Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

US Workers Are Highly Taxed If You Count Premiums

peoplespolicyproject.org

Post reply on HN
Print view View original

321–330 of 534 posts

Re: US Workers Are Highly Taxed If You Count Premiums

#321

Post by exodus_de »

maxxxxx wrote: post #102
exodus_de wrote: post #88

Earlier 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…

"It's basically like this: If you're gonna be poor, go to Germany. Everyone else will pay for you. If you're going to earn well, leave Germany, otherwise you're going to be paying for everyone else." You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US.

> You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US.

If you already have a serious health problem, you'll be hard pressed to find any country to take you and just take care of it pro-bono, if you're uninsured.

German public insurance only covers the bare minimum. I know enough people who are poor because of serious health issues. Sure, their medical costs were covered, but they're now welfare cases. They can't afford many treatments that would make their lives better. They would've had to buy extra insurance, but they chose not to, or couldn't afford it.

Relating that to the US: Don't skimp on insurance. Don't get an insurance that is capped at a low number, otherwise you will go bankrupt if shit hits the fan.

Re: US Workers Are Highly Taxed If You Count Premiums

#322

Post by chrisgd »

roenxi wrote: post #270
TallGuyShort wrote: post #216

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,…

'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…

You can't find out the price on most things and procedures that are the highest value (cancer care, dialysis, sickle-cell, etc.) are usually those with the least flexibility in price.

Re: US Workers Are Highly Taxed If You Count Premiums

#323

Post by SantalBlush »

tathougies wrote: post #187
munk-a wrote: post #174

Earlier quoted context omitted.

Perfect! So as a counter to that, and dialing my language back to patton-y style, America is going around stirring up shit that the rest of the world needs to shovel. Why is it that after Syria and ISIS have emerged and created a refugee crisis the US is miraculously missing (on a per-GDP basis) in the aide efforts. While America is fueling economic growth beyond the ability for the earth to sustain it why has it ref…

> Oh wait, that was too reductionist... maybe the US does a lot of good by sending food aide around the world but also causes problems... maybe the rest of the world is the same, being good sometimes and bad others, and no one nation is some beacon of light and purity that all others are constantly sucking[1] the productivity out of. I never claimed America was a beacon of light. I merely claimed that many non-Americ…

And many non-American countries have suffered from American hegemony. The US used concentration camps in the Phillipines and overthrew the Honduran government so we could have cheap fruit. Are you absolutely sure that the US provides a net benefit to other countries via its military?

Re: US Workers Are Highly Taxed If You Count Premiums

#324

Post by bzbarsky »

jedberg wrote: post #185
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…

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.

The state tax payments were a deduction, not a credit. So even before the recent SALT limitation raising state taxes would "harm" your state's citizens in the sense that you used "harm".

As an example, if your federal marginal rate were 25%, paying $4k in state taxes would only get you $1k off your federal taxes, not $4k.

Re: US Workers Are Highly Taxed If You Count Premiums

#325

Post by elliekelly »

mercutio2 wrote: post #273
tptacek wrote: post #126

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…

Agreed! The way countries with cheaper healthcare manage to spend less is by paying healthcare workers much less. Doctors and nurses in the US are high status. When they lobby against something, it’s hard to win. When I read people discussing cheaper healthcare, I always go looking for the part where they explain that healthcare professionals will make a significantly lower dollar per hour. I rarely find this discuss…

I wonder how the earnings of American doctors compare to European doctors once you've removed the high cost of an American education/all those student loans they're paying off.

Re: US Workers Are Highly Taxed If You Count Premiums

#326

Post by fucking_tragedy »

noelsusman wrote: post #293
FactolSarin wrote: post #89

Earlier quoted context omitted.

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.

You don't need an ER for any of those things. We already solved this problem with Urgent Care.

Where I am, urgent care closes at 8PM and only takes two of the several insurance providers that are common.

ER is open 24/7 and doesn't turn people away even if they don't accept their insurance plan.

Re: US Workers Are Highly Taxed If You Count Premiums

#327

Post by wolco »

lhorie wrote: post #228
Simon_says wrote: post #219

Earlier quoted context omitted.

It wasn't worth the cost in Toronto, either, but you didn't care because it wasn't you who paid the cost.

Technically I did, since my taxes pay for it. What I didn't pay for is the overhead of clerical work from two different corporations for mailing me letters informing me of how arbitrarily priced my doctor visit was.

You did pay for it. Half of the Ontario budget goes towards it.

The fact that you would go without thought of the cost but in a similiar situation would avoid because of the direct costs shows why the Ontario system is a poor model. The costs are hidden so more services are used. If costs were direct paid for out of your Ontario fund (a yearly budget that if not used would be carried forwarded or removed from your taxes) than a better balance could be found.

Re: US Workers Are Highly Taxed If You Count Premiums

#328

Post by chrisgd »

mschuetz wrote: post #109
jakobegger wrote: post #92

Earlier quoted context omitted.

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€

Yeah, and cost of health insurance in Austria is just 7,65% of your income, and it covers your children. When I've worked in the US, I've paid just as much for health insurance and still had high out-of-pockets and deductibles on top of that.

I will pay $4,800 to cover a family of 4. If I need to use it, I have a $6,000 deductible (company pays first $4k and I pay last $2k). All doctor visits are 100% deductible until it is fully paid, then $50 / visit. The HSA can be used to pay the deductible and pharmacy costs.

Re: US Workers Are Highly Taxed If You Count Premiums

#329

Post by trhway »

peteradio wrote: post #170
jakobegger wrote: post #92

Earlier quoted context omitted.

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€

Oh yea but how many billionaires does your country have. Hah!

not only billionaires. How about completely unauditable $700B defense budget producing beauties like F-35 plus additional supplemental couple hundred billions per year on actively establishing and maintaining democracy in a bunch of places far far away!

correction - wow! the first ever audit has finally happened https://www.defensenews.com/pentagon/2018/11/15/heres-what-t... :

"But department officials were quick to note that was no expectation that the audit would be clean, given the size and scope of the project."

Re: US Workers Are Highly Taxed If You Count Premiums

#330

Post by trashface »

baddox wrote: post #302
zrail wrote: post #30

Earlier quoted context omitted.

$300 is a steal.

Yeah, I saw that and thought "sign me up!" I paid $1200 for a chest X-ray at the emergency room in San Francisco (I was fine, but they understandably freak out about an adult male complaining about chest pain).

When I lived in SF I once cut into my finger with a rusty fish filet knife (don't ask). I went to the bernal hospital ER and they gave me a tetanus shot, but nothing else. A few weeks later I went to my family doc and mentioned this, and he said, "You went to an ER for a tetanus shot?" Me: "Uh, Yeah." Him: "That's like a $1500 tetanus shot."

They didn't have urgent care back then, but I understand there were "clinics" that could give those shots.

Post reply on HN