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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

#461

Post by oneguynick »

fisherjeff wrote: post #368
unreal37 wrote: post #205

Earlier quoted context omitted.

Yeah, that's the thing. The true cost is somewhat hidden because of the employer part of the premium. And the costs you pay out of pocket when an actual health event happens. I imagine you can still pay $1000+ out of pocket to have a baby in a US hospital, even if you have great insurance. Also, the article talks "average", while I imagine US health costs are highly variable depending on whether you are young, old, s…

> I imagine you can still pay $1000+ out of pocket to have a baby in a US hospital, even if you have great insurance. I just got that bill, in fact, and we have about the lowest deductible insurance you can buy, at a cost of about $1500/month. It was still $6500.

Can confirm the same in NYC. NYU Hospital with nothing fancy other than delivery of a beautiful Daughter. We had to go back due to some Jaundice but were told to visit NYPH for this instead. I imagine we will be well north of 9000 USD when all is said and done.

Re: US Workers Are Highly Taxed If You Count Premiums

#462

Post by exodus_de »

maxxxxx wrote: post #153
exodus_de wrote: post #137

Earlier quoted context omitted.

> Who cares about the deductible? It’s still a ripoff. You should care about the deductible, cause you entered the contract, silly. Get private insurance in Germany, there's also a deductible, unless you want to pay more. > We went to an eye doctor and paid 25 Euro cash including an ointment. The US is just horribly expensive and very unpredictable. That's because of price fixing (GOÄ). It's all they can charge. And…

In what way is your comment about price fixing relevant? I don't care if the lower price is because of price fixing or not.

Since the previous comment got flagged for "tone" (presumably), here's just facts:

- MRSA rates in german hospital are extremely high

- waiting times for specialists are measured in months

- rushed appointments and higher likelihood of diagnostic mistakes

- two-class system (public/private) that by law shuts out ordinary workers from better private care

- doctors are leaving in droves for countries like Switzerland (after spending decades in the "free" German education system)

All of these are results of price-fixing that people absolutely should care about. Proper healthcare costs money, especially in a developed country.

I'm getting downvoted into oblivion, presumably by people who fetishize a socialized system they themselves do not have and know very little about. It's enraging to say the least.

Re: US Workers Are Highly Taxed If You Count Premiums

#463

Post by jimbokun »

exodus_de wrote: post #310
jimbokun wrote: post #175

Earlier quoted context omitted.

"You should care about the deductible, cause you entered the contract, silly." This is stupid. There is no real way to shop and bring down health insurance costs in the US. It's tied to your job, meaning you would need to get many job offers, and turn them down when you find out the actual insurance costs until you find one that's better, and ignoring other employment factors. And then everything can change the next…

Insurance isn't tied to your job. You can (and often should) forego the employer's plan and purchase insurance on the open market. Most insurances have some form of deductible, it's what keeps them affordable. Insurance should be protecting you against a huge financial fallout, not against petty expenses. I agree it is a stupid system though and I'll tell you why: People want something for nothing. They want coverage…

Thanks for engaging, your comments are interesting and thought provoking.

"If there was a compulsion to purchase, the system could work, as it does in many other countries."

Wasn't that one of the major points of Obamacare, to make strides in that direction? And it did pass Supreme Court scrutiny, who decided yes it is a tax, and yes the government is allowed to tax us.

"Lastly you have "Medicare for all" which would basically bankrupt hospitals if you extrapolate from what current Medicare does to them financially."

Across our economy, competition and technology drive higher quality at lower cost. Doctors and hospitals need to have an incentive structure that rewards keeping the most people healthy at the lowest cost. "Capitation" models are meant to provide these incentives, where you don't get paid for "doing things" to patients, like ordering tests or performing surgeries. You get paid a fixed sum per patient to keep them healthy, adjusted for the "risk" associated with the patient (for example, if they have a chronic condition that needs ongoing treatment).

So an intelligent "Medicare for All" system could be designed to incentivize innovation and cost cutting and overall patient health, if implemented intelligently.

Re: US Workers Are Highly Taxed If You Count Premiums

#464

Post by exodus_de »

dsfyu404ed wrote: post #453
exodus_de wrote: post #321

Earlier quoted context omitted.

> You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US. If you already have a serious health problem, you'll be hard pressed to find any country to take you and just take care of it pro-bono, if you're uninsured. German public insurance only covers the bare minimum. I know enough people who are poor because of serious health issues. Sur…

>Don't get an insurance that is capped at a low number, otherwise you will go bankrupt if shit hits the fan. But shit will not hit the fan for the overwhelming majority of people. There's no good reason for someone in their 20s (or 30s) with, no dependents, no history of medical problems and doesn't partake in a dangerous lifestyle to load up on coverage. Loading up on coverage in that situation might make you feel w…

> It is not financially sound.

"Financially unsound" is getting an insurance capped at a low number, especially with a low deductible. That means you are paying all the money to protect against a somewhat-but not-really costly medical event that probably won't occur. A serious medical bill will still wipe you out.

Of course shit won't hit the fan for the majority of people, that's how insurance works. It's not a flat-rate for services, it's a protection against catastrophic (but unlikely) events. That can happen to you at any age, however if you are young you also will get a discount on insurance.

Re: US Workers Are Highly Taxed If You Count Premiums

#465

Post by awinder »

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…

You could definitely include the out-of-pocket costs (and how they differ between high deductible plans vs. low deductible vs. single-payer), and you should, for a fair comparison. This is researched to death effectively at this point but the overwhelming consensus is that single-payer delivers 100% coverage at around the same cost to individuals as the employer-sponsored plans w/ the same healthcare quality / outcomes. If you went on to compare the time-costs for every person that has to navigate insurance company shenanigans, the savings would be off the charts.

https://www.thenation.com/article/thanks-koch-brothers-proof...

The problem, as always, is what do you do with all the redundant bullshit jobs that are eliminated in the process.

Re: US Workers Are Highly Taxed If You Count Premiums

#466

Post by addicted »

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…

In the US those estimates can often be wrong.

Re: US Workers Are Highly Taxed If You Count Premiums

#467

Post by bodono »

mattlondon wrote: post #414
bodono wrote: 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…

A good citation can be found in the one you provided:

Under Key findings:

Its main weakness is health care outcomes. The UK appears to perform less well than similar countries on the overall rate at which people die when successful medical care could have saved their lives.

Among its strengths, the NHS does better than health systems in comparable countries at protecting people from heavy financial costs when they are ill. People in the UK are also less likely than in other countries to be put off from seeking medical help due to costs.

So: main strength - cheap, main weakness - health care outcomes!

It's no surprise that fewer people in the UK skip medical care due to costs when it's (close to) free. The problem is that the health care is bad when you get it (according to your own provided document)!

Re: US Workers Are Highly Taxed If You Count Premiums

#468

Post by [deleted] »

bilbo0s wrote: post #182
jdmichal wrote: post #136

Earlier quoted context omitted.

This is actually a huge lever of control for the federal government, and I think has contributed greatly to increase of federal power over the states. The reason being that states can tap into that large federal stream... If they meet the federal criteria. This kind of carrot system is actually how many federal laws that seem to effect the states work. For instance, no state was ever mandated to implement the No Chil…

Yeah, but then we'd just be dominated by states like Minnesota, California, Delaware, New York, etc. Basically, ginormous pools of money would start to build in the old Union and out on the west coast. But almost everyone in the middle would be hosed. (I mean places like Oklahoma and Colorado would likely be pretty happy, but everyone else would take substantial financial hits.)

[deleted]

Re: US Workers Are Highly Taxed If You Count Premiums

#469

Post by bodono »

philjohn wrote: post #420
bodono wrote: 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.

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…

Yes, emergency treatment is on the NHS but so what? That doesn't mean it's good! Emergency care is better in the US( even if it later bankrupts you). You can routinely wait for 6-12 hours in an emergency room in the UK (admittedly not for truly life-threatening situations). By most metrics, healthcare outcomes in the US are much better than in the NHS, quick google found this: https://qz.com/397419/the-british-seem-less-likely-to-get-ca...

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

I don't think you would consider this a small thing if you were one of the 500k people waiting > 6 months for basic treatment on the nhs: https://www.telegraph.co.uk/news/2018/08/11/numbers-going-pr...

Re: US Workers Are Highly Taxed If You Count Premiums

#470

Post by eigenstuff »

lg wrote: post #267
bilbo0s wrote: post #157

Earlier quoted context omitted.

> Most of federal spending is medicare, medicaid and social security... Well, there's also Defense, and then service payments on the debt. Those are the big 3 without question. So "the wrong people" must be in there somewhere? But the real reason we give more to the feds is because if we didn't it would be AWESOME for places like New York, Minnesota, Texas, Delaware, California etc, and TERRIBLE for places like Wisco…

and yet the first group of states votes in politicians that raise taxes and the second group votes in politicians that cut taxes?

That second group of states is half states in the black belt. Those state governments are bought and paid for and their people largely disenfranchised, same for much of Appalachia. (Like, c'mon, Mississippi is around 40% African American, you really think them electing Donald Trump reflects the true will of the people? Of course not!) They're run by shitty rich people with shitty agendas who are just out to further enrich themselves and have a vested interest in maintaining the power structures that be. That's why the South "votes against its own interests." It's literally a narrative invented by the coal industry so it could justify and get away with brutalizing West Virginia and leaving it far worse off than it was before. Coal owns WV all the way down to the school boards and sherrifs.
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