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The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes. Then there is no risk to hir

The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes. Then there is no risk to hiring a new employee beyond the wages you pay them. The US public does not want this, though, and the war of words over universal health care has led to incredibly deep entrenchment on the side of those opposed. All this despite the mountain of evidence from other countries, showing the greatly reduced total costs and improved life expectancy as well as a lack of bankruptcy and financial ruin for those caught in an emergency.

bernawil 7y ago
I can think of several countries with universal healthcare where hiring is still complicated to say the least. Not arguing it would still help, though!
- ancorevard 7y ago
  Welcome to Europe.
HillaryBriss 7y ago
> Then there is no risk to hiring a new employee beyond the wages you pay them. but you must not forget the additional administrative/accounting overhead, the risk from the wide variety of lawsuits one is vulnerable to as an employer, the risks of employee injury on the job, and costs associated with the possibility of laying off employees in the future. surely there are more costs than just wages.
- jher17 7y ago
  Sure. But this is the responsibility an employer must take on in order to hire someone’s labor.
intortus 7y ago
> The US public does not want this A majority does, in fact, want this. https://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/ https://www.pewresearch.org/fact-tank/2018/10/03/most-contin...
djsumdog 7y ago
In America, you have to work until you die. The major thing the gig economy takes from people is health care. It's insanely expensive, and the Affordable Care Act is a terrible shamble of broken policy. I spent time outside of the US and came back to find health care worse than when I left it: https://fightthefuture.org/article/returning-to-america-and-the-unaffordable-care-act/ https://fightthefuture.org/article/returning-to-america-and-... I have a friend who has been fighting brain cancer for over a year. The small company he was working for let him go (although they wouldn't admit it; it was likely over his condition) and his wife has to constant fight her own company's insurance company/policy to get treatments covered (and she is a lawyer; who literally works for a law firm doing mostly corporate liability cases). In any EU country, you get a terminal illness, you can take time off and live your life. Will you get the same level of treatment as you would in the US? Who cares. You get treatment, and you can spent time with the people you love and appreciate things until you get better or your friends say goodbye. In America, if you do not have a spouse, you just have to keep working until you can't any more .. and then you die.
- jchallis 7y ago
  Based on the very large revenue from foreign patients who come to America to get cancer treatment on their own dime, those patients and their families care about getting the best treatment.
  - stjohnswarts 7y ago
    You can't use the 0.1% cases to justify the 90% who will get wrecked financially because of major surgery, cancer treatment, etc because it's so expensive. Medical treatment shouldn't be a for profit business, there has to be a better way, and other countries have a better system (in the sense of doing the greatest good for the most people, and not just the 0.1%) than we do and we can copy the best of them as we will be doing it from scratch.
    - cptaj 7y ago
      I think it can be for profit but it needs regulation on how much you can bleed patients for. Selling pills for thousands of dollars when they cost you a dime to make is simply exploitative.
poilcn 7y ago
When an individual creates an enterprise it's expected to fail in 2 years. It does not mean death of the individual, but often it makes 'em go broke. Only one company in a hundred is successful. Other are doomed. Government-run projects do not live in alternative dimension. It is affected by the same things any private organization is affected. It is expected that a country would exist longer than an individual company. But want to bind the whole country to some huge bureaucratic organizations. Say, the one managing healthcare and the one managing pension founds. You won't stop at that, of course, but let's simplify to just that. There would be only two ways for them to survive in a long run. Bloating their budget, eating all other parts of the gov budget. After there is no where to "expand" (keeping the same quality of services), they would had to cut out some of their "clients". For a pension fund it would be to increase the age when people would be able to retire. For healthcare it would be to limit free services reject people who would be able to have certain services for free in certain cases, decrease quality of services. Then it would be inevitable death. As people are not immortal, organizations are not as well. If you had several private companies, the death of one of them would make others stronger. It would get rid of the weakest companies, keeping the strongest alive and in addition they would have opportunity to learn on errors of others. But you have one single company for each sector that manage the whole country. It results in country's collapse. There is no "mountain of evidence from other countries, showing the greatly reduced total costs and improved life expectancy as well as a lack of bankruptcy and financial ruin for those caught in an emergency". The idea of universal health care hasn't been tested by time yet (and in principal it will fail due to things I described above), so it's very reasonable that the US public rejects it.
- beepboopbeep 7y ago
  Wow. I hope you don't build models for a living.
- jshowa3 7y ago
  The idea of universal health care hasn't been tested by time yet (and in principal it will fail due to things I described above), so it's very reasonable that the US public rejects it. Uhhh... nearly every other country other than the US has had some form of national health service for decades and they spend less on healthcare per capita for comparable quality. What you're spouting is nonsense.
maximente 7y ago
> The US public does not want this, though evidence? from 2017 shows more support than not. https://www.pbs.org/newshour/health/62-percent-u-s-want-federal-government-ensure-health-care-poll-says https://www.pbs.org/newshour/health/62-percent-u-s-want-fede...
- bonestamp2 7y ago
  And I think a lot of the people who don't support it also don't fully understand it, or have a misconception about how it will negatively impact them based on a few anecdotes they've heard from countries that do have universal healthcare (some of which are true, and many of which are false).
dragonwriter 7y ago
> The US public does not want this That's far from clear. Polling fairly consistently shows that the US public favors at least some degree of it (particularly shifting the healthcare burden from employers to government, other benefits have less political salience), though any particular plan for the detailed mechanism may have trouble gaining majority support.
- joshypants 7y ago
  Yeah, more illustrative to say the US insurance industry does not want this.
- bllguo 7y ago
  But it seems like an apathetic kind of want. There are degrees imo; if the people truly wanted something they would exert more effort than this showing. As it stands people may say they want it in polls but won't even vote for politicians that will make it a reality.
  - kritiko 7y ago
    you have stories in the US of people dying from lack of access to insulin or rationing insulin.I wouldn't question that they "truly wanted" to live. but political organizing in the US around healthcare and other social benefits seems to pale in comparison to European countries. to say nothing of how low voter participation is.
    - bllguo 7y ago
      i feel like people take it personally when it's pointed out that political will in the US is, for lack of a better term, pathetically low
  - jack_jennings 7y ago
    Don’t confuse the apathy of the politicians that can run for office (and have the financial backing to do so), with the apathy of voters.
Reedx 7y ago
> All this despite the mountain of evidence from other countries, showing the greatly reduced total costs and improved life expectancy Does this account for confounding factors? Such as the US having the highest obesity rates, which has a massive impact on costs and life expectancy. I'm for universal healthcare, but "X has these results in Y, therefore it'll be the same in Z" is a poor argument and weakens the overall case.
- ska 7y ago
  There are lots of confounding factors, so predicting outcomes is a dodgy business. One thing that is easier to evaluate is the cost of delivering equivalent care - the US system turns out to be quite inefficient that way, which implies the potential for significant cost savings at least.
irrational 7y ago
>The US public does not want this I don't think this is true. I think what the US public doesn't want is the higher taxes to pay for it. We are already swimming in debt and wages haven't kept up with inflation. My daughter is making exactly the same wages now that I made when I was her age 25 years ago, in comparable jobs.
- munk-a 7y ago
  I think the US public doesn't want to lose more of their money to healthcare than it currently is - and this is the attack that's most commonly leveraged against universal healthcare... "Your taxes will go up!" well yes, they will, but my out of pocket will go down as I'll no longer be shoveling so much money from my salary (either pre- or post- collection) to health insurance.
  - subhobroto 7y ago
    You hit the nail on the head. I have written answers on Quora that show numbers to support your thoughts. I used to paste links to these posts here but people felt I was spamming, so I don't do that anymore. Feel free to look at my other comments and posts on Quora as well as reach out to me. We need more people like you to bring prosperity. The status quo will not bring us prosperity.
- jschwartzi 7y ago
  I pay $421/month for health insurance that has a 20% deductible, meaning that I could still be bankrupted by a major surgery or a couple of weeks in the hospital. I would much rather put that $421/month into taxes and have Medicaid or something similar A) keep costs down, and B) ensure an acceptable quality of treatment. You're likely paying something similar whether you realize it or not. When I quit my job the COBRA cost of the insurance was like $600 or $700/month. It's just that your employer is hiding that cost from you and giving you "free" medical insurance. And when you quit your job, you lose your medical insurance after 6 months. That means you lose access to your doctor and you may have to change who you see. Sometimes the new doctor is way worse, and there is a very real cost to you in terms of their standard of care. So it's pretty disingenuous to argue that this would be a new tax. And making it illegal for employers to offer health insurance while also expanding Medicaid to all Americans would actually remove a major barrier to quitting your job and EG starting a company or working for a small company.
bogomipz 7y ago
>"The US public does not want this, though" Could you share some data that supports this? Polls I have seen show that a majority of Americans support expanded health care coverage.[1][2][3] There is some division howwever on whether that is best done via Medicare For All or a regular single payer system. [1] https://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/ https://www.pewresearch.org/fact-tank/2018/10/03/most-contin... [2] https://www.kff.org/slideshow/public-opinion-on-single-payer-national-health-plans-and-expanding-access-to-medicare-coverage/ https://www.kff.org/slideshow/public-opinion-on-single-payer... [3] https://www.pewresearch.org/fact-tank/2017/01/13/more-americans-say-government-should-ensure-health-care-coverage/ https://www.pewresearch.org/fact-tank/2017/01/13/more-americ...
CodeWriter23 7y ago
> Then there is no risk to hiring a new employee beyond the wages you pay them. This is a gross oversimplification. Two risks that immediately come to mind, increases to the Employer’s Disability Insurance and Unemployment Insurance either through fraud(speaking from experience), or, in the scenario mentioned by gp, when you lay the worker off at the end of the need. My comment also is a gross oversimplification.
deleted 7y ago
[deleted]
slantedview 7y ago
> The US public does not want this, though Actually a majority of Americans support the idea of single payer healthcare [1], and the number goes up depending on how the question is asked. The problem is the political obstacles, which are enormous given the power of the health insurance, pharma, and hospital industries. https://www.kff.org/slideshow/public-opinion-on-single-payer-national-health-plans-and-expanding-access-to-medicare-coverage/ https://www.kff.org/slideshow/public-opinion-on-single-payer...
subhobroto 7y ago
> The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes Yes, it's clear that our prosperity hinges on how quickly we decouple health care from our employers. Employers don't want to be in the business of providing healthcare to their employees and its painfully obvious. I just don't understand why smart people think it's a good idea for anyone other than me decide what my healthcare needs are! I would like to have a separate discussion whether the government is the best party to handle this. If you look for my writing here and on Quora, you will see that I have for over a decade being campaigning the government was the best party, but after having really worked on it (thanks to people getting in touch with me from my writing), I no longer believe the government is the best partner. Instead, I think the government managed marketplace where people choose private insurance is actually a brilliant solution and ACA already provides that, so we already have that in place. The value the government brings here is extreme negotiating ability with the private insurance providers that individual citizens lack. > The US public does not want this I strongly disagree. I have spoken with far too many (thousands) of people to know that majority of the U.S. hate their employer provided insurance and are worse off for it. I can give you specific instances where an employee was worse off due to the employer provided insurance and had to declare bankruptcy due to medical bills than if they were unemployed to begin with and were on welfare instead! I seriously believe: 1. the tax incentives to provide employer provided insurance should be abolished. They made sense at a time that's past us now. 2. employers instead should be required to pay a premium for choosing to provide primary insurance to employees instead of letting employees continue with the coverage they have or get one from the marketplace 3. Employers are free to provide secondary and supplementary care insurance if they chose to, not due to regulation. This leaves behind only those employers who genuinely care about their employees instead of pretending to do something because someone forces them to. I support the individual mandate in the ACA because it ensures negative self selection in the marketplace. This will allow people to gain control of their own healthcare, get a benefit package that's more transparent and gain better control of their own lives. As software engineers, we are in the top tier of employment. We earn in the top tier of the population and handle levels of complexity in the top tier of the population. Our personal experiences don't reflect that of the general population. Even then, the engineer making $180k/yr at Microsoft might have a very different healthcare experience compared to the engineer making $180k/yr at Google depending on the choices that the benefits administrators at Microsoft and Google have made! That's just insane and a level of complexity that's just unnecessary.
m-p-3 7y ago
It makes me sick that so many Americans are willing to keep their taxes lower and pay their own healthcare insurance (which are absurdly high, and you still have premiums to pay, etc) instead of having the peace of mind that if they become seriously sick, that it won't ruin them and their close relatives. Sure, you might be healthy now but do you really want to take a gamble like this and keep more money in your wallet now, and potentially lose everything due to bad luck later? I guess it's the American way?
- FireBeyond 7y ago
  It blows my mind that deathbed divorces are a thing here, for fear of burdening families with medical bills. And that that is socially, in any way, acceptable, or even tolerable.
tathougies 7y ago
Alternatively, incentivize companies to offer more pay rather than healthcare. For example, by disallowing group bargaining for healthcare by an employer.
mrlala 7y ago
>The US public does not want this Yes, they do.
- DuskStar 7y ago
  It depends on how you phrase the question. "Do you want the US government to pay your health care bills" is a yes for most people. "Do you want to only have the choice of Veterans Affairs medical care" isn't quite as popular, and IMO that's what we'd end up with. (And considering the number of people who commit suicide by self-immolation to protest the VA's care... I really don't want that)
- kevingadd 7y ago
  If they want it why do they keep voting in representatives who actively fight it the whole way? This is kind of a pointless question, because the answer is complex and includes things like 'gerrymandering' and 'vote suppression', but it's still a fact that many elected representatives from both parties actively fight public health care.
ptaipale 7y ago
The strange thing here is that United States uses more public money to health care than European welfare states. So Americans already now pay more taxes for health than Europeans. Some aspects of the U.S. health care system are incredibly ineffective use of money. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm There are reasons for this; some of them good (the best care in the U.S. is very high quality and leading-edge technology, and consumer protection through litigation tries to minimize errors); some are bad (e.g. because of litigation, legal costs are very high, and the system seems to carry a lot of overheads, and many people still lack coverage). It seems the so-called Obamacare wasn't a very good approach, because so many people felt it was ripping them off. Clearly it is easier to build an efficient public health care system from nothing (like e.g. my country Finland did in 20th century) than transform an existing system (which the U.S. has and where there are lots of incumbent operators that have "assets" that they protect.
nitwit005 7y ago
> The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes. Or just disconnect this stuff from the employer. It seems strange that employers are involved in something like health insurance. It creates friction changing jobs, and much of the population isn't employed.
deathanatos 7y ago
> The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes. Then there is no risk to hiring a new employee beyond the wages you pay them. All that is needed is to undo employers providing health-care. The government could provide it, but it could also work akin to auto or home insurance where you the individual choose the company yourself. (I do think we need other reforms, principally price transparency, in order to manage the current cost problems w/ health care. There is no sane way for any person to evaluate anything about any insurance setup if they cannot gauge what it will cost them!) Tax-based universal healthcare would accomplish this, but I do not think it is necessarily the only option. It does need to stop being attached to the employer. Losing my job should not cost me my healthcare, too.
AnthonyMouse 7y ago
> The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes. Then there is no risk to hiring a new employee beyond the wages you pay them. That's still the same problem. If the taxes that fund the health care are paid by employees then a living wage would have to be higher to account for having to pay the taxes. If they're paid by the employer, there goes the money they were going to use to hire the employee, or they have to raise prices and we're back to causing a higher cost of living. Taxes aren't magic. The money still has to come from somewhere. The actual problem is that housing and health care cost too much. It's necessary to solve that regardless of who is paying for them, at which point there is no longer a pressing need to try to shift the burden somewhere else, because the burden is no longer so onerous.

bernawil 7y ago

I can think of several countries with universal healthcare where hiring is still complicated to say the least. Not arguing it would still help, though!

ancorevard 7y ago
Welcome to Europe.

HillaryBriss 7y ago

> Then there is no risk to hiring a new employee beyond the wages you pay them. but you must not forget the additional administrative/accounting overhead, the risk from the wide variety of lawsuits one is vulnerable to as an employer, the risks of employee injury on the job, and costs associated with the possibility of laying off employees in the future. surely there are more costs than just wages.

jher17 7y ago
Sure. But this is the responsibility an employer must take on in order to hire someone’s labor.

intortus 7y ago

> The US public does not want this A majority does, in fact, want this. https://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/ https://www.pewresearch.org/fact-tank/2018/10/03/most-contin...

djsumdog 7y ago

In America, you have to work until you die. The major thing the gig economy takes from people is health care. It's insanely expensive, and the Affordable Care Act is a terrible shamble of broken policy. I spent time outside of the US and came back to find health care worse than when I left it: https://fightthefuture.org/article/returning-to-america-and-the-unaffordable-care-act/ https://fightthefuture.org/article/returning-to-america-and-... I have a friend who has been fighting brain cancer for over a year. The small company he was working for let him go (although they wouldn't admit it; it was likely over his condition) and his wife has to constant fight her own company's insurance company/policy to get treatments covered (and she is a lawyer; who literally works for a law firm doing mostly corporate liability cases). In any EU country, you get a terminal illness, you can take time off and live your life. Will you get the same level of treatment as you would in the US? Who cares. You get treatment, and you can spent time with the people you love and appreciate things until you get better or your friends say goodbye. In America, if you do not have a spouse, you just have to keep working until you can't any more .. and then you die.

jchallis 7y ago
Based on the very large revenue from foreign patients who come to America to get cancer treatment on their own dime, those patients and their families care about getting the best treatment.
- stjohnswarts 7y ago
  You can't use the 0.1% cases to justify the 90% who will get wrecked financially because of major surgery, cancer treatment, etc because it's so expensive. Medical treatment shouldn't be a for profit business, there has to be a better way, and other countries have a better system (in the sense of doing the greatest good for the most people, and not just the 0.1%) than we do and we can copy the best of them as we will be doing it from scratch.
  - cptaj 7y ago
    I think it can be for profit but it needs regulation on how much you can bleed patients for. Selling pills for thousands of dollars when they cost you a dime to make is simply exploitative.

poilcn 7y ago

When an individual creates an enterprise it's expected to fail in 2 years. It does not mean death of the individual, but often it makes 'em go broke. Only one company in a hundred is successful. Other are doomed. Government-run projects do not live in alternative dimension. It is affected by the same things any private organization is affected. It is expected that a country would exist longer than an individual company. But want to bind the whole country to some huge bureaucratic organizations. Say, the one managing healthcare and the one managing pension founds. You won't stop at that, of course, but let's simplify to just that. There would be only two ways for them to survive in a long run. Bloating their budget, eating all other parts of the gov budget. After there is no where to "expand" (keeping the same quality of services), they would had to cut out some of their "clients". For a pension fund it would be to increase the age when people would be able to retire. For healthcare it would be to limit free services reject people who would be able to have certain services for free in certain cases, decrease quality of services. Then it would be inevitable death. As people are not immortal, organizations are not as well. If you had several private companies, the death of one of them would make others stronger. It would get rid of the weakest companies, keeping the strongest alive and in addition they would have opportunity to learn on errors of others. But you have one single company for each sector that manage the whole country. It results in country's collapse. There is no "mountain of evidence from other countries, showing the greatly reduced total costs and improved life expectancy as well as a lack of bankruptcy and financial ruin for those caught in an emergency". The idea of universal health care hasn't been tested by time yet (and in principal it will fail due to things I described above), so it's very reasonable that the US public rejects it.

beepboopbeep 7y ago
Wow. I hope you don't build models for a living.
jshowa3 7y ago
The idea of universal health care hasn't been tested by time yet (and in principal it will fail due to things I described above), so it's very reasonable that the US public rejects it. Uhhh... nearly every other country other than the US has had some form of national health service for decades and they spend less on healthcare per capita for comparable quality. What you're spouting is nonsense.

maximente 7y ago

> The US public does not want this, though evidence? from 2017 shows more support than not. https://www.pbs.org/newshour/health/62-percent-u-s-want-federal-government-ensure-health-care-poll-says https://www.pbs.org/newshour/health/62-percent-u-s-want-fede...

bonestamp2 7y ago
And I think a lot of the people who don't support it also don't fully understand it, or have a misconception about how it will negatively impact them based on a few anecdotes they've heard from countries that do have universal healthcare (some of which are true, and many of which are false).

dragonwriter 7y ago

> The US public does not want this That's far from clear. Polling fairly consistently shows that the US public favors at least some degree of it (particularly shifting the healthcare burden from employers to government, other benefits have less political salience), though any particular plan for the detailed mechanism may have trouble gaining majority support.

joshypants 7y ago
Yeah, more illustrative to say the US insurance industry does not want this.
bllguo 7y ago
But it seems like an apathetic kind of want. There are degrees imo; if the people truly wanted something they would exert more effort than this showing. As it stands people may say they want it in polls but won't even vote for politicians that will make it a reality.
- kritiko 7y ago
  you have stories in the US of people dying from lack of access to insulin or rationing insulin.I wouldn't question that they "truly wanted" to live. but political organizing in the US around healthcare and other social benefits seems to pale in comparison to European countries. to say nothing of how low voter participation is.
  - bllguo 7y ago
    i feel like people take it personally when it's pointed out that political will in the US is, for lack of a better term, pathetically low
- jack_jennings 7y ago
  Don’t confuse the apathy of the politicians that can run for office (and have the financial backing to do so), with the apathy of voters.

Reedx 7y ago

> All this despite the mountain of evidence from other countries, showing the greatly reduced total costs and improved life expectancy Does this account for confounding factors? Such as the US having the highest obesity rates, which has a massive impact on costs and life expectancy. I'm for universal healthcare, but "X has these results in Y, therefore it'll be the same in Z" is a poor argument and weakens the overall case.

ska 7y ago
There are lots of confounding factors, so predicting outcomes is a dodgy business. One thing that is easier to evaluate is the cost of delivering equivalent care - the US system turns out to be quite inefficient that way, which implies the potential for significant cost savings at least.

irrational 7y ago

>The US public does not want this I don't think this is true. I think what the US public doesn't want is the higher taxes to pay for it. We are already swimming in debt and wages haven't kept up with inflation. My daughter is making exactly the same wages now that I made when I was her age 25 years ago, in comparable jobs.

munk-a 7y ago
I think the US public doesn't want to lose more of their money to healthcare than it currently is - and this is the attack that's most commonly leveraged against universal healthcare... "Your taxes will go up!" well yes, they will, but my out of pocket will go down as I'll no longer be shoveling so much money from my salary (either pre- or post- collection) to health insurance.
- subhobroto 7y ago
  You hit the nail on the head. I have written answers on Quora that show numbers to support your thoughts. I used to paste links to these posts here but people felt I was spamming, so I don't do that anymore. Feel free to look at my other comments and posts on Quora as well as reach out to me. We need more people like you to bring prosperity. The status quo will not bring us prosperity.
jschwartzi 7y ago
I pay $421/month for health insurance that has a 20% deductible, meaning that I could still be bankrupted by a major surgery or a couple of weeks in the hospital. I would much rather put that $421/month into taxes and have Medicaid or something similar A) keep costs down, and B) ensure an acceptable quality of treatment. You're likely paying something similar whether you realize it or not. When I quit my job the COBRA cost of the insurance was like $600 or $700/month. It's just that your employer is hiding that cost from you and giving you "free" medical insurance. And when you quit your job, you lose your medical insurance after 6 months. That means you lose access to your doctor and you may have to change who you see. Sometimes the new doctor is way worse, and there is a very real cost to you in terms of their standard of care. So it's pretty disingenuous to argue that this would be a new tax. And making it illegal for employers to offer health insurance while also expanding Medicaid to all Americans would actually remove a major barrier to quitting your job and EG starting a company or working for a small company.

bogomipz 7y ago

>"The US public does not want this, though" Could you share some data that supports this? Polls I have seen show that a majority of Americans support expanded health care coverage.[1][2][3] There is some division howwever on whether that is best done via Medicare For All or a regular single payer system. [1] https://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/ https://www.pewresearch.org/fact-tank/2018/10/03/most-contin... [2] https://www.kff.org/slideshow/public-opinion-on-single-payer-national-health-plans-and-expanding-access-to-medicare-coverage/ https://www.kff.org/slideshow/public-opinion-on-single-payer... [3] https://www.pewresearch.org/fact-tank/2017/01/13/more-americans-say-government-should-ensure-health-care-coverage/ https://www.pewresearch.org/fact-tank/2017/01/13/more-americ...

CodeWriter23 7y ago

> Then there is no risk to hiring a new employee beyond the wages you pay them. This is a gross oversimplification. Two risks that immediately come to mind, increases to the Employer’s Disability Insurance and Unemployment Insurance either through fraud(speaking from experience), or, in the scenario mentioned by gp, when you lay the worker off at the end of the need. My comment also is a gross oversimplification.

deleted 7y ago

[deleted]

slantedview 7y ago

> The US public does not want this, though Actually a majority of Americans support the idea of single payer healthcare [1], and the number goes up depending on how the question is asked. The problem is the political obstacles, which are enormous given the power of the health insurance, pharma, and hospital industries. https://www.kff.org/slideshow/public-opinion-on-single-payer-national-health-plans-and-expanding-access-to-medicare-coverage/ https://www.kff.org/slideshow/public-opinion-on-single-payer...

subhobroto 7y ago

> The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes Yes, it's clear that our prosperity hinges on how quickly we decouple health care from our employers. Employers don't want to be in the business of providing healthcare to their employees and its painfully obvious. I just don't understand why smart people think it's a good idea for anyone other than me decide what my healthcare needs are! I would like to have a separate discussion whether the government is the best party to handle this. If you look for my writing here and on Quora, you will see that I have for over a decade being campaigning the government was the best party, but after having really worked on it (thanks to people getting in touch with me from my writing), I no longer believe the government is the best partner. Instead, I think the government managed marketplace where people choose private insurance is actually a brilliant solution and ACA already provides that, so we already have that in place. The value the government brings here is extreme negotiating ability with the private insurance providers that individual citizens lack. > The US public does not want this I strongly disagree. I have spoken with far too many (thousands) of people to know that majority of the U.S. hate their employer provided insurance and are worse off for it. I can give you specific instances where an employee was worse off due to the employer provided insurance and had to declare bankruptcy due to medical bills than if they were unemployed to begin with and were on welfare instead! I seriously believe: 1. the tax incentives to provide employer provided insurance should be abolished. They made sense at a time that's past us now. 2. employers instead should be required to pay a premium for choosing to provide primary insurance to employees instead of letting employees continue with the coverage they have or get one from the marketplace 3. Employers are free to provide secondary and supplementary care insurance if they chose to, not due to regulation. This leaves behind only those employers who genuinely care about their employees instead of pretending to do something because someone forces them to. I support the individual mandate in the ACA because it ensures negative self selection in the marketplace. This will allow people to gain control of their own healthcare, get a benefit package that's more transparent and gain better control of their own lives. As software engineers, we are in the top tier of employment. We earn in the top tier of the population and handle levels of complexity in the top tier of the population. Our personal experiences don't reflect that of the general population. Even then, the engineer making $180k/yr at Microsoft might have a very different healthcare experience compared to the engineer making $180k/yr at Google depending on the choices that the benefits administrators at Microsoft and Google have made! That's just insane and a level of complexity that's just unnecessary.

m-p-3 7y ago

It makes me sick that so many Americans are willing to keep their taxes lower and pay their own healthcare insurance (which are absurdly high, and you still have premiums to pay, etc) instead of having the peace of mind that if they become seriously sick, that it won't ruin them and their close relatives. Sure, you might be healthy now but do you really want to take a gamble like this and keep more money in your wallet now, and potentially lose everything due to bad luck later? I guess it's the American way?

FireBeyond 7y ago
It blows my mind that deathbed divorces are a thing here, for fear of burdening families with medical bills. And that that is socially, in any way, acceptable, or even tolerable.

tathougies 7y ago

Alternatively, incentivize companies to offer more pay rather than healthcare. For example, by disallowing group bargaining for healthcare by an employer.

mrlala 7y ago

>The US public does not want this Yes, they do.

DuskStar 7y ago
It depends on how you phrase the question. "Do you want the US government to pay your health care bills" is a yes for most people. "Do you want to only have the choice of Veterans Affairs medical care" isn't quite as popular, and IMO that's what we'd end up with. (And considering the number of people who commit suicide by self-immolation to protest the VA's care... I really don't want that)
kevingadd 7y ago
If they want it why do they keep voting in representatives who actively fight it the whole way? This is kind of a pointless question, because the answer is complex and includes things like 'gerrymandering' and 'vote suppression', but it's still a fact that many elected representatives from both parties actively fight public health care.

ptaipale 7y ago

The strange thing here is that United States uses more public money to health care than European welfare states. So Americans already now pay more taxes for health than Europeans. Some aspects of the U.S. health care system are incredibly ineffective use of money. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm There are reasons for this; some of them good (the best care in the U.S. is very high quality and leading-edge technology, and consumer protection through litigation tries to minimize errors); some are bad (e.g. because of litigation, legal costs are very high, and the system seems to carry a lot of overheads, and many people still lack coverage). It seems the so-called Obamacare wasn't a very good approach, because so many people felt it was ripping them off. Clearly it is easier to build an efficient public health care system from nothing (like e.g. my country Finland did in 20th century) than transform an existing system (which the U.S. has and where there are lots of incumbent operators that have "assets" that they protect.

nitwit005 7y ago

> The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes. Or just disconnect this stuff from the employer. It seems strange that employers are involved in something like health insurance. It creates friction changing jobs, and much of the population isn't employed.

deathanatos 7y ago

> The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes. Then there is no risk to hiring a new employee beyond the wages you pay them. All that is needed is to undo employers providing health-care. The government could provide it, but it could also work akin to auto or home insurance where you the individual choose the company yourself. (I do think we need other reforms, principally price transparency, in order to manage the current cost problems w/ health care. There is no sane way for any person to evaluate anything about any insurance setup if they cannot gauge what it will cost them!) Tax-based universal healthcare would accomplish this, but I do not think it is necessarily the only option. It does need to stop being attached to the employer. Losing my job should not cost me my healthcare, too.

AnthonyMouse 7y ago

> The way to protect workers is to shift the burden of health care and other costly benefits onto the government, supported by taxes. Then there is no risk to hiring a new employee beyond the wages you pay them. That's still the same problem. If the taxes that fund the health care are paid by employees then a living wage would have to be higher to account for having to pay the taxes. If they're paid by the employer, there goes the money they were going to use to hire the employee, or they have to raise prices and we're back to causing a higher cost of living. Taxes aren't magic. The money still has to come from somewhere. The actual problem is that housing and health care cost too much. It's necessary to solve that regardless of who is paying for them, at which point there is no longer a pressing need to try to shift the burden somewhere else, because the burden is no longer so onerous.