
US Workers Are Highly Taxed If You Count Premiums - viburnum
https://www.peoplespolicyproject.org/2019/04/08/us-workers-are-highly-taxed-when-you-count-health-premiums/
======
Someone1234
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 "discounts."

For example my under one year old needed to go to the emergency room due to a
high fever for several hours, we paid over $300 on top of paying over a
thousand in combined employer/employee premiums each month. That's with
insurance picking up at least that much.

~~~
TallGuyShort
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," they said. So I asked them to
check how it was coded and tell me what the "code" cost. They looked it up. It
was coded wrong, apparently. They would have to talk to the doctor and
couldn't, so I would need to make a return appointment, or I could just let
them draw my blood. Still don't know what the coding was or was supposed to
be, or really what that even means. I just needed to get life insurance and
get back to work. I found out the price once I was billed for it.

~~~
roenxi
'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 price.

~~~
Delfino
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 knowledge of how it compared t other places.

~~~
bzbarsky
That's odd. Dentists, unlike doctors, will in my experience just give you a
price if you ask for it... Maybe this varies state to state?

~~~
fre3k
They used to but it's dwindling. A friend of mine is a dentist and he said
when he first graduated from dental school some 15 years ago, his father and
his practice dealt directly with the patient and had a list of all of their
prices on their website and in their office. As customers increasingly wanted
to have their insurance cover dental they had fewer and fewer people paying
out of pocket and going through insurance. So prices went up due to increased
complexity of the business.

~~~
enonevets
At my dental office, they can tell you the total cost without insurance which
is the maximum they would charge for any procedure. If you paid in cash in
full, they would do a discount (for non-insured).

For those insured, it depended on the insurance you had but they would give
you a rough estimate based on the plan you had (mostly because they can’t be
100% certain what the insurance will cover down to the exact dollar amount.

In my experience the estimate is often off but close enough that I am not
worried I’d owe an insane amount afterwards.

------
rhacker
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 creating massive social programs that
enrich the wrong people. I think the current strategy is broken. The other
nice thing about this, is that we'd pay less in taxes AND the states/cities
would be able to handle every damn thing it needs. It would be like 2x to 3x
the money they are getting right now.

~~~
jedberg
The whole point of allowing people to deduct their state tax payments was to
solve exactly this problem. Let the states that want to tax more and provide
more social services do so without harm to their citizens.

Of course that deduction is gone now, which just further solidifies government
power.

~~~
bilbo0s
My own suspicion is that we got rid of that because government _wants_ to harm
the citizens of certain states. That's likely one of the benefits of having
federal power, the ability structure the system to perpetuate your hold on it.
In the US, our politicians do this all the time.

~~~
jedberg
Well, there are actually good arguments to be made on both sides of the issue.
For example, one argument is, "why should people who live in high cost states
pay less federal tax for the same federal services?" The counter-argument
being "they don't need as many government services since they get the same
benefits from their state" and also "their incomes are higher so their total
dollar contribution is still just as high".

It's a tough issue. From the Federal perspective is makes a lot of sense to
get rid of the SALT deductions, and I suspect the next time the Dems are in
charge they will "be unable" to restore the deduction for "reasons", since
both parties want the extra revenue.

------
tptacek
Just a quick note that health insurance premiums do not in fact get plowed
directly into rents and administrative redundancies; we pay more than Europe
(and Medicare) does in administrative costs, but far-and-away the largest
components of health care expenditures in the US are in inpatient and
outpatient procedure billings (outpatient by a factor of almost 2x inpatient,
itself something like 3-4x all administrative costs).

We certainly do seem to pay far too much for health care! But the explanations
aren't as simple as evil health insurers. The system appears to be
structurally pretty messed up, and alterations to the payer-side alone,
without radical changes to the provider side, are unlikely to solve the
problem.

~~~
mattlondon
What I was wondering about was how much money is needed for the sheer
administration of processing claims and payments in the US system?

In the UK in the NHS, there is none of the layers of beurocracy and paperwork
related to call-centers and payment handling and claims inspectors (as far as
I know anyway) that I assume is commonplace in the US hospitals and insurance
companies. You go in, see the doctor, then leave. Usually the only "paperwork"
required is booking another appointment if you need to come back - no forms,
no invoices, no payment etc.

I guess it is the same argument made about universal income benefits - if we
just gave _everyone_ (rich or poor) in the country a set amount of money each
year we'd save billions in not having to means-test every claimant
individually and actually save money by giving it away to _everyone_.

~~~
fabricexpert
This argument does hold significant validity, unfortunately there is an
irrational need to ensure that a minority are not exploiting the system, even
at the cost of those who pay for the system.

For example, I think all buses in London should be free. Look around the bus
and you'll see that most people aren't directly paying (under 16, over 60, on
benefits) and by taking away the need to check for payment we could get people
on and off the buses much faster and completely remove the need for card
readers.

------
titanomachy
The Canadian figures seem insanely low. 11.5% total? When I lived in BC making
an approximately average income, my effective tax rate alone was 21% [EDIT:
originally put 23%]. I paid pension, health insurance, and unemployment
deductions on top of that. And that only counts the employee side of
deductions.

This example is "married with two kids", so it's possible that there are
massive offsets that I didn't have access to as a single person, but 11.5%
still seems very low.

I would expect Canada to fare favourably in this comparison, though. The taxes
are not as bad as most Americans think. Although they do ramp up very quickly
for higher earners, which was an incentive for moving to the states as my
income increased. Also, pay is higher in the US (by a factor of about 2 or 3)
for the same job.

~~~
MichaelBurjack
You might have a skewed sense of what median Canadian income is. And your job
might be further above that median than you realize.

Median Canadian individual income is ~$35,000 [0].

In B.C., your average 2019 tax rate would be 13.34% not including non-
refundable tax credits (and so the effective rate would likely be a point or
two lower). [1]

A median tax rate of 11.5% against a median Canadian individual income seems
entirely reasonable.

\----

0:
[https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=111002...](https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1110023901)

1: [https://www.ey.com/ca/en/services/tax/tax-
calculators-2019-p...](https://www.ey.com/ca/en/services/tax/tax-
calculators-2019-personal-tax)

~~~
titanomachy
It seems you're right. I know I was close to the average for my region, but
that's a high cost-of-living city with a much higher median income than 35k. I
may have also been conflating household and individual income.

Lessons: 1) I have no concept of the median experience in my country, 2) a
single number can't answer the question "does this country have high taxes".

~~~
MichaelBurjack
Truthfully, the only reason I had the numbers at hand was because I'd
personally fallen for your "Lesson #1" before.

I spent my 20s far below median (which I knew), and my 30s far above median
(which I didn't realize, at least not at first). Very different lived
experiences :)

And I know many folks around me (friends, family, colleagues) look around
(confirmation bias & availability heuristic, amongst others) and believe that
$60k-$80k (or more) represents a "typical" lived Canadian experience. They
are, to a person, universally surprised to see the actual median income (as
was I when first tracking it down).

It certainly is viewpoint-shifting. Cheers!

------
biesnecker
I once considered relocating with the same company to a similar role in
London. The base pay in London is lower, and the marginal tax rates are high,
but overall cost of living isn't too terribly far off (compared to the SF Bay
Area), and doing calculations like these it seemed that while it would be
something of a step down total compensation-wise, it wasn't nearly as large of
one as it at first seemed. I didn't make the jump, but actually doing the math
made it seem a lot more reasonable than it did at the outset.

~~~
yomly
What fraction of SF salary did they ask you to take out of interest? I knew a
googler who said London was 0.7*Mountain View total comp as an engineer

~~~
biesnecker
Yeah, it was about 75%.

------
learnstats2
The article decides to include employer-side payroll taxes in its US
calculations as though this is an income tax - but this is not (appears not to
be) done for other countries, where payroll taxes are often higher, so it's
not a fair comparison.

The inevitable Wikipedia link:
[https://en.wikipedia.org/wiki/Payroll_tax#/media/File:Payrol...](https://en.wikipedia.org/wiki/Payroll_tax#/media/File:Payroll_and_income_tax_by_country.png)

------
ngngngng
The US healthcare system is making many people extremely rich. Someone has to
pay for that.

~~~
awakeasleep
Think of what it'd do to the insurance worker economy if we switched to a
medicare for all system! It's pretty fucked up that such a large chunk of our
country is now essentially parasitic.

(I say this while recognizing that runaway medical costs aren't solely the
result of insurers)

~~~
riku_iki
Curious if there can be Amazon for healthcare..

~~~
SantalBlush
Considering the reported working conditions of some Amazon employees, let's
not.

The most sustainable choice will be neither monopolistic pricing, nor
cutthroat pricing at the expense of medical staff, but somewhere in the
middle.

------
refurb
This analysis ignores VAT taxes entirely, which can add significantly to an
employee’s tax burden.

~~~
munk-a
VAT taxes (or sales tax in the US) will tend to more heavily effect lower
income workers, which will not be the majority of people on HN. VAT taxes are
heavily regressive and, outside of the luxury class of such would be nice to
see phased out.

~~~
refurb
Most sales taxes in the US aren’t applied to staple good like food, blunting
the impact on lower income workers.

I would disagree it doesn’t impact higher income works because you’re still
paying sales tax on luxury items and because of the high prices, the tax is
very high.

In Canada it’s not uncommon for the HST to be 15%.

~~~
Scoundreller
> In Canada

And if your income is low enough, you get an HST credit to control for its
regressive nature.

------
viburnum
It’s worse if you include 401k payments to offset a more generous public
pension.

~~~
munk-a
Or really any public pension. I feel like if you're <40 then you should be
planning for Social Security to not exist when you get old, anything else
seems overly optimistic.

~~~
ajross
There's literally no analysis that shows social security completely failing at
any point. That's spin you're getting from partisan media, and it's absolutely
infuriating the people allow this to persist.

In a few years, given no changes, the cash flow will go negative and we'll
begin spending down the trust fund. By 2035 or so (I forget the numbers, and
the projections tend to vary widely anyway because of differing models and,
yeah, partisan spin) the trust fund will be spent and the social security
administration will need to adjust, as it will be taking in something like 80%
of obligations.

A 20% shortfall is a big accounting problem. It's hardly "plan for it not to
exist".

~~~
shuckles
The trust fund is an accounting fiction that doesn't hold any economically
productive assets. Congress spent social security's surplus in the general
budget and issued special obligation bonds in return that accumulate
"interest" on paper but do not ever collect from the government. They cannot
be sold on the market. Taxes or debt needs to be raised or benefits need to be
cut effectively now.

This is from a 1999 OMB report:

``These [trust fund] balances are available to finance future benefit payments
and other trust fund expenditures–but only in a bookkeeping sense. These funds
are not set up to be pension funds, like the funds of private pension plans.
They do not consist of real economic assets that can be drawn down in the
future to fund benefits. Instead, they are claims on the Treasury, that, when
redeemed, will have to be financed by raising taxes, borrowing from the
public, or reducing benefits or other expenditures.``

------
philjohn
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 pay a flat rate of £104 a year for a prepayment
certificate.

Private health insurance is still a thing - it just gets you a nicer room in a
private hospital and quicker treatment for non life-threatening conditions.

~~~
bodono
Except for the fact that the NHS is utter garbage and anyone here making 150k
is on private health insurance.

~~~
mattlondon
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...](https://www.kingsfund.org.uk/sites/default/files/2018-06/NHS_at_70_how_good_is_the_NHS.pdf)

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 prescription medicine due to cost. For comparison on
the NHS it was 5% and 2% respectively. Mind-boggling.

I'd agree though that anyone on 150K plus (and probably anyone in a job from
the 40K range upward (if not lower)) would have private medical cover. As
others have noted, private cover basically just means you get seen quicker/at
a more convienient time and the waiting room is nicer - the care is no better
or worse than the NHS IME (although I dont have any data on that - just a
personal anecdote)

~~~
bodono
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)!

~~~
mattlondon
Nowhere in that report does it say it is "garbage", as you suggest it is.

Yes it is not as good as some other wealthy countries, but it is by no means
"garbage", e.g. on page 35: "The results show that although the UK does well
by global standards, it performs poorly compared with the other developed
countries in our comparison group". _"..does well by global standards.."_
completely contradicts the idea that it is "garbage".

There are some interesting comments in the document suggesting that some of
the health outcomes might actually be social which was news to me an quite
interesting - e.g. the british "stiff upper lip"/"keep calm and carry on"
might be causing people to defer medical help, or that the large income
disparity could be skewing it. Interesting & worrying stuff.

~~~
bodono
Does well by global standards?! Yes, we should definitely be comparing our
healthcare system to those found in places like the Congo. It has bad
healthcare outcomes and costs a lot for them, that is bad, don't get hung up
on the single word 'garbage', it's called hyperbole.

------
dandare
Tangential: As a non-native speaker, I find the word PREMIUM highly
problematic. You need a lot of contexts to understand that the article is
talking about health care costs not covered by health insurance.

~~~
fabricexpert
It's not because you are a non-native speaker. It's not a widely used English
term without the word Insurance in front of it, however it is a standard
American English term.

It is also not the costs "not covered by health insurance", rather the
insurance premium is the cost of the policy itself.

~~~
dandare
Interesting, thanks! But from what I know people in US often end up paying
extra cash (on top of their health insurance) for procedures, checkups, and
drugs. This is rather rare in EU. That should be included in whatever
international comparison.

------
arosier
>It’s just that they pay it into a private insurance system that wastes large
portions of it on rents and administrative redundancy.

Would love to see a breakdown of real estate and admin costs for private
insurance systems throughout the States to understand how much could be saved
by eliminating redundancy.

Not seeing this broken out in Anthem's Financials:
[https://ir.antheminc.com/static-
files/73562e56-886c-4ff5-a36...](https://ir.antheminc.com/static-
files/73562e56-886c-4ff5-a365-d4324728524f)

~~~
dnautics
Private healthcare insurance has margins well below most profitable companies,
in the us. If anything I'd hazard that the poor treatment of consumers by
these entities stems from being barely able to hold the line, not because of
greed. Rising medical costs, I think, have the blame elsewhere, but insurance
companies sure do make a good Boogeyman for politicians, because they are very
poorly understood.

~~~
analog31
Somebody's gouging us. Who? Everybody cries poor and points the finger at
everybody else. Nobody knows where the money is actually going.

~~~
jimbokun
Doctors?

Seems to be a huge reluctance for anyone in politics to place the blame on
them. But I'm pretty sure they make far more in the US than anywhere else in
the world.

~~~
bradknowles
And they pay huge amounts of their income to malpractice insurance.

Hmm. There's that word "insurance" again.

~~~
analog31
From what I've read, doctors are also substantial owners of the malpractice
insurance companies. Also, their premiums are paid by their employers. In
fact, salaries don't tell the entire story for doctors, since they are heavily
invested in their own industry. For instance, at one point my health insurance
provider advertised itself as being doctor-owned.

As mentioned above, a problem is that the system is so opaque, seemingly by
design. A potential benefit of a government run system is that there could
simply be fewer business entities. For instance, doctors could just work for
the government, for a decent salary.

------
raphaelj
This does not take into account the fact that in most countries with an
universal health care system, you will only contribute to it during your +/\-
40 years career while you'll benefit from it during your whole life.

~~~
refurb
You don’t pay taxes once you’re retired? That’s certainly not true in places
like Canada.

------
mikeash
The difference is that your taxes go up as you earn more, but your health
insurance premiums don’t. Lower middle class workers are getting screwed, but
the top earners are doing great! It’s a feature, not a bug.

------
rayiner
The international comparison is a bit eyebrow raising. It has two countries
(Canada and the Netherlands), which are on the lower side in terms of overall
taxation, on opposite sides of the scale. The Netherlands is listed as the
highest tax jurisdiction, at 48%, despite having one of the lower tax burdens
in Europe:
[https://en.wikipedia.org/wiki/List_of_countries_by_tax_reven...](https://en.wikipedia.org/wiki/List_of_countries_by_tax_revenue_to_GDP_ratio).
Canada is listed as just 11%.

------
shireboy
This article makes some good points up until the end. It criticizes private
sector waste without evaluating waste in the public sector. I see how the
taxpayer impact could possibly* be a wash, and do see problems in the private
sector for sure. But my experiences with just about any US federal system does
not cause me to see them as a bastion of efficiency. Without a profit
incentive or really any incentive beyond occasional bad press, and with strict
salary and firing controls they do not innovate or improve. Look at the VA for
an example. Horror stories do exist for British and Canadian systems as well
as others I’m sure.

* This article also ignores the fact that many of the countries listed also still have private insurance supplementals. Those may need to be added for a fair comparison.

In the end I don’t have good solution, but think the traditional arguments in
both directions are generally hyperbolic and over simplified. Unless data
shows conclusively otherwise, I lean toward free market solutions.

------
tathougies
Individual US tax payers pay for most of the world's security. This is one tax
of being the global super power, so it's not particularly surprising that when
you include all things the US tax payer pays for privately that is taxed in
other countries, you arrive at a number higher than other similar countries.

In reality, there is no country with which we can fairly compare US tax rates.

~~~
titanomachy
I'm not convinced that US military intervention in the last 40 years has led
to a net increase in global security.

Although the _existence_ of the US military probably helps. As long as they
don't do anything.

I'm undecided on this one.

~~~
tathougies
> Although the existence of the US military probably helps. As long as they
> don't do anything.

But the US has one of the largest all-volunteer armies in the world, with some
of the most advanced technology, so it makes sense that it costs more. My
comment is not a justification for America's military power, it is simply an
observation that American tax payers pay for something the rest of the world
gets to enjoy for free -- the threat that if another country attempts to upset
the balance of power from which many countries profit (namely many of those in
Western Europe), the United States (and only or mainly the United States) will
stage an intervention.

For example, regardless of Norway's foreign policy, they benefit from American
warfare (or threat of warfare) in the middle east which ultimately does lower
the supply of oil. Same with Saudi Arabia. None of these countries contribute,
which is why it makes sense that the american tax payer pays more.

~~~
munk-a
Partially yea, it may be that using the word "security" in that first post was
a wording error that caused a bunch of people to misunderstand you. But then,
in this follow up, you've mentioned that Norway is benefiting from the US
lowering the supply of oil (I assume via setting it, and the people who
extract it, on fire)... I am not Norwegian and can't speak as to their
preference, but given that Norway is currently scaling back their oil
exploration efforts along with the general character of Norwegians that I've
met, I'll make an effort. I'm going to assume that the Norwegian ethical
stance is against the US starting wars in the middle east and killing people
to make their oil a bit more valuable.

~~~
tathougies
> Norwegian ethical stance is against the US starting wars in the middle east
> and killing people to make their oil a bit more valuable.

I mean the American ethical stance, as demonstrated numerous times by various
popular votes, is also against war. However, that does not change the fact
that countries benefit from it. Ultimately, while perhaps making some
countries hypocritical, none of what you said changes the argument I put
forth: namely that, by virtue of being the only country whose citizens are
forced to pay for the status quo (which has the effect of subsidizing the
economies of many of the countries to which the article attempts to compare
the united states), there is no way to properly compare US tax policy to any
other country.

> Partially yea, it may be that using the word "security" in that first post
> was a wording error that caused a bunch of people to misunderstand you

Indeed. For some reason, many people define security as not just security of
the status quo but also some cosmic fight between good and evil.

~~~
munk-a
No.

Both countries do not benefit from it, otherwise they would view these wars as
just and support them. The political machines in both countries support these
wars and force the populace into them - in part (in the US at least) by being
a two party system without any way to politically express a desire to not go
to war, one party is more hawkish but both parties are full of hawks.

As an American I am happy to say, "Please, America, stop messing up the world
for everyone with your endless economic wars." A bully cannot neutrally
justify their own actions, they are biased in approving of the path they have
chosen.

~~~
tathougies
> otherwise they would view these wars as just and support them

So the claim is that it is only possible to benefit monetarily from things
that are ethically sound?

~~~
munk-a
No, the point is that a subset of the populace benefiting monetarily isn't
equivalent to a country benefiting. People can rationally say that acquisition
of wealth is not the sole goal of existence.

------
geggam
One thing he missed.

Only in the US can you be bankrupted with full coverage, a simple medivac
helicopter ride would take care of most Americans.

~~~
dragonwriter
You can't be bankrupted with full coverage (except by the cost of premiums),
but very few, proportionately, Americans have anything like full coverage.

~~~
geggam
you are simply wrong

------
dre85
My understanding is that in the US there are even companies which can be hired
by hospitals and other care centers to "optimize" the codes before the final
submission to the insurance. I take this to mean that they can ensure that
you're using the right codes and also probably try to maximize the payout.

------
harrumph
Markets such as the US health care market, characterized by ineslastic demand
and secret prices, should never, ever be tolerated under any circumstances.
This arrangement is here to benefit the supply side and screw the demand side
and it has to be stopped. The only pathway out of this crisis starts with the
federal government replacing private insurers, relegating them to selling
supplemental coverage. Such companies also should be legally compelled to run
as mutual insurance companies, where any profit deriving from good risk
management is sent back to policyholders. It is long past time everybody in
the US admitted that markets have completely failed in US health care.

------
alexiazf
I think I'm privileged to live in Australia where I do not need to pay for my
visits to the hospital and for my operation when I had appendicitis. Whereas
in the US I've seen it is 30-70k. It's also interesting that there is a range
of prices depending on the hospital. Would this be representative of treatment
quality? How much one can pay shouldn't be the determinant of the optimal
treatment that one deserves to receive.

------
lordnacho
I actually spoke to someone today who is hiring a guy from a FANG in SV to go
and work in Denmark. He told me taxes are high enough over there it isn't all
that different.

Plus like many Americans he was curious about living in Denmark. Cycling
everywhere, laid back lifestyle, that sort of thing.

------
paulkon
Misappropriation of funds due to lobbying and regulatory capture.

The film 'Vice' on Dick Cheney outlines just how permeable American government
is to such non-public interests.

It's no wonder tax avoidance is such an interesting topic for those who stand
to pay the most if they do nothing.

------
adamnemecek
Not just that, they are also getting nothing in return.

The US voters need to realize just how much are they getting fucked over by
the military-industrial complex.

I’m not against taxes, I’m against taxes that go to pay for wars as opposed to
medical insurance, infrastructure and education.

~~~
z2
That budget seems to be always nonnegotiable, despite the occasional media
outrage. Realistically, how can US voters change this?

As an aside, the US is the only country I've seen give military personnel
priority boarding for civilian flights. With all due respect to veterans, it
seems so strange to do this sort of worshiping in what is effectively
peacetime.

~~~
rootusrootus
It's a small thing, and I consider it a bit of payback for what society did to
veterans back in the days of Vietnam.

~~~
adamnemecek
It’s bullshit because the govt makes these meaningless gestures but when it’s
time to open the wallet, all of sudden they are out of respect.

------
bernardlunn
About time. As a Brit who worked in America for many years this was blindingly
obvious. It is only who you pay your tax to.

------
Shivetya
US workers are highly taxed if you bother to count every tax they pay from
payroll, property, sales, and embedded taxes.

------
ars
"Fools rush in where angels fear to tread"

You can't average averages in this way. You'll get easily manipulated data.

He's using a single average data for a married, single income worker, and
combining that with the average for health insurance.

You can't do that. You need to calculate each individual person's income and
share of healthcare costs, and only then average the results.

------
novalis78
The only problem with the ‘Medicare for all’ system is that it won’t reduce
that insanely high ‘stealth’ taxation - it will just add to it... However, at
least with efforts like Oklahoma’s Surgery Center etc one stands a chance to
escape the compulsory racket through market efficiency. Potentially.

------
timwaagh
only country doing worse: netherlands. no surprise there.

------
penagwin
I never understood why people are against some form of universal healthcare.
The idea of "socialism" or "communism" scare many conservatives, but it just
doesn't make sense here.

How universal healthcare sorta works - we all put money in a pot, and use it
to pay for healthcare.

How health insurance works - we put money into a company, who uses it to pay
for healthcare, while taking a significant cut as it's a private entity.

With the correct organization (which the government is notoriously terrible
at) it would seem to me that it could only be cheaper to have taxpaid
healthcare?

~~~
btilly
I find it ironic that you stated the answer to your own question and didn't
notice.

That is, how notoriously terrible the government is at organization is a major
reason for why people are against universal healthcare. Whether their concerns
are overblown or not I leave to opinion. But that is a major fear for many.

~~~
acdha
> how notoriously terrible the government is at organization is a major reason

A major propaganda point, not a reason based on data. It’s really hard to find
a first-world country which has a medical system which doesn’t compare
favorably with American insurance companies on either cost or quality — the
baked-in conflicts of interest are too powerful.

~~~
mattkrause
Insurance companies are also not exactly....paragons of good customer service
themselves. I was camping with a friend when he managed to slice off the tip
of his finger. The insurance company fought him tooth and..err...nail to avoid
paying out for not having the ER visit “pre-approved”

~~~
acdha
That was my point: I’ve known a fair number of people from other countries and
I’ve never heard any reaction other than stunned disbelief when they
experienced the American private insurance system — up to and including giving
up jobs here just to avoid the stress of not knowing whether you really will
get treated or not.

------
pochamago
"If you include things that aren't taxes, people are taxed a lot more"

~~~
kelnos
If you don't do _something_ , comparing tax rates between countries is
meaningless when you get different things for those tax dollars.

I think the developed world (minus us here in the US, of course) has finally
realized that access to health care is a basic human right and _should_ be
included.

~~~
gwright
The primary reason that some people push back against this notion of health
care as a "basic human right" is that it is an example of a "right" that can
only be provided by force. And by force I mean that the only way it can be
"guaranteed" by the government is for the government to forcibly collect taxes
to pay for the services. Forceable redistribution is required. Perhaps even
forcible job assignments (nurses, doctors, technicians, etc) if you really
want to make sure the right is provided equally to everyone (ratio of patients
to doctors, etc.).

In contrast rights such as freedom of speech, assembly, press, religion and so
on can be guaranteed through inaction of the government. Nothing needs to be
taken away from anyone to guarantee these rights. Basically this is the
difference between positive rights and negative rights.

One large problem with bucketing positive and negative rights together as
"basic rights" and insisting that the government must guarantee these basic
rights is that it becomes difficult to identify a limiting principle. If
health care is a "basic right", then why isn't "food" or "shelter" or
"clothing"? How would we go about guaranteeing those things?

Please don't interpret my comments as suggesting that reasonably priced health
insurance and accessible health care services aren't important. They are, but
there are ways of structuring those services and socializing some of the costs
that don't require that they be considered "basic rights".

It is interesting that you qualify your claim that health care is a "basic
human right" to the "developed world". Does that mean that it is not a "basic
human right" in other parts of the world? Why not? If it is a basic human
right, shouldn't it be protected universally? And if you think it should be
provided universally who should be responsible for providing that right
outside the developed world? And if it there is some complex economic
conditions that are pre-requisites then is it really a "basic human right"?

~~~
kelnos
> It is interesting that you qualify your claim that health care is a "basic
> human right" to the "developed world". Does that mean that it is not a
> "basic human right" in other parts of the world?

You misunderstand. I personally believe that everyone has a right to access to
healthcare. My point was that the developed world has finally decided (for the
most part) to recognize and codify that into law and taxation, whereas much of
the less-developed world has not (to be fair, a decent amount of it has,
though).

