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US Workers Are Highly Taxed If You Count Premiums

peoplespolicyproject.org

311–320 of 534 posts

Re: US Workers Are Highly Taxed If You Count Premiums

#311

Earlier 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, but then we'd just be dominated by states like Minnesota, California, Delaware, New York, etc. Basically, ginormous pools of money would start to build in the old Union and out on the west coast. But almost everyone in the middle would be hosed. (I mean places like Oklahoma and Colorado would likely be pretty happy, but everyone else would take substantial financial hits.)

> Yeah, but then we'd just be dominated by states like Minnesota, California, Delaware, New York, etc. Basically, ginormous pools of money would start to build in the old Union and out on the west coast. But almost everyone in the middle would be hosed.

Not really. States like California are net payers, but only just, because they have large diverse populations and end up getting back almost all of what they pay in.

It's true that a lot of the middle states are net recipients, but most of them are still below $4000 per capita.

And the bigger problem is that so much of the money is wasted. Each Congressman goes to Washington to bring back pork, and they do, but pork is inefficient. So they bring back $10,000 per capita in funding after paying in $6000, but only $5000 of the $10,000 is put to productive use. Does that really help the states compared to just keeping their original $6000 and using all of it productively because you don't have to negotiate with 49 other states for how to spend your own money?

Re: US Workers Are Highly Taxed If You Count Premiums

#312

Earlier quoted context omitted.

Think of what it'd do to the insurance worker economy if we switched to a medicare for all system! It's pretty fucked up that such a large chunk of our country is now essentially parasitic. (I say this while recognizing that runaway medical costs aren't solely the result of insurers)

Curious if there can be Amazon for healthcare..

Considering the reported working conditions of some Amazon employees, let's not.

The most sustainable choice will be neither monopolistic pricing, nor cutthroat pricing at the expense of medical staff, but somewhere in the middle.

Re: US Workers Are Highly Taxed If You Count Premiums

#313

Earlier quoted context omitted.

Yes. I couldn’t find an angle to negotiate with. I could afford to pay, so trying to use hardship as a lever to bring down the bill wouldn’t have been honest.

Normally you just call and say youd like to lower the bill

Not so easy if you’re google-able and clearly work in tech. They won’t squeeze blood from a stone, but if they smell money, they aren’t going to negotiate. The advice frequently found on reddit about negotiating is good, but keep in mind it’s targeted at individuals with, best case, 0 net worth and worst case hundreds of thousands in debt.

Your mileage will vary depending on the bill collector, hospital system, staff etc., but keep in mind someone has to be paying the bills. American, work in tech, post on Hackernews? It’s probably going to be you.

Always worth a shot though. Worst case they’ll usually let you go on a 0% APR payment plan for years and years.

Re: US Workers Are Highly Taxed If You Count Premiums

#314
post #130

Earlier 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 poor in the US, insurance is free. It's the lower middle class and middle class who are frequently bankrupted by these costs.

> If you're poor in the US, insurance is free

Depends on if the individual's state accepted Medicaid expansion funds from the federal government (states like Texas and Florida haven't) and whether the individual makes less than ~$16.5k/yr.

I wouldn't call either $0k/yr in North Carolina, or $17k/yr in New York, lower middle class. Neither of those incomes in those places would give an individual access to Medicaid.

Re: US Workers Are Highly Taxed If You Count Premiums

#315

Earlier quoted context omitted.

A basic non-complication natural child birth will cost at least a couple of thousand out of pocket for most insurances.

With insurance, more complicated births aren't that much more. We were out of pocket $4k for the birth of our twins (maxed our deductible). The total 'sticker price; was over a million USD (they spent a combined 10 weeks in the NICU).

Over a million for 10 weeks in nicu? Who sets these rates?

Re: US Workers Are Highly Taxed If You Count Premiums

#316
post #130

Earlier 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).

> I moved from Denmark to the US, and I pay around $400 in health insurance premiums (health, eye, and dental) for a whole family. My health alone is $2,100/month for a family of four. I suspect your employer is paying a large portion of your premiums as a benefit. This is quite common in the US, and a significant portion of the problem, as people think they're getting great insurance "cheap". They're not - it's just…

Employers can also negotiate for group rates that someone buying insurance on the individual market won't have access to.

Not only do employers pay for a portion of employee healthcare costs, they also get better coverage for less.

Re: US Workers Are Highly Taxed If You Count Premiums

#317

Earlier quoted context omitted.

I know that German universities are generally free, while, for example, their UK counterparts charge around 10,000 GBP a year.

The tuition fee in the UK isn't really a fee at all, at least for most domestic students. In practice, it's more like a graduate tax. Student loans are only repayable if you're earning over £25,725 per year. Your repayments are 9% of your income over that threshold. Your loan is automatically forgiven after 30 years. Because of these terms, the vast majority of students never fully repay their loan. https://www.money…

That's sad though. This means that most students never earn more than 25k per year, even if they studied..

Re: US Workers Are Highly Taxed If You Count Premiums

#318

Earlier quoted context omitted.

In what way is your comment about price fixing relevant? I don't care if the lower price is because of price fixing or not.

Yes, you don't care because you're completely ignorant. How would you feel about your job if I set the price for your wages at 12€/hour? Price fixing causes shortages and/or lowers quality. I hope you don't have to go to a German hospital and catch yourself some MRSA, or wait months in agony to get an MRI to diagnose your neurological disorder, or get an appointment with basically any specialist. Because that's the r…

"you're completely ignorant"

Thanks. Very stylish.

Re: US Workers Are Highly Taxed If You Count Premiums

#319
post #270

Earlier quoted context omitted.

'You should know the price before you agree to buy the product' seems like such an innocuous principle. Why isn't their broad-based support of it for medical care? If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the…

Yeah, this has baffled me before. I remember learning in my Family & Consumer Sciences class about the importance of being an informed consumer. Then, in college I had to get a dental procedure done and I called around to try to find out the price from different dentists and no one could give me any actual numbers. I ultimately just had to pick a place based on reviews and found out the price after the fact with no k…

That's odd. Dentists, unlike doctors, will in my experience just give you a price if you ask for it... Maybe this varies state to state?

Re: US Workers Are Highly Taxed If You Count Premiums

#320
post #252

Earlier quoted context omitted.

Can't even find out what stuff costs beforehand either. I had to get a blood test. I had gotten burned before where my insurance said they covered a physical, but it turns out their definition of a physical didn't include the doctor's definition, which included blood tests. So before I had my blood drawn, I asked them to tell me what the tests would cost if my insurance didn't cover it. "It depends on how it's coded,…

I think of this every time someone acts like U.S. healthcare is a market in any positive sense: our son had his first birthday before we got the last hospital bill (they were hoping we’d gift them money beyond their negotiated rate with our insurance company) while nobody I know from another country has ever had any experience with that.

That may be so-called "balance billing". It is illegal in some states.
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