18-21 year olds would go there to party for mardis gras, and the road quality showed it.
NB: in most states minors can drink alcohol if served by a parent.
I'm not encouraging underage binge drinking, but if you want to have a quick pint with your high school senior, that's absolutely legal.
Re: US Workers Are Highly Taxed If You Count Premiums
#239Earlier quoted context omitted.
The whole point of allowing people to deduct their state tax payments was to solve exactly this problem. Let the states that want to tax more and provide more social services do so without harm to their citizens. Of course that deduction is gone now, which just further solidifies government power.
My own suspicion is that we got rid of that because government wants to harm the citizens of certain states. That's likely one of the benefits of having federal power, the ability structure the system to perpetuate your hold on it. In the US, our politicians do this all the time.
Well, there are actually good arguments to be made on both sides of the issue. For example, one argument is, "why should people who live in high cost states pay less federal tax for the same federal services?" The counter-argument being "they don't need as many government services since they get the same benefits from their state" and also "their incomes are higher so their total dollar contribution is still just as high".
It's a tough issue. From the Federal perspective is makes a lot of sense to get rid of the SALT deductions, and I suspect the next time the Dems are in charge they will "be unable" to restore the deduction for "reasons", since both parties want the extra revenue.
Re: US Workers Are Highly Taxed If You Count Premiums
#240Earlier quoted context omitted.
For me it's the opposite. I moved from Denmark to the US, and I pay around $400 in health insurance premiums (health, eye, and dental) for a whole family. In Denmark, only health is covered, so for eye and dental many go out-of-country to get it cheap. The US is much cheaper for all health insurances, except if your poor. Obama tried to fix that, but made it worse and more expensive for everyone (socialism).
If you're employed and your employer is generous, then your insurance premiums can be inexpensive (low double digits per month if you're single, low triple digits if you have dependents) . My wild speculation is that most employers aren't as generous as they could be. If you're "poor", insurance is actually cheap, because that's when you get public insurance. However, if you're just middle income, health care is a no…
The last step is a full-coverage default public option, paid for out of taxes. Enough to eliminate the billing departments outside of actual luxury medicine.
As far as cost controls/etc, set by something like a dutch auction within a given metro area, and then some bean counter will get to figure out if it's cost effective to ship people that are outside of metro areas in to them to provide non-urgent care.