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Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. In Sweden we pay less per c

Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. In Sweden we pay less per capita than americans do (from taxes) and my total _maximum_ healthcare costs for _all_ treatments, medications, surgury etc, that in the US would be paid by your employer or yourself are: $125/year max for all visits and procedures [1] + $250/year max for all prescribed medications (with up to 75% discounts before reaching those $250)[2]. This makes treating my Crohn's + MEN-1 an issue of going to visits, doing surguries and scans, and picking up my medications at the local pharmacy (I order in their app since my medications are rare) every three months. [0] https://www.visualcapitalist.com/u-s-spends-public-money-healthcare-sweden-canada/ https://www.visualcapitalist.com/u-s-spends-public-money-hea... [1] https://www.1177.se/Stockholm/Regler-och-rattigheter/Hogkostnadsskydd/ https://www.1177.se/Stockholm/Regler-och-rattigheter/Hogkost... [2] https://www.apoteket.se/mina-recept-inloggad/mer-om-hogkostnadsskydd/ https://www.apoteket.se/mina-recept-inloggad/mer-om-hogkostn...

enraged_camel 8y ago
>>Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. Americans don't actually have an objection to paying more for healthcare. What they do have an objection to is paying for other people's healthcare. America is a deeply individualistic society, and the idea of one's tax dollars being spent to benefit others lies at the root of most people's objections to single-payer, or anything else that smells like "socialism".
- raesene9 8y ago
  It's interesting you say that, I've heard that line of argument before but it is quite puzzling. Are you suggesting that a person on Low income in the US doesn't object to paying more than they have for their own healthcare (i.e. that they wouldn't like that healthcare to be cheaper) That seems a bit counter-intuitive, as usually people don't like being bankrupt.
  - WrtCdEvrydy 8y ago
    Americans believe that only poor people get bankrupt... then they get cancer. It's hard to swallow an increase on taxes when you're healthy and think you will never get sick.
    - raesene9 8y ago
      I can understand (although not agree with) the idea that rich people don't want to subsidise poor people's healthcare, but the argument I was responding to appeared to say that Americans don't mind paying more for their healthcare, which puzzles me. I'd have thought that lower income Americans would be pretty happy to have a source of cheaper healthcare, even if it wasn't quite as effective as the expensive stuff.
    - AlfeG 8y ago
      There is a miriad less mortal deseases then cancer, that can broke anyone, especially if its Your kids are suffering...
- tapland 8y ago
  And you do have a system where you pay more than anyone else for the pleasure of poor people dying. Harshly worded but that is already solved, and somehow I don't see people being happy with it. I think it's pretty clear that taxes per capita to healthcare being third highest in the world isn't common knowledge.
- swozey 8y ago
  All this leads to is less people going in for annual checkups and preventative health care which leads to people becoming catastrophically sick ($40k medical bills) vs. preventing that situation from happening at all if it can be prevented; or catching it early on so it can be mitigated. It's been a long time since I've worked in retail where I had no employee provided healthcare but back then I'd only go to the doctor if my arm was falling off. Everything else was "this feels weird, I'll wait it out, hopefully it goes away because I don't have $150-200 for a checkup if it turns out to be nothing." A simple example is dental care. Yearly checkups, cleanings, etc and actively working to prevent major issues leads to far less diseases (blood, etc). But when you don't have decent insurance knowing that you might go in and get told you've got a $400 cavity or need a $1500 root canal out of pocket dissuades a lot of people from even going in. Thankfully I have generally healthy teeth but I hadn't gone to a dentist since my teens (parents insurance) until a few years ago. And once you tell someone that you might be shocked by the number of people who come out of the woodwork to tell you they haven't gone either. I generally thought I was incredibly healthy and invincible until 28 when out of the blue I got appendicitis, which was $35k. I still had my "only go if my arms falling off" mentality back then but eventually the pain was so unbearable that I drove myself to the ER as I knew something serious was going on. Thankfully I had insurance. That really taught me that there's a lot of things in my body that I have no control over regardless of how healthy and active I am and having a fall back plan to help when catastrophe happens is critical.
  - ams6110 8y ago
    A lot of people just don't like doctors. I have good insurance, but I haven't been to a doctor (MD) in probably close to 20 years. I do get regular dental cleaning and checks though.
    - swozey 8y ago
      Oh believe me, I sat in my car outside for an hour before I even forced myself to go into the ER. I was afraid of doctors, hadn't been in years, and my first foray since then would be taking myself to the ER. I was terrified. And.. it wasn't bad at all. I'd never had surgery. They knocked me out and I woke up and didn't even know it was over with until I checked my stomach for the scar.
- MiddleEndian 8y ago
  Ironically, I support single payer healthcare (or at least a dramatic restructuring that decouples pricing from employment) specifically because of individualism. Right now, you need to work at a corporation to get collective bargaining for healthcare prices. This presents a huge disadvantage to people wanting to be contractors, self-employed artists, people wanting to start small businesses, people who only want to work every other year for whatever reason, etc. Your options are limited because you need to be part of a corporate collective to get reasonable healthcare options.
  - User23 8y ago
    I support a variant of single payer healthcare too: you pay for your own healthcare out of pocket. All this requires is that wages be high enough and health care costs be controlled. If this sounds impossible, you should consider that it was how our system worked in the USA in living memory.
    - Retra 8y ago
      You then deny that health insurance is a reasonable way to plan for illness?
      - User23 8y ago
        As currently implemented? Absolutely, it observably isn't. Why do we need middlemen preying on fear, confusion, and preventing any reasonable price discovery from occurring while driving an absolutely absurd inflation rate[1]. Please note those are monthly, not annual numbers, and some months alone hit 5%! Keeping costs down and wages up has plenty of other positive effects too. [1] https://ycharts.com/indicators/us_health_care_inflation_rate https://ycharts.com/indicators/us_health_care_inflation_rate
- zrav 8y ago
  I don't think that "individualistic" is a strong enough word. European society, for instance, is also very individualistic, yet doesn't have anywhere near the levels of indoctrination against "socialism". It seems Americans (generalizing here) have been let to believe that someones gain can only happen at someone else's loss, thinking there can't be a win-win situation.
- deogeo 8y ago
  > America is a deeply individualistic society Polls say otherwise: http://nymag.com/intelligencer/2018/08/new-poll-majority-of-gop-voters-support-medicare-for-all.html http://nymag.com/intelligencer/2018/08/new-poll-majority-of-... Who benefits from convincing Americans they're individualistic and should remain isolated when negotiating with giant corporations?
- mnm1 8y ago
  I agree. Unfortunately, Americans are not all multi millionaires or billionaires and almost all Americans are too stupid to realize that they won't be able to afford their own healthcare without a "socialized" government run system. Such stupidity is a hallmark trait of such an individualistic, selfish society in which people cannot think of others or or collective action. Other traits are high levels of depression, anxiety, and drug abuse due to isolation and the complete lack of community. But hey, at least you can watch your neighbor die slowly of cancer he can't afford to get treatment for from afar. That seems to be something Americans enjoy.
rayiner 8y ago
> In Sweden we pay less per capita than americans do (from taxes) Taxes as a percentage of GDP in Sweden is 37%, versus about 27% in the United States.
- raesene9 8y ago
  but of course that doesn't mean Sweden pays more from those taxes on Healthcare than the US. Looking at the "Government and compulsory" figures here https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm the US appears to be at $8407 per person for gov. + compulsory spending and Swedent is at $4606.
- czps 8y ago
  Healthcare gets funded in each country by a combination of taxes and people paying out of pocket. In the U.S. employer subsidized health care insurance should be viewed as part of an employee’s compensation. What matters in such discussions is not the tax rate but the overall spending per capita and how much it costs at point of contact. The relevant facts are that the U.S. spends far more per capita and costs far more at point of contact than every other OECD country. I think the person you responded to was attempting to point out that Sweden’s healthcare costs come mostly from taxes and is cheap at point of contact. I don’t believe they meant to give the impression that taxes in the U.S. are higher than in Sweden.
superpermutat0r 8y ago
Absolutely, public spending on healthcare in USA is enormous. Higher than military budget. USA is unfortunately country where enormous amounts of people are sick. Mostly side effects of obesityand lack of physical activity.
- lisper 8y ago
  All of this is a side-effect of the uniquely American philosophy that says that if someone is making money they must be making a net positive contribution to society, because otherwise why would anyone buy their product? This approach overlooks externalities and rent-seeking. The net result is that we have a lot of people making money selling things to people that they want but makes them sick (soda, cigarettes, corn chips) and a lot of other people making money professing to make them less sick, and yet another group of people making money by professing to control the costs of the second group, and lot of other people making money lobbying politicians to keep the laws in place that maintains the status quo. So everyone's making money (except for the slackers who dare to get sick), so everything must be hunky dory. The American health care system is the broken-window theory writ large.
  - nightski 8y ago
    While I do not disagree with you altogether, I have a hard time believing it would be possible to come up with some sort system that is inclusive of these externalities. Look at what a crapshow nutrition science is - do we really want government encouraging/discouraging foods more so than it already is? Look at how bad farm subsidies have affected our health in general.
- s_y_n_t_a_x 8y ago
  The spending is due to research and development, not because more people are sick.
  - superpermutat0r 8y ago
    Not really, it's Medicaid and Medicare. https://en.m.wikipedia.org/wiki/Expenditures_in_the_United_States_federal_budget https://en.m.wikipedia.org/wiki/Expenditures_in_the_United_S...
hhs 8y ago
I think most medical professionals may agree with this: the U.S. healthcare system is built on rewarding volume and doing more things. It's an especially attractive field for clinicians who specialize because they have to do special things - with highly regulated barriers to entry. And while there has been recognition by experts in recent years to push for quality and efficiency (since doing more procedures, especially those unnecessary, raises the risk of harm), the system has been slow to both incentivize this and lower the overall costs.
sarcasmOrTears 8y ago
With healthcare you either have a true free market, as in no licenses, no patents, etc or you need the State to regulate it and provide it for everybody. The US has the worst possible combination.
- rayiner 8y ago
  A “true free market” doesn’t have no patents any more than it has no rights in land. Patents prevent what would othwrwise be a market failure (free riding) just as property rights in land prevent tragedy of the commons. Put differently, you can’t have markets where you can just take things instead of entering into transactions. Because you can do that in the state of nature, markets are inherently artificial constructs.
- s_y_n_t_a_x 8y ago
  America's healthcare system is what furthers the world's healthcare through research and development. Because it is for profit, the quality and advances are superior. Other countries that reap the benefits of drugs that America create while only paying generic prices when Americans have to pay for the inflated prices that pay for those expensive drug trials.
  - thefounder 8y ago
    How much R&D did pharma boy do?
    - s_y_n_t_a_x 8y ago
      That's your counter? One instance of abuse? I'll take that if it comes with all the breakthroughs the American healthcare system has developed.
badpun 8y ago
If you make American-level software engineer salary in Sweden, your EFFECTIVE (not marginal, effective) tax rate is a freaking 55% - at least that’s the number given to me by a recruiter whi tried to bring me there. Also, you pay 25% VAT. I’m sorry, but that’s a bit outrageous.
- deleted 8y ago
  [deleted]
- mseidl 8y ago
  As a German software engineer that used to work in the USA, do I pay more taxes in Germany, yes. But, I don't have to worry about going bankrupt from medical issues. In Seattle where I used to live daycare is 30,000$ a year per kid. In Germany it's at most like 200-300 euros a month. Plus you get kindergeld too(200 euros per kid). We don't go into 10s of thousands to hundreds of thousands of dollars in debt for school. Even with my "good" benefits I had at my job in the US, I would never move back.
  - hollerith 8y ago
    For how many years did you work in the USA?
  - s_y_n_t_a_x 8y ago
    Most Americans have good healthcare through their employer. The premiums are reasonable, and the quality is great. Only if you're self employed or part time do you pay out of pocket, something you need to factor in when you make life decisions.
    - cimmanom 8y ago
      I think maybe you mean to qualify that as “most American software engineers?” Or maybe even “most Americans in white collar jobs”, although that’s not a universal, and the premiums and quality of care in many of those plans is absolute crap. Heck, even as a software engineer, my medical insurance is mediocre and a high-deductible plan costs more in premiums ON TOP OF what my employer pays than I’d spend out of pocket in a year without a major medical emergency.

enraged_camel 8y ago

>>Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. Americans don't actually have an objection to paying more for healthcare. What they do have an objection to is paying for other people's healthcare. America is a deeply individualistic society, and the idea of one's tax dollars being spent to benefit others lies at the root of most people's objections to single-payer, or anything else that smells like "socialism".

raesene9 8y ago
It's interesting you say that, I've heard that line of argument before but it is quite puzzling. Are you suggesting that a person on Low income in the US doesn't object to paying more than they have for their own healthcare (i.e. that they wouldn't like that healthcare to be cheaper) That seems a bit counter-intuitive, as usually people don't like being bankrupt.
- WrtCdEvrydy 8y ago
  Americans believe that only poor people get bankrupt... then they get cancer. It's hard to swallow an increase on taxes when you're healthy and think you will never get sick.
  - raesene9 8y ago
    I can understand (although not agree with) the idea that rich people don't want to subsidise poor people's healthcare, but the argument I was responding to appeared to say that Americans don't mind paying more for their healthcare, which puzzles me. I'd have thought that lower income Americans would be pretty happy to have a source of cheaper healthcare, even if it wasn't quite as effective as the expensive stuff.
  - AlfeG 8y ago
    There is a miriad less mortal deseases then cancer, that can broke anyone, especially if its Your kids are suffering...
tapland 8y ago
And you do have a system where you pay more than anyone else for the pleasure of poor people dying. Harshly worded but that is already solved, and somehow I don't see people being happy with it. I think it's pretty clear that taxes per capita to healthcare being third highest in the world isn't common knowledge.
swozey 8y ago
All this leads to is less people going in for annual checkups and preventative health care which leads to people becoming catastrophically sick ($40k medical bills) vs. preventing that situation from happening at all if it can be prevented; or catching it early on so it can be mitigated. It's been a long time since I've worked in retail where I had no employee provided healthcare but back then I'd only go to the doctor if my arm was falling off. Everything else was "this feels weird, I'll wait it out, hopefully it goes away because I don't have $150-200 for a checkup if it turns out to be nothing." A simple example is dental care. Yearly checkups, cleanings, etc and actively working to prevent major issues leads to far less diseases (blood, etc). But when you don't have decent insurance knowing that you might go in and get told you've got a $400 cavity or need a $1500 root canal out of pocket dissuades a lot of people from even going in. Thankfully I have generally healthy teeth but I hadn't gone to a dentist since my teens (parents insurance) until a few years ago. And once you tell someone that you might be shocked by the number of people who come out of the woodwork to tell you they haven't gone either. I generally thought I was incredibly healthy and invincible until 28 when out of the blue I got appendicitis, which was $35k. I still had my "only go if my arms falling off" mentality back then but eventually the pain was so unbearable that I drove myself to the ER as I knew something serious was going on. Thankfully I had insurance. That really taught me that there's a lot of things in my body that I have no control over regardless of how healthy and active I am and having a fall back plan to help when catastrophe happens is critical.
- ams6110 8y ago
  A lot of people just don't like doctors. I have good insurance, but I haven't been to a doctor (MD) in probably close to 20 years. I do get regular dental cleaning and checks though.
  - swozey 8y ago
    Oh believe me, I sat in my car outside for an hour before I even forced myself to go into the ER. I was afraid of doctors, hadn't been in years, and my first foray since then would be taking myself to the ER. I was terrified. And.. it wasn't bad at all. I'd never had surgery. They knocked me out and I woke up and didn't even know it was over with until I checked my stomach for the scar.
MiddleEndian 8y ago
Ironically, I support single payer healthcare (or at least a dramatic restructuring that decouples pricing from employment) specifically because of individualism. Right now, you need to work at a corporation to get collective bargaining for healthcare prices. This presents a huge disadvantage to people wanting to be contractors, self-employed artists, people wanting to start small businesses, people who only want to work every other year for whatever reason, etc. Your options are limited because you need to be part of a corporate collective to get reasonable healthcare options.
- User23 8y ago
  I support a variant of single payer healthcare too: you pay for your own healthcare out of pocket. All this requires is that wages be high enough and health care costs be controlled. If this sounds impossible, you should consider that it was how our system worked in the USA in living memory.
  - Retra 8y ago
    You then deny that health insurance is a reasonable way to plan for illness?
    - User23 8y ago
      As currently implemented? Absolutely, it observably isn't. Why do we need middlemen preying on fear, confusion, and preventing any reasonable price discovery from occurring while driving an absolutely absurd inflation rate[1]. Please note those are monthly, not annual numbers, and some months alone hit 5%! Keeping costs down and wages up has plenty of other positive effects too. [1] https://ycharts.com/indicators/us_health_care_inflation_rate https://ycharts.com/indicators/us_health_care_inflation_rate
zrav 8y ago
I don't think that "individualistic" is a strong enough word. European society, for instance, is also very individualistic, yet doesn't have anywhere near the levels of indoctrination against "socialism". It seems Americans (generalizing here) have been let to believe that someones gain can only happen at someone else's loss, thinking there can't be a win-win situation.
deogeo 8y ago
> America is a deeply individualistic society Polls say otherwise: http://nymag.com/intelligencer/2018/08/new-poll-majority-of-gop-voters-support-medicare-for-all.html http://nymag.com/intelligencer/2018/08/new-poll-majority-of-... Who benefits from convincing Americans they're individualistic and should remain isolated when negotiating with giant corporations?
mnm1 8y ago
I agree. Unfortunately, Americans are not all multi millionaires or billionaires and almost all Americans are too stupid to realize that they won't be able to afford their own healthcare without a "socialized" government run system. Such stupidity is a hallmark trait of such an individualistic, selfish society in which people cannot think of others or or collective action. Other traits are high levels of depression, anxiety, and drug abuse due to isolation and the complete lack of community. But hey, at least you can watch your neighbor die slowly of cancer he can't afford to get treatment for from afar. That seems to be something Americans enjoy.

rayiner 8y ago

> In Sweden we pay less per capita than americans do (from taxes) Taxes as a percentage of GDP in Sweden is 37%, versus about 27% in the United States.

raesene9 8y ago
but of course that doesn't mean Sweden pays more from those taxes on Healthcare than the US. Looking at the "Government and compulsory" figures here https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm the US appears to be at $8407 per person for gov. + compulsory spending and Swedent is at $4606.
czps 8y ago
Healthcare gets funded in each country by a combination of taxes and people paying out of pocket. In the U.S. employer subsidized health care insurance should be viewed as part of an employee’s compensation. What matters in such discussions is not the tax rate but the overall spending per capita and how much it costs at point of contact. The relevant facts are that the U.S. spends far more per capita and costs far more at point of contact than every other OECD country. I think the person you responded to was attempting to point out that Sweden’s healthcare costs come mostly from taxes and is cheap at point of contact. I don’t believe they meant to give the impression that taxes in the U.S. are higher than in Sweden.

superpermutat0r 8y ago

Absolutely, public spending on healthcare in USA is enormous. Higher than military budget. USA is unfortunately country where enormous amounts of people are sick. Mostly side effects of obesityand lack of physical activity.

lisper 8y ago
All of this is a side-effect of the uniquely American philosophy that says that if someone is making money they must be making a net positive contribution to society, because otherwise why would anyone buy their product? This approach overlooks externalities and rent-seeking. The net result is that we have a lot of people making money selling things to people that they want but makes them sick (soda, cigarettes, corn chips) and a lot of other people making money professing to make them less sick, and yet another group of people making money by professing to control the costs of the second group, and lot of other people making money lobbying politicians to keep the laws in place that maintains the status quo. So everyone's making money (except for the slackers who dare to get sick), so everything must be hunky dory. The American health care system is the broken-window theory writ large.
- nightski 8y ago
  While I do not disagree with you altogether, I have a hard time believing it would be possible to come up with some sort system that is inclusive of these externalities. Look at what a crapshow nutrition science is - do we really want government encouraging/discouraging foods more so than it already is? Look at how bad farm subsidies have affected our health in general.
s_y_n_t_a_x 8y ago
The spending is due to research and development, not because more people are sick.
- superpermutat0r 8y ago
  Not really, it's Medicaid and Medicare. https://en.m.wikipedia.org/wiki/Expenditures_in_the_United_States_federal_budget https://en.m.wikipedia.org/wiki/Expenditures_in_the_United_S...

hhs 8y ago

I think most medical professionals may agree with this: the U.S. healthcare system is built on rewarding volume and doing more things. It's an especially attractive field for clinicians who specialize because they have to do special things - with highly regulated barriers to entry. And while there has been recognition by experts in recent years to push for quality and efficiency (since doing more procedures, especially those unnecessary, raises the risk of harm), the system has been slow to both incentivize this and lower the overall costs.

sarcasmOrTears 8y ago

With healthcare you either have a true free market, as in no licenses, no patents, etc or you need the State to regulate it and provide it for everybody. The US has the worst possible combination.

rayiner 8y ago
A “true free market” doesn’t have no patents any more than it has no rights in land. Patents prevent what would othwrwise be a market failure (free riding) just as property rights in land prevent tragedy of the commons. Put differently, you can’t have markets where you can just take things instead of entering into transactions. Because you can do that in the state of nature, markets are inherently artificial constructs.
s_y_n_t_a_x 8y ago
America's healthcare system is what furthers the world's healthcare through research and development. Because it is for profit, the quality and advances are superior. Other countries that reap the benefits of drugs that America create while only paying generic prices when Americans have to pay for the inflated prices that pay for those expensive drug trials.
- thefounder 8y ago
  How much R&D did pharma boy do?
  - s_y_n_t_a_x 8y ago
    That's your counter? One instance of abuse? I'll take that if it comes with all the breakthroughs the American healthcare system has developed.

badpun 8y ago

If you make American-level software engineer salary in Sweden, your EFFECTIVE (not marginal, effective) tax rate is a freaking 55% - at least that’s the number given to me by a recruiter whi tried to bring me there. Also, you pay 25% VAT. I’m sorry, but that’s a bit outrageous.

deleted 8y ago
[deleted]
mseidl 8y ago
As a German software engineer that used to work in the USA, do I pay more taxes in Germany, yes. But, I don't have to worry about going bankrupt from medical issues. In Seattle where I used to live daycare is 30,000$ a year per kid. In Germany it's at most like 200-300 euros a month. Plus you get kindergeld too(200 euros per kid). We don't go into 10s of thousands to hundreds of thousands of dollars in debt for school. Even with my "good" benefits I had at my job in the US, I would never move back.
- hollerith 8y ago
  For how many years did you work in the USA?
- s_y_n_t_a_x 8y ago
  Most Americans have good healthcare through their employer. The premiums are reasonable, and the quality is great. Only if you're self employed or part time do you pay out of pocket, something you need to factor in when you make life decisions.
  - cimmanom 8y ago
    I think maybe you mean to qualify that as “most American software engineers?” Or maybe even “most Americans in white collar jobs”, although that’s not a universal, and the premiums and quality of care in many of those plans is absolute crap. Heck, even as a software engineer, my medical insurance is mediocre and a high-deductible plan costs more in premiums ON TOP OF what my employer pays than I’d spend out of pocket in a year without a major medical emergency.