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

nysenate.gov

331–340 of 569 posts

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

#331

Earlier quoted context omitted.

Probably depends what you mean by high income. I think someone making 100k will not pay that much and that is considered high in a lot of places. But I am not sure that is considered high in NYC. High is probably more like 150k - 200k+ and that still wont be anywhere near 60%. I do get to ~40% when you add up federal, state and city. I don't think anyone is really looking at an actual 60%. Maybe 50% if you're making…

I’m in Quebec so I paid 29% on everything over 66k to federal and my provincial rates were 20% (over 50k), 26% (over 100k), and 29% (over 150k). We also have a 15% sales tax. I paid more than a 50% effective rate last year. This is the cost of our social safety net. It feels like too much too me and I’ll be relocating next year.

Quebec has one of the higher tax rates in canada. You still get a similar safety net in the rest of canada for lower (albeit still high if you are a high earner) taxes.

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

#332
post #4

With California and New York both exploring statewide single payer healthcare it looks like the Overton window is moving closer to legitimate discussion of a nationwide single payer plan in the US. It’ll be interesting to watch, since this is such a hot-button topic here on many levels.

its would be interesting to see a deep-blue state coalition single payer system. that might pave the way to a national version of it.

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

#333

Earlier quoted context omitted.

If you're renting, your landlord is paying property tax and passing it on to you.

By that logic, no one pays taxes except consumers.

Isn't this basically the case at the end of the day? Just about everything seems to eventually get passed on to the consumer.

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

#334

Earlier quoted context omitted.

> Reality is it's pretty grim. Don't know if I'd recommend it to other countries to be honest. As someone who's never experienced the UK health care system, and only know one person who has (as a foreigner, so they paid out of pocket and said the experience was positive, but otherwise not a good data point) ... I'd like to hear a bit more detail about how it's pretty grim, if you're willing to elaborate.

I'd love to get you to listen in to a phone call where I try to get an appointment with my doctor. You'd have to be up at 0800 on the dot, while I desperately try to get into the phone queue. Then you'll hear me beg with the world's rudest receptionist for an appointment, which I won't get. There's no incentive for these people to be helpful or polite, because they get paid anyway and there's no market, so they aren'…

You don't have a yearly physical with your GP under NHS?

Also, I just spent a total of seven hours last week making calls just to get insurance to even process my prescription that they had previously approved.

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

#335

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

And don’t forget your healthcare costs.

"To some economists, the question is moot: Americans already pay a massive “tax” to fund health care, they say. It just happens to go to private insurance companies, rather than the federal government."

...

"Health insurance costs raise the average effective tax rate on American labor from 29 percent to 37 percent, they said."

https://www.washingtonpost.com/business/2019/10/16/americans...

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

#336

Earlier quoted context omitted.

How much of this do you think comes from the Bay Area and Los Angeles housing costs and the ability to remote work in the last couple of years (which seems to be coming to an end... possibly) and how much do you think is because of policy and city deterioration which has been publicized? I can't speak for CA but I see parallels in Seattle, though there's only movement to other cities within other WA cities (mainly th…

The common refrain is very Yogi-Berra-like, "nobody lives there anymore, it's too crowded." Few people on the right want to connect things like rising homelessness -> rising rents and property values in the same period -> an influx of high paying jobs. There aren't concrete policy proposals given to fix those things given the circumstances of the last decade, just finger-pointing at whatever particularly policy someo…

Why would you even mention "the right" in any conversation involving the governance of San Francisco? What level of control does a party need before accepting responsibility for their governing instead of looking for an exiled boogeyman to blame?

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

#337

Earlier quoted context omitted.

Who gets "good" care here? Senators and millionaires definitely do. But, most people don't get good care, many people are missing essential care (dental), and everyone has to wait. Often months. We in the US pay more per capita for worse care than most other developed nations (Canada/UK/Nordic countries). Name your country where the care is worse than the US please and let us know how much they pay for it per capita…

Actually, the median American has access to exceptional care. What is actually the case is that care available to the bottom quartile of Americans is below the care received on average in a top-tier universal care nation, and the US spends an absolute fortune delivering this quartile with substandard care. We also spend a bit more than average providing exceptional care to everyone else, except that we also spend a t…

60% of the US has access to "good" healthcare. Why is it ok to throw the under 40% under the bus?

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

#338

Earlier quoted context omitted.

I'd love to get you to listen in to a phone call where I try to get an appointment with my doctor. You'd have to be up at 0800 on the dot, while I desperately try to get into the phone queue. Then you'll hear me beg with the world's rudest receptionist for an appointment, which I won't get. There's no incentive for these people to be helpful or polite, because they get paid anyway and there's no market, so they aren'…

You don't have a yearly physical with your GP under NHS? Also, I just spent a total of seven hours last week making calls just to get insurance to even process my prescription that they had previously approved.

There's no way in hell an NHS GP would agree to see me just for a physical without some very specific major problem actually in evidence.

If you never want to see your GP again then yeah petition for the UK system.

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

#339
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 am not an accountant nor someone who benefits from these deductions, but I'm casually interested. From what I've seen, a few: 1. Charity can be meaningfully different from chipping in $200 to something if you can afford to pay for large parts of a program, meaning things can have your name on them, or you can get events that you care about hosted at your church while saving on your taxes. 2. Tax advantaged accounts everywhere. Max out all retirement of course, but also education accounts for your four kids. Then I think there's some interesting tax advantages to whole life insurance, but I don't know which end those come on. 3. Structuring more of your life as a business. For example, I use my affordable car almost exclusively for work but it's not worth the trouble to track it for deductions because I still do best with standard deduction. Once you pass that, may as well track everything. And you should buy a large SUV instead of a minivan for your family so you can use the more favorable depreciation schedule that encourages SUV use over minivan and car use. Deduct your laptop and phone and phone plan because if you're making a lot of money, there's almost no chance you're using those for personal stuff more than for business. Probably some travel and dining fit as deductions too. Clothing, maybe? This is all completely legitimate (well, maybe it's not because of my ignorance on particular applications, but the spirit is consistent with how deductions work.)

You also may have the ability to structure some of your income as business appreciation so as to not pay taxes yet. True, it's still trapped until you pay taxes, but it's still resources you have available to you that haven't yet caused you to suffer tax expenditures. As a rule, you should never volunteer taxes that you can legally defer.

It'll all add up, though probably not to an overwhelming amount. My impression is that a lot of the exaggerations of low tax rates come from very slimy accounting driven by agendas (to say nothing of expressing taxes in a given year as a fraction of total accumulated wealth.)

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

#340

50% of health resources are used in the final 5 years of life. The young should not pay for the healthcare of the elderly. Society should be apportioned into different age categories, and funded separately, with a 'base' tier for all citizens and legal residents, and a higher tier for those with private or employer insurance.

> The young should not pay for the healthcare of the elderly.

I take an alternative view. When you're young, the payments you make into Medicare taxes are to take care of you later when you need it. A long-term HSA of sorts.

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