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US Workers Are Highly Taxed If You Count Premiums

peoplespolicyproject.org

421–430 of 534 posts

Re: US Workers Are Highly Taxed If You Count Premiums

#421
post #411

Earlier quoted context omitted.

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 pre…

Same personal anecdote - have excellent BUPA coverage, just allows you to skip the lines for non serious things, if you have a heart attack you'll be going to an NHS A&E whether you have private insurance or not.

Re: US Workers Are Highly Taxed If You Count Premiums

#422

Earlier quoted context omitted.

The reason for this is that if one state has better social programs then another and higher taxes the poorest are going to move there, and the high earners are going to move away.

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. The idea that the poor will mass migrate to California and the rich will mass migrate to South Dakota is pretty unrealistic. The poor can't afford to live in California even with social assistance, and the rich don't want to live in South Dakota no matter…

>This doesn't seem to be a major problem for the EU

Are you serious?

https://en.wikipedia.org/wiki/European_migrant_crisis

Re: US Workers Are Highly Taxed If You Count Premiums

#423
post #411

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.

Utter garbage is a bit strong but yes a lot of people on that income will have additional private health insurance. Insurance which is cheap as chips because it only covers additional things. Even if you're buying privately (not as a company benefit) you're paying £900ish a year per person.

Re: US Workers Are Highly Taxed If You Count Premiums

#424
post #270

Earlier quoted context omitted.

'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…

Yeah, this has baffled me before. I remember learning in my Family & Consumer Sciences class about the importance of being an informed consumer. Then, in college I had to get a dental procedure done and I called around to try to find out the price from different dentists and no one could give me any actual numbers. I ultimately just had to pick a place based on reviews and found out the price after the fact with no k…

The current federal administration has mandated the hospitals to publish their prices online since 2019.

I have no illusions, a person without a degree in accounting probably won't be able to decipher these prices, but that could be a step in a proper direction.

Re: US Workers Are Highly Taxed If You Count Premiums

#425
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 reason for this is that if one state has better social programs then another and higher taxes the poorest are going to move there, and the high earners are going to move away.

See for instance, the flood of high earners moving from NY and California to Wyoming.

Re: US Workers Are Highly Taxed If You Count Premiums

#426

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…

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 agree this is all a huge pain. I've been burned on "this test cost you x because of the facility it was done in and if you had gone to one of our partner labs (which you'd have no way of knowing without calling us), you could have had it done in for 1/4x".

I recently learned that there are 2 different codes involved and that it's the combination that matters.

1. The diagnostic code - the reason why you need that test

2. The procedure code - what the test is

My insurance tells me that their coverage (as in whether they cover a service or do not) is different for the same procedure code with a different diagnostic code. I'm not sure if that implies that their coverage price for the same procedure code also varies by the diagnostic code.

Your doctor can give you both codes for the test they're prescribing. In theory, your insurance company can tell you what they'll pay for the combination, and then you can contact each lab / hospital / service provider to get an estimate for what they'd bill. It's unclear how much recourse you have if the bill turns out to be significantly different than the estimate… that is once the bill actually arrives, sometimes 30–60 days later. I'm not sure if the service provider's bill varies for the same procedure code with a different diagnostic code.

Admittedly this is all a huge pain and with my insurance company at least, cannot be done online, you must call and wait. It's all such a time sink that I usually just get the service done upfront and hope. Sometimes the end consumer cost is practically free, sometimes it's hundreds of dollars or more.

It should be more feasible for us to know a rough estimate for a procedure across providers upfront.

Re: US Workers Are Highly Taxed If You Count Premiums

#427
post #422

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. The idea that the poor will mass migrate to California and the rich will mass migrate to South Dakota is pretty unrealistic. The poor can't afford to live in California even with social assistance, and the rich don't want to live in South Dakota no matter…

>This doesn't seem to be a major problem for the EU Are you serious? https://en.wikipedia.org/wiki/European_migrant_crisis

That's taking about external migration (refugees and illegal immigrants), not internal migration under the EU's freedom of movement. Of course, the latter was a major factor in the Brexit referendum, so I wouldn't say it's not a major problem for the EU...

Re: US Workers Are Highly Taxed If You Count Premiums

#428

Earlier quoted context omitted.

It happens with high deductible plans. When I had back surgery I was with a public employer PPO. Total out of pocket was like $300 for about $500k of procedures. Half the people in my recovery PT were selling cars and emptying 401ks to make the mortgage.

That’s the crazy thing about the US system. For a lot of people things work smoothly like it did for you. Then you have a significant number of other people who get totally screwed with out of network stuff, billing errors and the insurance declining payment for random things. These people now have to have to negotiate often for years, fight collection agencies and often end up owing thousands and tens of thousands o…

That is generally the failure mode of complex systems. Say if you made flawed software a couple of decades ago, chances were it crashed. Today flawed software will produce many different errors. Not that the former is necessarily better, just that it is something to understand about the modern world were we aren't limited by scarcity. Same thing with e.g. food or education.

Re: US Workers Are Highly Taxed If You Count Premiums

#429
post #422

Earlier quoted context omitted.

>This doesn't seem to be a major problem for the EU Are you serious? https://en.wikipedia.org/wiki/European_migrant_crisis

That's taking about external migration (refugees and illegal immigrants), not internal migration under the EU's freedom of movement. Of course, the latter was a major factor in the Brexit referendum, so I wouldn't say it's not a major problem for the EU...

What's even the point of the distinction if the EU is not adequately restricting immigration from those other countries? The point remains the same: people from poor countries are mass migrating to rich countries with the most social programs. This is a major problem for the EU.

Re: US Workers Are Highly Taxed If You Count Premiums

#430
post #260
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…

When people who are fans of the "Scandinavian model" in the U.S. try and hype it up, this is what they seldom understand (or at least publicly recommend). In Sweden, until you hit ~$65,000 in yearly income, all of the taxes you pay on income (which is a relatively high rate) goes to your local government. Only after that point, your extra income goes to the federal government. [1] This model cuts out the immensely la…

Is there some kind of balancing which prevents the nice areas (i.e. containing more affluent people) from becoming really nice, and the poorer areas becoming worse?
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