A piece - Why are some people opposed to a universal health care system? (deductible, cancer)
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For example, in the UK, everyone is covered by the NHS which assures a base level of health care. But everyone is free to buy 'top up' health insurance or pay for private (non-NHS) services if they want a higher level of care. The reality is that most people don't need a higher level of care which is why only around 10% of the UK population buy it.
For many the idea of paying huge taxes for UHC and then having to buy another policy for top-up care is very unappealing if they have decent coverage now.
For many the idea of paying huge taxes for UHC and then having to buy another policy for top-up care is very unappealing if they have decent coverage now.
Most UHCs offer decent coverage which is why relatively few people in the UK have bought top up insurance. The point is that people always have that option.
You suggest that the taxes would be "huge". There are a number of aspects to this.
The first is that the US taxpayer is already paying 65% of all healthcare costs. So we are already paying for most of our healthcare out of existing taxation.
Second, you have to balance an increase in taxes against the current cost of insurance premiums, co-pays and deductibles. Right now, my insurance premiums are around $4,000/year just for me. Then there is the deductible - say $500 - $1,000/year - and the co-pays. So easily $5,000/year. That pays for a big tax increase.
Third, there is cost. Every other developed country offers health care, usually UHC, a lot cheaper than the USA does. So we need to consider whether moving to a UHC would also allow us to bring the overall cost of health care down. That would let us mitigate any tax increase as a result of picking up the final 35% of health care cost and also reduce the cost of that other 65%.
So, in summary. The tax increase does not have to be "huge" and will be heavily mitigated or even wiped out by the savings in insurance premiums, deductibles and co-pays.
We are selectively anti-tax. We pay tax for roads, for the fire department, for the police and for the schools. We even pay tax for health care but just don't realise that we do.
Most UHCs offer decent coverage which is why relatively few people in the UK have bought top up insurance. The point is that people always have that option.
You suggest that the taxes would be "huge". There are a number of aspects to this.
The first is that the US taxpayer is already paying 65% of all healthcare costs. So we are already paying for most of our healthcare out of existing taxation.
Second, you have to balance an increase in taxes against the current cost of insurance premiums, co-pays and deductibles. Right now, my insurance premiums are around $4,000/year just for me. Then there is the deductible - say $500 - $1,000/year - and the co-pays. So easily $5,000/year. That pays for a big tax increase.
Third, there is cost. Every other developed country offers health care, usually UHC, a lot cheaper than the USA does. So we need to consider whether moving to a UHC would also allow us to bring the overall cost of health care down. That would let us mitigate any tax increase as a result of picking up the final 35% of health care cost and also reduce the cost of that other 65%.
So, in summary. The tax increase does not have to be "huge" and will be heavily mitigated or even wiped out by the savings in insurance premiums, deductibles and co-pays.
Indeed it would be wiped out, with money to spare. Once again:
$14,867 - Taxes (includes health insurance/retirement (i.e. FICA)) $x2,250 - Health Care $17,117 - Total Costs - Taxes/Health Care
US family of 4 earning $80k w/employer-subsidized insurance pays:
$x6,120 - FICA Taxes (SS - similar to Canadian pension)
$x4,790 - Federal Income Taxes (includes $2k child tax credit)
$x6,000 - Employer subsidized health insurance (low) [current figure $4,710] $x2,500 - Deductible, miscellaneous cost (low) $19,410 - Total Costs - Taxes/Health Care
US citizen w/employer insurance pays about $2k a year more - plus still has exposure to balance billing and max-out-of-pocket issues.
For the US family forced to buy privately or on the ACA, their costs would look more like this:
$x6,120 - FICA Taxes
$x4,790 - Federal Income Taxes
$x8,000 - ACA subsidized premium national average $x6,000 - Deductible (maximum out-of-pocket up to $13,700) $24,910 - Total Costs - Taxes/Health Care
That is at least a $7,800/year difference for those not covered by an employer. And, the American still has another almost $8k balance billing and max out-of-pocket exposure.
Most UHCs offer decent coverage which is why relatively few people in the UK have bought top up insurance. The point is that people always have that option.
You suggest that the taxes would be "huge". There are a number of aspects to this.
The first is that the US taxpayer is already paying 65% of all healthcare costs. So we are already paying for most of our healthcare out of existing taxation.
Second, you have to balance an increase in taxes against the current cost of insurance premiums, co-pays and deductibles. Right now, my insurance premiums are around $4,000/year just for me. Then there is the deductible - say $500 - $1,000/year - and the co-pays. So easily $5,000/year. That pays for a big tax increase.
Third, there is cost. Every other developed country offers health care, usually UHC, a lot cheaper than the USA does. So we need to consider whether moving to a UHC would also allow us to bring the overall cost of health care down. That would let us mitigate any tax increase as a result of picking up the final 35% of health care cost and also reduce the cost of that other 65%.
So, in summary. The tax increase does not have to be "huge" and will be heavily mitigated or even wiped out by the savings in insurance premiums, deductibles and co-pays.
The reason it is a "lot" cheaper in other countries is because they limit access to care, period. They do X number of knee replacements or X number of gall bladder surgeries each year. Need to see a specialist, well, here is your 14 month wait. Start to finish, it will take 2 years for many non-emergency procedures. Yes, everyone is going to jump on that and say the waiting time is only X, but that is from the time your doctor agrees to do the procedure, not the wait times leading up to that appointment. Sure, if you have a sinus infection you can get into a doctor in a day or two, but those appointments are not what drives up costs. People love UHC because they think it is "free"---what they really mean is they don't get a bill. Those that actually have had to use it for more than a cold, know better. Go find people in Canada that have needed a knee replacement or other non-emergency procedure--they will tell you a different tale that when you are assuming here.
I don't know where you get the idea that we are paying for "most" of our healthcare out of taxation. Yes, we pay most of Medicare and Medicaid out of taxes, but the rest of the country pays their health insurance via their employer.
In Ariadne22 made up example, her figures are way off if look at reliable sources like the Kaiser Foundation or even the various government sites. Her numbers also are assuming everyone maxes out their deductible and out of pocket costs and that just is not the case at all, nor is she taking into account the tax savings on those premiums and out of pocket costs....
The reason it is a "lot" cheaper in other countries is because they limit access to care, period. They do X number of knee replacements or X number of gall bladder surgeries each year. Need to see a specialist, well, here is your 14 month wait. Start to finish, it will take 2 years for many non-emergency procedures. Yes, everyone is going to jump on that and say the waiting time is only X, but that is from the time your doctor agrees to do the procedure, not the wait times leading up to that appointment. Sure, if you have a sinus infection you can get into a doctor in a day or two, but those appointments are not what drives up costs. People love UHC because they think it is "free"---what they really mean is they don't get a bill. Those that actually have had to use it for more than a cold, know better. Go find people in Canada that have needed a knee replacement or other non-emergency procedure--they will tell you a different tale that when you are assuming here.
I don't know where you get the idea that we are paying for "most" of our healthcare out of taxation. Yes, we pay most of Medicare and Medicaid out of taxes, but the rest of the country pays their health insurance via their employer.
In Ariadne22 made up example, her figures are way off if look at reliable sources like the Kaiser Foundation or even the various government sites. Her numbers also are assuming everyone maxes out their deductible and out of pocket costs and that just is not the case at all, nor is she taking into account the tax savings on those premiums and out of pocket costs....
Simply not true.
The vast majority see a specialist in less than four weeks. Here in the USA, it took me eight weeks to see a specialist when I had a problem with my ankle. In fact, the UK NHS does just as well as the USA but for half the cost.
The reason it is a "lot" cheaper in other countries is because they limit access to care, period. They do X number of knee replacements or X number of gall bladder surgeries each year. Need to see a specialist, well, here is your 14 month wait. Start to finish, it will take 2 years for many non-emergency procedures. Yes, everyone is going to jump on that and say the waiting time is only X, but that is from the time your doctor agrees to do the procedure, not the wait times leading up to that appointment. Sure, if you have a sinus infection you can get into a doctor in a day or two, but those appointments are not what drives up costs. People love UHC because they think it is "free"---what they really mean is they don't get a bill. Those that actually have had to use it for more than a cold, know better. Go find people in Canada that have needed a knee replacement or other non-emergency procedure--they will tell you a different tale that when you are assuming here.
The reason why it is a lot cheaper in most every other country is because it is. Period. The $100k knee replacement (that is as likely to be sub-par as not) from a US hospital is $10k(!) in Singapore and you will NOT get a hospital acquired infection. I don't know what it would be in France but I know that the French surgeon is making around $80k/yr vs $200k/yr. You don't think that will make health care in the US more expensive overall?
A week long hospital stay is very likely to have a four figure price for the various medications a patient might need. The exact same medications in another part of the world can be 1/20 of that. It also has to be said that in many countries they DO limit access to care and... they just might not do that knee replacement on a patient that weighs 475lbs. The US facility will do a knee replacement on anyone who can pay for it. I get that if you weigh 475lbs. and are denied that knee replacement you would be bummed, but... it might be sufficient incentive to bring about a change in lifestyle.
There is zero incentive for Americans to stay out of the hospital in the first place! Health CARE costs way too much. A comprehensive blood panel is four figures and you will need two office visits on top of that. You have health insurance but it has a four figure deductible. Are you really going to spend it all in one place? As I understand it 33% of Americans did not see a dentist last year. Half of Americans have serious untreated dental maladies. A significant portion of heart disease is caused by untreated dental decay.
The reason why it is a lot cheaper in most every other country is because it is. Period. The $100k knee replacement (that is as likely to be sub-par as not) from a US hospital is $10k(!) in Singapore and you will NOT get a hospital acquired infection. I don't know what it would be in France but I know that the French surgeon is making around $80k/yr vs $200k/yr. You don't think that will make health care in the US more expensive overall?
A week long hospital stay is very likely to have a four figure price for the various medications a patient might need. The exact same medications in another part of the world can be 1/20 of that. It also has to be said that in many countries they DO limit access to care and... they just might not do that knee replacement on a patient that weighs 475lbs. The US facility will do a knee replacement on anyone who can pay for it. I get that if you weigh 475lbs. and are denied that knee replacement you would be bummed, but... it might be sufficient incentive to bring about a change in lifestyle.
There is zero incentive for Americans to stay out of the hospital in the first place! Health CARE costs way too much. A comprehensive blood panel is four figures and you will need two office visits on top of that. You have health insurance but it has a four figure deductible. Are you really going to spend it all in one place? As I understand it 33% of Americans did not see a dentist last year. Half of Americans have serious untreated dental maladies. A significant portion of heart disease is caused by untreated dental decay.
I dropped my dental insurance because it was costing me more than my dental treatment. I go to the dentist three times a year for cleaning and a checkup. That costs me around $270/year but it catches any problems early. Total dental care other than cleaning over the past 5 years has been around $1,750.
Both my sisters-in-law did not go to the dentist for years because they couldn't afford it. They recently received an inheritance and used part of it to get their teeth done. It cost them thousands of dollars.
Some Americans will go to Mexico for dental treatment because it is cheaper. When I lived in Geneva, I crossed the border into France for dental care for the same reasons.
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