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No One Goes There Anymore

noonegoesthereanymore.blogspot.com

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Re: No One Goes There Anymore

#161

Post by jerome-jh »

magicalhippo wrote: post #30

When I see about half my paycheck going to taxes it feels a bit rough. But then I think of stories like this, and how easily it could have been me with an illness requiring expensive medical treatment and possibly preventing me from working regular jobs. And so I pay my tax with pleasure, knowing that if something were to happen to me or my fellow citizen, at least there wouldn't be millions of dollars in hospital bi…

From this side of the Altantic, it looks like the US economy is organized so that the lower working class only earns just enough to live. No wonder they are homeless when illness, disability or bad luck strikes.

I am not implying this applies to OP.

Re: No One Goes There Anymore

#162

Post by GordonS »

masonic wrote: post #125
dan-robertson wrote: post #60

Earlier quoted context omitted.

Few countries even in Europe will let your effective income tax rate reach 50% but this may be an effect of tax system structure more than anything else. Eg in the U.K. the max marginal income tax rate is 45% but that doesn’t count payroll taxes (employer or employee), which are called “national insurance”, or student loan “repayments” (9% of income above a threshold, though not super relevant to people in the top ba…

in the U.K. the max marginal income tax rate is 45% That's a big change from years ago, when it was 95% (hence "it's one for you, nineteen for me" in the Beatles' "Taxman").

Also in the UK. When you take into account the council tax and national insurance (extra income tax by another name), the effective tax rate for is easily above 50% for most "high earners". And that is without considering fuel duty, VED, VAT etc.

Re: No One Goes There Anymore

#163

Post by quotz »

magicalhippo wrote: post #30

When I see about half my paycheck going to taxes it feels a bit rough. But then I think of stories like this, and how easily it could have been me with an illness requiring expensive medical treatment and possibly preventing me from working regular jobs. And so I pay my tax with pleasure, knowing that if something were to happen to me or my fellow citizen, at least there wouldn't be millions of dollars in hospital bi…

Or perhaps you could just donate that much money to a non-profit that takes care of people in unfortunate circumstances like this

Re: No One Goes There Anymore

#164

Post by tankenmate »

ccktlmazeltov wrote: post #59
lotsofpulp wrote: post #44

Earlier quoted context omitted.

US government healthcare spend is huge, it is not tiny compared to military. $1.1T according to this source in fiscal year 2018: https://www.taxpolicycenter.org/briefing-book/how-much-does-... This website states in 2018, the federal government spent $582B on Medicare, and $389B on Medicaid, plus all the tax exemption for employer sponsored health insurance and ACA subsidies to individual buyers, etc. https://www.the…

That's because of private healthcare that prevent them from properly negotiating prices. If universal healthcare was a thing these costs would be much lower.

It's not just that, the Medicare Prescription Drug, Improvement and Modernisation Act bars Medicare from negotiating drug prices.

Re: No One Goes There Anymore

#165

Post by mantap »

nerdbaggy wrote: post #42

This is a touchy subject but with my genetic condition I’m scared to have kids. It sucks having this and I don’t know if I would want to watch my kids suffer through it. But I’m glad my parents did cause life isn’t that bad in the end.

Depending on the condition it may be possible to do genetic screening with potential partners, assuming you are single right now.

And you can always adopt.

Re: No One Goes There Anymore

#166

Post by fhars »

sokoloff wrote: post #154
PaulAJ wrote: post #147

Earlier quoted context omitted.

Also the self-employed in the USA have to pay over the odds for rubbish schemes. Large employers can be assumed to employ mostly healthy people, but an individual is more likely to want health insurance if they already know they are a bad risk. This "moral hazard" means that selling health insurance to the self-employed is a money-losing proposition unless you screw them at every opportunity.

I’m no fan of health insurance as currently instantiated, but I don’t see it as screwing them at every opportunity if they are actuarially unprofitable otherwise.

Ah, yes, the good old supply and demand theory of health: if you can‘t pay for your healthcare, you obviously have no need for it, because needs are only things you are willing and able to pay for.

Re: No One Goes There Anymore

#167

Post by [deleted] »

drran wrote: post #141
sandworm101 wrote: post #128

Earlier quoted context omitted.

"Net value taxation" may be the future. How much were you worth last year? How much are you worth today? Net = income. We would need exceptions for things like houses, but such an approach would capture all capital gains in real time.

"Net value taxation" is called inflation. 20% inflation will make everyone rich in no time.

[deleted]

Re: No One Goes There Anymore

#168

Post by labawi »

sokoloff wrote: post #154
PaulAJ wrote: post #147

Earlier quoted context omitted.

Also the self-employed in the USA have to pay over the odds for rubbish schemes. Large employers can be assumed to employ mostly healthy people, but an individual is more likely to want health insurance if they already know they are a bad risk. This "moral hazard" means that selling health insurance to the self-employed is a money-losing proposition unless you screw them at every opportunity.

I’m no fan of health insurance as currently instantiated, but I don’t see it as screwing them at every opportunity if they are actuarially unprofitable otherwise.

Depends on framing. If you divide the population by an arbitrary standard with a very high health bias (employed, in big co), and adjust payments accordingly, then those on the wrong side of your arbitrary standard get shafted.

The second group may be unprofitable with lower payments, but the insurer doesn't even want the second group, the profits are from decreased expenditures on the first group.

Re: No One Goes There Anymore

#169

Post by sokoloff »

fhars wrote: post #166
sokoloff wrote: post #154

Earlier quoted context omitted.

I’m no fan of health insurance as currently instantiated, but I don’t see it as screwing them at every opportunity if they are actuarially unprofitable otherwise.

Ah, yes, the good old supply and demand theory of health: if you can‘t pay for your healthcare, you obviously have no need for it, because needs are only things you are willing and able to pay for.

It’s more like “if the cost to serve a broad population P is $X, I don’t think it’s screwing them to say ‘the price cannot be lower than $X’ because we are a health insurance company, not a charity.”

I think you’re arguing that perhaps health outcomes should not be funded by private for-profit insurance companies and I’d agree, but while it is, this outcome seems grounded in actuarially sound math.

Re: No One Goes There Anymore

#170

Post by TuringNYC »

perl4ever wrote: post #106
sandworm101 wrote: post #95

Earlier quoted context omitted.

If we are making international comparisons, I would add the cost of health insurance in california as a "tax". That's the only way to reasonably compare western countries. I had a friend try to adopt a baby from china many years ago (1990s). He was rejected. The Chinese thought he didn't earn enough to safely raise a kid. They were using a means test designed for US applicants. My friend lobbied to explain all the th…

I don't follow how this could be possible. I'd think most people in the US either would be getting health insurance from the government (Medicare, Medicaid), from an "Obamacare" exchange and subsidized, or from an employer where they don't pay cash. So where would the discrepancy in accounting between that and Canada come from? It seems unlikely that the Chinese government would assume that even Americans buy health…

>> or from an employer where they don't pay cash.

Most employers in the US subsidize healthcare, but employees still pay. You usually pay X if you are single, a bit more if you are married, and ~2.5X if you are married with children. Each company has negotiated it slightly differently and it also depends on the specific plan and the state you are in.

but that is not all.

You also pay a co-pay ($15-$50) per visit to a doctor and a co-pay for many prescription drugs. In NYC, a pregnancy with my diamond healthplan cost ~$10k

You also pay a deductible (can be $0 to $5000 or more) where you cover the first $X of the annual payments.

Finally, depending on the state you are in (some allow it, some do not) you also pay balance billing. Basically, the hospital/doctor comes up with some surprise figure of how much you owe, they subtract what insurance paid, and you owe the rest. Usually it is nothing. In the case of more complicated things like surgery, it can be thousands.

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