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NY Senate Bill S5474 proposing a universal single payer health plan for NYers

nysenate.gov

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Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#311

Post by endisneigh »

DaveExeter wrote: post #230
endisneigh wrote: post #25

Earlier quoted context omitted.

Not really, there are people who get great health care for free from their employer, and others who get a greatly discounted rate. Their employers will not necessarily savings with their employees. The result for these employees could be more taxes for the same or worse care they’re already receiving. In aggregate I believe it’s the right move but let’s not act like everyone wins here.

> Not really, there are people who get great health care for free from their employer It is not 'for free' it is part of your compensation! It's like saying your employer pays 6.2% + 1.45% in SS/Medicaid taxes 'for free'. That is part of your compensation.

I meant free in that you don’t pay a premium, but fair point.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#312

Post by bdzr »

heavyset_go wrote: post #52
endisneigh wrote: post #15

Earlier quoted context omitted.

The amount paid per capita and whether you would pay more taxes are not exclusive things. I’m not sure why people keep bringing up Europe - the USA is not Europe. For one doctors are paid more in the USA compared to Europe, medicine is more expensive here, more of the R and D originates here, etc

A lot of that R&D is already funded with our taxes via the NIH.

A significant portion is not. Clinical trials are unbelievably expensive, see https://www.science.org/content/blog-post/drugs-come-compreh....

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#313

Post by [deleted] »

thebean11 wrote: post #256
vlan0 wrote: post #186

Earlier quoted context omitted.

Where is that? My parents lived in North County and paid 13k+ a year on a $350k house. Their current place in Tampa is about 400k and the taxes are less than half of what they were in NY. Maybe Florida is a special case?

I'm basing this off of apartments in NYC. I often see ~$600k co-cops with $800 monthly co op fees (of which half is maintenance half is taxes). That seems low to me compared with similarly priced homes elsewhere.

[deleted]

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#314

Post by throw0101a »

endisneigh wrote: post #15
ceejayoz wrote: post #5

Earlier quoted context omitted.

No, it wouldn't. The European single-payer systems pay half what we do per-capita, factoring in private and public spending in both systems. The US system is wildly cost inefficient. See the chart at https://data.oecd.org/healthres/health-spending.htm

The amount paid per capita and whether you would pay more taxes are not exclusive things. I’m not sure why people keep bringing up Europe - the USA is not Europe. For one doctors are paid more in the USA compared to Europe, medicine is more expensive here, more of the R and D originates here, etc

> The amount paid per capita and whether you would pay more taxes are not exclusive things.

You're already paying for health care coverage via monthly/annual premiums and via reduced salaries where your employer's portion is part of the 'total compensation' you get (but doesn't show up in your pay check).

Even if the amount at the end stays exactly the same it may be an improvement because (a) there are no "in network" worries about going to the "wrong" hospital or getting the "wrong" doctor", and (b) it is universal coverage so (i) you may not have to worry about losing your job and losing coverage as well as (ii) you can change jobs and have the same (universal) coverage.

It'd be a deal even if it costs exactly the same.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#315

Post by revnode »

jonahbenton wrote: post #302
revnode wrote: post #149

Earlier quoted context omitted.

You paid much more than that. A substantial part of your rent is property taxes. I also doubt you included sales taxes in that number. Then there's more esoteric stuff like tariffs, etc

No. Property tax rates are extremely- some would say criminally- low in NYC. I would think it unusual for more than 20% of rent to go to property tax. Mortgage much much more likely to be the dominant expense for a residential landlord, but varies significantly with age. There are many longtime landlords for whom their tenants are now nearly all profit. Which is INSANE.

Why are you assuming he lives in NYC?

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#316

Post by MrWiffles »

mortehu wrote: post #279
ABCLAW wrote: post #236

Earlier quoted context omitted.

If you're a "high earner" there are a panoply of services that allow you to structure your income, wealth appreciation, or other forms of wealth generation in tax-optimized vehicles. The tax universes at 200k/yr and 500k/yr-2m/yr income look very different.

If we're talking wages here, what are the options exactly? Is there anything bigger than 401(k)? This is ignoring charity, which I believe is available to anyone anyway.

I believe - someone more financially literate (and far richer!) correct me if I'm wrong - that you can convert some of those wages into various different vehicles and get paid in non-wage forms in certain cases. Correlation != causation of course, but if you're making $500k/year chances are pretty good a large chunk of that is non-wage income such as capital gains, corporate bonuses, trust funds, etc. And even if it was all wage-derived, over time you could easily realize major capital gains on it if you're lucky enough to (a) make a huge chunk 'o change, (b) have low-enough cost of living to be able to move it into investments and then (c) have enough life stability to be able to continue this pattern for several years or decades (or better yet, have grandparents and parents who did then passed the wealth down to you). Even after taxes as high as 50%, with enough raw wage income you can definitely pivot your "margin" into vehicles that yield serious ROI over time, and can even leverage the highly disparate cost of living to your advantage: use NYC's housing market to justify a ridiculous salary, then live super cheap out there somehow (insert hand-waving magic reference here), and use the difference to buy housing out in, say, rural Texas or Kansas before the pandemic, rent it out via property company, reap profit month-after-month.

From there you follow the directions on your shampoo bottle:

1. Lather

2. Rinse

3. Repeat

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#317

Post by endisneigh »

drm237 wrote: post #106
endisneigh wrote: post #49

Earlier quoted context omitted.

If you think employers will share the savings with their employees, think again.

I don't think they're saying that at all. I think the point was, a payroll tax won't necessarily increase costs for a company because it would be offset by eliminating the current healthcare costs.

Right, but my point is that to keep the relative advantage they’d have to pay.

For example imagine a company attracts talent by paying median + healthcare, and another that just paid median. For the latter they would have more costs, no?

The savings aren’t offset unless they were already offering the incentive.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#318

Post by docstryder »

If we go by data, the US healthcare system is the most expensive (not arguable) and is not even in the top 5 among developed countries in the most important measures. These kind of experiments are welcome (if they come to pass). People deserve better for what they pay currently.

one of these references is from an US insurance company who you would think would be biased for US healthcare

https://www.cignaglobal.com/blog/healthcare/top-10-countries...

https://www.washingtonpost.com/world/2021/08/05/global-healt...

https://www.internationalinsurance.com/health/systems/

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#319

Post by et2o »

docstryder wrote: post #310
et2o wrote: post #285

I’m an MD who trained in NYC. I have also had emergency surgery in the NHS at one of their most prestigious hospitals in London and so I feel like I’ve seen the system a little bit from the inside. It was far cheaper for me than it would have been as a Brit in the USA, but the standard of care was lower. They didn’t have some technical and staffing resources late in the afternoon that would be a baseline in any of th…

If we go by data, the US healthcare system is the most expensive (not arguable) and is not even in the top 5 among developed countries in the most important measures. Also a doc, though that is not really relevant for this discussion. one of these references is from an US insurance company who you would think would be biased for US healthcare https://www.cignaglobal.com/blog/healthcare/top-10-countries... https://www…

I said “if you have private insurance,” which I think is the key qualifier. One of the other commenters expanded upon it well below.

I’m not making an argument for cost-effectiveness either.

We can get private insurance to pay for elective surgeries, new medications, etc. that are either not covered in other countries or have extremely long wait periods. And the higher reimbursement I think is helpful for providing staffing and paying for equipment that they (in my admittedly n of 1 experience) simply didn’t have for me. I suppose it is a tradeoff.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#320

Post by sixothree »

revnode wrote: post #149
beebmam wrote: post #96

Earlier quoted context omitted.

That's 60% marginal rates. Last year I paid 17% of my total income in taxes.

You paid much more than that. A substantial part of your rent is property taxes. I also doubt you included sales taxes in that number. Then there's more esoteric stuff like tariffs, etc

And don’t forget your healthcare costs.
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