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US Workers Are Highly Taxed If You Count Premiums

peoplespolicyproject.org

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Re: US Workers Are Highly Taxed If You Count Premiums

#411

Post by bodono »

philjohn wrote: post #405

So - in the UK you pay national insurance, which ostensibly pays for the NHS and retirement benefits. 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. You do pay £9 for each item on a prescription, but if you get more than 3 items a month you can…

Except for the fact that the NHS is utter garbage and anyone here making 150k is on private health insurance.

Re: US Workers Are Highly Taxed If You Count Premiums

#412

Post by arethuza »

AlexTWithBeard wrote: post #156
bilbo0s wrote: post #146

Earlier quoted context omitted.

I wonder if 10 thousand is a lot for undergraduate education to a German, or Austrian, or French person? EDIT: Doh! Just checked the cost of undergrad in some of those nations. Umm, Yeah. I guess if I were a German or French guy, I'd likely find tuition levels in the US a bit outrageous.

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

Nitpick: you can't really generalize about education in the UK as Scotland has a completely different system to England and Wales (and I don't know about NI).

For example, tuition fees at Scottish universities are "free" (i.e. paid for by the Scottish Government) for Scottish residents and people from other EU countries (but not the rest of the UK).

Re: US Workers Are Highly Taxed If You Count Premiums

#413

Post by tallanvor »

zrail wrote: post #30
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…

$300 is a steal.

In Norway you max out your copay at around $250/year for everything except some prescriptions. Once you hit the cap, they send you a card in the mail that you show your doctor, pharmacist, etc. so they don't charge you a further copay.

Re: US Workers Are Highly Taxed If You Count Premiums

#414

Post by mattlondon »

bodono wrote: post #411
philjohn wrote: post #405

So - in the UK you pay national insurance, which ostensibly pays for the NHS and retirement benefits. 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. You do pay £9 for each item on a prescription, but if you get more than 3 items a month you can…

Except for the fact that the NHS is utter garbage and anyone here making 150k is on private health insurance.

Citation needed.

I dont think that the NHS is utter garbage - sure there is room for improvement, but it seems that it is not "garbage" at all according to recent research: https://www.kingsfund.org.uk/sites/default/files/2018-06/NHS...

That report has some very interesting charts. E.g. Figure 9 shows that almost 25% of people in USA skipped going to the doctors due to cost, or almost 20% of people in USA skipped prescription medicine due to cost. For comparison on the NHS it was 5% and 2% respectively. Mind-boggling.

I'd agree though that anyone on 150K plus (and probably anyone in a job from the 40K range upward (if not lower)) would have private medical cover. As others have noted, private cover basically just means you get seen quicker/at a more convienient time and the waiting room is nicer - the care is no better or worse than the NHS IME (although I dont have any data on that - just a personal anecdote)

Re: US Workers Are Highly Taxed If You Count Premiums

#415

Post by mattlondon »

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…

What I was wondering about was how much money is needed for the sheer administration of processing claims and payments in the US system?

In the UK in the NHS, there is none of the layers of beurocracy and paperwork related to call-centers and payment handling and claims inspectors (as far as I know anyway) that I assume is commonplace in the US hospitals and insurance companies. You go in, see the doctor, then leave. Usually the only "paperwork" required is booking another appointment if you need to come back - no forms, no invoices, no payment etc.

I guess it is the same argument made about universal income benefits - if we just gave everyone (rich or poor) in the country a set amount of money each year we'd save billions in not having to means-test every claimant individually and actually save money by giving it away to everyone.

Re: US Workers Are Highly Taxed If You Count Premiums

#416

Post by Vinnl »

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…

I'm not from the US and had to look up "inpatient" and "outpatient", so to share what I've found: as I understand it it's different ways of recording what a patient is suffering from, with "inpatient" being used when a cause is known, and "outpatient" when a doctor can only describe the symptoms, without knowing what they are caused by.

And I guess the relevance is that discerning and switching between the two when a better diagnosis is made causes large administrative overhead?

Re: US Workers Are Highly Taxed If You Count Premiums

#417

Post by phonebanshee »

henrikschroder wrote: post #350
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,…

I was at the dentist today because I managed to chip a tooth yesterday, and needed it fixed. Before the procedure, they asked if I wanted an estimate, I said sure, and got one in a minute. The dental industry works the same as the medical, I have a half-useless insurance that covers too little, and out-of-pocket expenses are always higher than you expect. But if they can do estimates before a procedure, why the hell…

Dental insurance isn't insurance in the normal sense. It's more a way to prepay dental expenses with pre-tax dollars.

Re: US Workers Are Highly Taxed If You Count Premiums

#418

Post by germanier »

exodus_de wrote: post #294
enraged_camel wrote: post #149

Earlier quoted context omitted.

>>Guess what, private insurance companies will also negotiate prices. They negotiate prices based on the size of the pool. This is why if you are a small business the rates you will get will be worse than if you were a large enterprise. With socialized healthcare, the pool is the entire citizenry, which is what gives the government substantial leverage when negotiating.

The German government doesn't negotiate anything. They set prices, period. Set them too low and you create shortages. Guess what the German healthcare system has, it's a shortage of doctors , especially specialists. German doctors are leaving for greener pastures, like Switzerland. They are replaced by doctors from Eastern Europe. Quality suffers. Waiting times are high. Most Germans are too uninformed or arrogant to…

> The German government doesn't negotiate anything. They set prices, period

Incorrect. In the public system, the fees are negotiated between the GKV Spitzenverband (federal association of public health insurers) and the KBV (federal association of public doctors).

Germany still is in the top group regarding quality of care indicators.

Re: US Workers Are Highly Taxed If You Count Premiums

#419

Post by sparkling »

mamon wrote: post #269
lazulicurio wrote: post #229

Earlier quoted context omitted.

> This doesn't seem to be a major problem for the EU, which has unrestricted internal migration but social programs are administered by the individual member states I might be off the mark here, but from my understanding wasn't unrestricted migration one of the big drivers behind Brexit? Or at least the idea that the "poor countries" were "taking advantage" of the "rich countries"?

My understanding is that unrestricted immigration has the opposite effect: rich countries taking advantage of poor ones, via “brain drain”. That’s why the average age of medicine doctors in Poland seems to be around 50: all the younger ones went to Germany or Scandinavia. It’s true for blue collar workers as well: try hiring a contractor to remodel your house and then watch them leave the job unfinished because they…

Both is true. There is brain drain as well as welfare migration. My hometown in Germany with a population of ~300k now has ~11k migrants from Romania und Bulgaria. Aside from various social problems this is also a big strain on the social systems. 85%+ of households are dependent on child support checks.

Re: US Workers Are Highly Taxed If You Count Premiums

#420

Post by philjohn »

bodono wrote: post #411
philjohn wrote: post #405

So - in the UK you pay national insurance, which ostensibly pays for the NHS and retirement benefits. 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. You do pay £9 for each item on a prescription, but if you get more than 3 items a month you can…

Except for the fact that the NHS is utter garbage and anyone here making 150k is on private health insurance.

Except that's not the case at all.

The NHS is underfunded, sure, but in an emergency situation (you know, the kind that will bankrupt you in the US) you won't get treated privately, it will be done on the NHS. Sure, if you have cancer your Chemo will be given in nicer surroundings, but it's the same drugs administered under the same protocol.

All private insurance in the UK gives you is that - a nicer environment and quicker access to treatment for non life-threatening conditions.

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