
US Workers Are Paying High Taxes. But Without Any of the Benefits - mjfern
https://jacobinmag.com/2019/04/labor-tax-rates-united-states-health-insurance
======
mrep
Discussed 5 days ago with 504 comments (same author and article, just a
different website):
[https://news.ycombinator.com/item?id=19609191](https://news.ycombinator.com/item?id=19609191)

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strstr
This isn’t surprising in light of [0]. The core statement in [0] is that
american health costs are high. In particular, predictably high based on
Actual Individual Consumption.

[0][https://randomcriticalanalysis.com/2018/11/19/why-
everything...](https://randomcriticalanalysis.com/2018/11/19/why-everything-
you-know-about-healthcare-is-wrong-in-one-million-charts-a-response-to-noah-
smith/)

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ggregoire
Salaries in the US are more than twice as high as salaries in Europe tho.
Maybe not having any benefits is a part of the equation to get those salaries?
(naive suggestion, I'm not an economist)

(Source for the salaries: [https://www.thebalancecareers.com/average-salary-
information...](https://www.thebalancecareers.com/average-salary-information-
for-us-workers-2060808)

$28,000 for no high school degree -> people with BS gets this kind of salary
in Europe. $37,000 for high school degree -> people with MS gets this kind of
salary in Europe. Same logic for the other salaries on this chart.)

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alexandercrohde
Maybe, if Salaries in the US are twice as high as Europe, then the average
American is already paying more total tax than the average European and thus
might expect more benefits.

~~~
analyst74
A lot of the benefits' cost are labour (i.e. doctors, fire fighters, etc),
hence are more expensive to provide. It's the circle of life.

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anonymous5133
If you look at the federal budget, it is easy to see that the federal
government is misallocating a significant amount or tax money to purposes that
don't really benefit the average American. Interest on the national debt and
military spending are the two big ones. There are probably also wasteful
spending in most of the other programs as well.

Then there is the issue of too much inefficiency within existing insurance
programs. American consumers are not getting a good value for the healthcare
dollars that they do spend.

Lastly, I would say that the American education system is too expensive and
too inefficient at training new medical staff.

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onlyrealcuzzo
It's easy to rip on US military spending, but it's actually not far out-of-
line with other OECD countries. Considering the amount of war-mongering we do,
I don't know how anyone expects it to be average or lower. For reference, it's
about double the average country: [https://www.pgpf.org/chart-
archive/0184_ally_defense_spendin...](https://www.pgpf.org/chart-
archive/0184_ally_defense_spending)

It's 63% higher than China and ~double France's & the UK's. Russia's is
actually 38% higher than ours (not that Russia is a model country for
anything):
[https://data.worldbank.org/indicator/ms.mil.xpnd.gd.zs](https://data.worldbank.org/indicator/ms.mil.xpnd.gd.zs)

Maybe if we could stop starting wars constantly, we could lower our military
spending. But it doesn't look like that's the direction the voting population
is moving toward.

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AnthonyMouse
> As the Mercatus Center noted last year, by implementing a Medicare for All
> system, the US could insure 30 million more people, provide dental, vision,
> and hearing coverage to everyone, and virtually eliminate out-of-pocket
> expenses, all while saving $2 trillion over the first decade of
> implementation.

This is assuming Medicare would have the same cost structure if it insured
everyone that it does right now, which is incorrect because Medicare is
currently being subsidized by private insurance.

In order to make healthcare in the US cost less, something that is currently
being paid for has got to go away. That isn't primarily "insurance company
profits" or anything like that. The profits are a single digit percentage of
the premiums.

The costs come from things like the extraordinarily high cost of getting FDA
approvals reducing competition between pharma companies, doctors choosing
unnecessary tests for liability reasons and patients preferring them when
someone else is paying for them and things of that nature. It is not clear how
Medicare would change any of that, given that it currently doesn't solve them
even for existing Medicare patients, it just pays below its share of the fixed
costs and lets private insurance pick up the difference.

You have to actually get the costs down. In theory you could just declare by
fiat that you aren't going to pay as much, which would cause _something_ to be
cut, but not the inefficiencies that the law continues to require. A
"solution" that causes good things to be cut so that existing wasteful things
will still fit into the budget is not very good.

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grey-area
_This is assuming Medicare would have the same cost structure if it insured
everyone that it does right now, which is incorrect because Medicare is
currently being subsidized by private insurance._

No, it's assuming that the successful outcomes and cost-benefits of single-
payer, as proven throughout the world, can also be applied to the US.

~~~
asark
At this point the fact that the whole friggin' rest of the OECD states have
managed to come up with something less-broken _and_ less expensive than what
we do, and that AFAIK even the most "free market" and incomparable to ours
demographically and geographically (e.g. Singapore) have done this with price
controls and a "public option" or similar, is such easy-to-come-by and oft-
repeated info that "gee I just don't know how this could work in the US" or
"more government intervention can't possibly fix anything" can't be charitably
interpreted. It's concern trolling or gross ignorance. Period. We've been
talking about this for decades. The data are there. They're not hidden. It's
not theoretical. Pick a demonstrated-to-work system and do it.

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Mirioron
I'm in one of the other OECD states and I'd pick American healthcare over mine
most of the time. You guys have so many more treatment options available.

~~~
asark
Ours is the one where you end up with one hundred bills from a twenty
different providers, fighting insurance & hospital billing departments for a
hundred plus hours on the phone, and five-figures of out of pocket expenses
for a completely normal pregnancy & birth of a child, if you've got decent
insurance. It holds back entrepreneurship, and it threatens to take all the
money you've saved up, at any time. Inheritance? The hospitals will get it
before you do. Your savings for retirement? You're just holding on to it
before the hospitals eventually get it. Maybe your kid gets seriously sick and
then you just don't retire ever. Freedom! Choice!

It's a huge source of risk and anxiety _even if you have insurance_. The
extreme budgeting uncertainty and stress are hard to put in dollar terms, but
they're _expensive_ , on top of what's already the most expensive system
around, and getting more expensive at something like double the inflation
rate. It's inhumane and unsustainable. If it blew every other system out of
the water it might, _might_ be worth all that, but it doesn't, so it isn't, at
all.

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tanzbaer
And yet the U S has a higher birth rate and more entrepreneurs than Europe.
Can't be that bad.

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hollandheese
What the hell do those have to do with health care?

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dgemm
Everyone knows this but those that benefit from the status quo also have
enough influence to keep it.

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stunt
Reading the history, They did a great job to make people pay tax without
asking question.

