5 ms·

> I don't understand how people can be so anti-universal healthcare in the US. Because I have zero faith that it will end up costing me less, and have a simila

by xienze 5y ago

> I don't understand how people can be so anti-universal healthcare in the US. Because I have zero faith that it will end up costing me less, and have a similar level of quality. I’m in tech. Combined HHI is something in the $200s. I pay about $300 per month for the entire family, $5K out of pocket max. So in a worst case scenario, let’s say healthcare costs me $9K per year. That’s what, 4% of my HHI? Will a universal healthcare plan hit me via taxes for 4% or less? Fat fucking chance. And again, we’re not even talking about quality of care, just price. In the end, the poor will benefit greatly, the rich will carry on as usual, and people in the middle will get squeezed to death.

bananapub 5y ago
yikes, dude.
gambiting 5y ago
I....just have no words. Do you really believe everything you wrote? And like....that's probably the worst example of individualism and "me first" attitude I've seen on this website.
- disgruntledphd2 5y ago
  My favourite assumption is that people with 200k household income are in the middle. Mind you, that kind of belief is super common amongst people (like me) who are in the top decile of income.
ceejayoz 5y ago
> Because I have zero faith that it will end up costing me less, and have a similar level of quality. The US spends 2-3x per capita (counting both public and private spending; https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm) than the rest of the OECD, with remarkably similar health outcomes. > I pay about $300 per month for the entire family, $5K out of pocket max. You're just paying your healthcare tax to your employer (in the form of lost salary; they're not chipping in the other $1-2k/month out of charity) instead of the government. It's silly to only count your contribution instead of the overall per-capita cost of healthcare.
- simonh 5y ago
  The problem is the anti-single payer faction in the US is large, powerful and well funded. They would do their level best to cripple any such system as badly as possible, so they could say "I told you so", as they did with Obamacare. Therefore it is quite possible a single payer system in the US would not work out anywhere near as good a deal as it has almost everywhere else. It's hard to believe it could possibly still end up worse than the current system, but I worry that it would be a 'hold my beer' moment.
- dwater 5y ago
  Just to make this point explicit: Your health care does not cost $300 a month. Your employer is paying for it as well, and as ceejayoz suggested it might be $1-2k a month. Add that in to your calculations.
boopboopbadoop 5y ago
Do you plan to retire? What will happen then? Do your family and friends have the same insurance plan? What will happen to them if they don’t? Seems short-sighted, yet telling, to talk only about the present time, and only about yourself.
- runako 5y ago
  > Do you plan to retire? What will happen then? When people retire, they are automatically covered by the socialized Medicare insurance program. Medicare is extremely popular among its recipients, many of whom nonetheless oppose socialized medicine for the general populace.
  - boopboopbadoop 5y ago
    I wasn’t aware of that. Is there a minimum age to qualify? I remember hearing some stories coming out of the 2016 election similar to what you mentioned, the hypocrisy/irony is palpable.
    - runako 5y ago
      Medicare is available to Americans 65 and over, regardless of income or assets. One of the proposed means to improve our healthcare system is to reduce that age from 65, potentially to as low as 0.
yunohn 5y ago
> In the end, the poor will benefit greatly, the rich will carry on as usual, and people in the middle will get squeezed to death. While I disagree with nearly all of your post, I can find reason in the closing statement. I feel like this logic often evades the people asking for higher taxes to support their causes. It’s always the middle class that ends up paying for it. It creates a lot of resentment which is exactly what fuels the rest of your post. I wish there was a way this could be avoided, but obviously, it’s by design.
- wonderwonder 5y ago
  This is a systematic issue though, not an intent problem. Why do the middle class end up paying for it while the rich which own 40% of the assets don't? Due to lobbying and constantly electing politicians that are the same over and over again. The top 10% in the US own 70% of the assets. Just make the rich pay their taxes and the situation is resolved but we just keep gouging the middle class. Middle class should establish a fund to pay for lobbyists.
  - yunohn 5y ago
    > This is a systematic issue though, not an intent problem. It’s definitely systemic/systematic, but it’s also intent? The tax system is intentionally designed by the ruling/wealth classes to extract the working classes money. Each individual tax may not have this explicit intent, but the sheer number of loopholes and bypasses are omnipresent.
    - wonderwonder 5y ago
      Sorry, yes, meant its not the intent of the middle class. Its absolutely the intent of the rich, large corporations and their lobbyists.
scoutt 5y ago
What if you get a stroke tomorrow and you can't work anymore? > In the end, the poor will benefit greatly "The true measure of any society can be found in how it treats its most vulnerable members." -Gandhi.
AlexTWithBeard 5y ago
That $300 per month you're paying for the whole family - does it include employer's contribution? From my experience, a decent insurance for the family is somewhere in $20k-ish range per year, which is closer to 10% of your income. This lines up with 10% UK National Health Services charges HM's subjects. It will not have a similar level of quality though, forget it. The lines will get longer and the definition of "medically necessary" will become way more frugal. And for your income level it probably won't cost you less. Neither for mine. Nor for that of many HN users. But it will solve SO MANY annoying problems for so many people at once that I still think it's justified. First, losing job does will not mean you're losing your medical coverage. You probably have not lost a job for a prolonged period of time. Neither did I. But the fact that it might potentially happen gives me uneasy feeling. If (when?) I lose my job, medical insurance will be the single biggest charge on my account, probably more than all other stuff combined. Second, all these infamous cases when someone with insurance was admitted into the hospital, but then it suddenly turned out some junior aide to the senior anesthesiologist is out of network, therefore the insurance won't pay him. This doesn't happen often enough for most people to start pestering their congressmen, but it nevertheless happens. Third, it will make the gap between salaried employees and contractors smaller. There are a lot of talks about whether such-and-such is actually not a contractor, but a salaried employee. And usually it all drills down to the benefits the person receives. One of the ways of solving this problem is making the benefits the same for contractors and for the employees. While it will not close the gap completely, it will make it more palatable. Fourth, those willing to get a higher level of service will be able to buy private insurance. In countries with national healthcare private medical insurance is cheap - may be 10% of what we're paying now. I can keep going. The trick is that none of these cases on its own is big enough to affect the majority of population, but combined I'm sure each of us will eventually be hit by one of them.
simonh 5y ago
You also pay for Medicare, Medicaid, CHIP, health care exchange subsidies and lots more through your general taxes. This comes to $1.5 Trillion in Federal health care spending per year, or 8% of GDP funded by your taxes. It turns out 8% of GDP is almost exactly what the UK spends on health care in total, including public and private spending. So your taxes to the federal government are paying about the same proportionately that we are for health care here in the UK, and you are also paying thousands of dollars a year for private health care on top. There's no way to spin this, you are getting utterly and completely shafted. As it happens I also get private health care through my employer in the UK, but it only costs me £380 per year because the vast majority of my health care needs are met by the NHS promptly and to an excellent standard. The private top-up care only matters in truly exceptional situations, and even then it's mainly about comfort and maybe bypassing a queue for non-urgent care. Bearing in mind all the care I and my family have received over the years, and the zero stress I have ever had about affording it, I pay my taxes to the NHS with a happy heart.
runako 5y ago
For non-Americans reading this: $300/month is not a health insurance cost for a family anywhere in the United States. Either a) the employer is eating most of the cost or b) this is not what you have in mind when you think "health insurance". A typical health insurance plan for a family of 4 costs closer to $1,500-$2,500 per month in the US if you are looking for something close(r) to the level of coverage available in socialized medicine countries (or in the parts of the US medical system that are socialized). That cost is on top of the automatic taxes we pay to cover Medicare, Medicaid, and the VA medical system (these 3 together account for a majority of US healthcare spending).

by xienze 5y ago

bananapub 5y ago

yikes, dude.

gambiting 5y ago

I....just have no words. Do you really believe everything you wrote? And like....that's probably the worst example of individualism and "me first" attitude I've seen on this website.

disgruntledphd2 5y ago
My favourite assumption is that people with 200k household income are in the middle. Mind you, that kind of belief is super common amongst people (like me) who are in the top decile of income.

ceejayoz 5y ago

> Because I have zero faith that it will end up costing me less, and have a similar level of quality. The US spends 2-3x per capita (counting both public and private spending; https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm) than the rest of the OECD, with remarkably similar health outcomes. > I pay about $300 per month for the entire family, $5K out of pocket max. You're just paying your healthcare tax to your employer (in the form of lost salary; they're not chipping in the other $1-2k/month out of charity) instead of the government. It's silly to only count your contribution instead of the overall per-capita cost of healthcare.

simonh 5y ago
The problem is the anti-single payer faction in the US is large, powerful and well funded. They would do their level best to cripple any such system as badly as possible, so they could say "I told you so", as they did with Obamacare. Therefore it is quite possible a single payer system in the US would not work out anywhere near as good a deal as it has almost everywhere else. It's hard to believe it could possibly still end up worse than the current system, but I worry that it would be a 'hold my beer' moment.
dwater 5y ago
Just to make this point explicit: Your health care does not cost $300 a month. Your employer is paying for it as well, and as ceejayoz suggested it might be $1-2k a month. Add that in to your calculations.

boopboopbadoop 5y ago

Do you plan to retire? What will happen then? Do your family and friends have the same insurance plan? What will happen to them if they don’t? Seems short-sighted, yet telling, to talk only about the present time, and only about yourself.

runako 5y ago
> Do you plan to retire? What will happen then? When people retire, they are automatically covered by the socialized Medicare insurance program. Medicare is extremely popular among its recipients, many of whom nonetheless oppose socialized medicine for the general populace.
- boopboopbadoop 5y ago
  I wasn’t aware of that. Is there a minimum age to qualify? I remember hearing some stories coming out of the 2016 election similar to what you mentioned, the hypocrisy/irony is palpable.
  - runako 5y ago
    Medicare is available to Americans 65 and over, regardless of income or assets. One of the proposed means to improve our healthcare system is to reduce that age from 65, potentially to as low as 0.

yunohn 5y ago

> In the end, the poor will benefit greatly, the rich will carry on as usual, and people in the middle will get squeezed to death. While I disagree with nearly all of your post, I can find reason in the closing statement. I feel like this logic often evades the people asking for higher taxes to support their causes. It’s always the middle class that ends up paying for it. It creates a lot of resentment which is exactly what fuels the rest of your post. I wish there was a way this could be avoided, but obviously, it’s by design.

wonderwonder 5y ago
This is a systematic issue though, not an intent problem. Why do the middle class end up paying for it while the rich which own 40% of the assets don't? Due to lobbying and constantly electing politicians that are the same over and over again. The top 10% in the US own 70% of the assets. Just make the rich pay their taxes and the situation is resolved but we just keep gouging the middle class. Middle class should establish a fund to pay for lobbyists.
- yunohn 5y ago
  > This is a systematic issue though, not an intent problem. It’s definitely systemic/systematic, but it’s also intent? The tax system is intentionally designed by the ruling/wealth classes to extract the working classes money. Each individual tax may not have this explicit intent, but the sheer number of loopholes and bypasses are omnipresent.
  - wonderwonder 5y ago
    Sorry, yes, meant its not the intent of the middle class. Its absolutely the intent of the rich, large corporations and their lobbyists.

scoutt 5y ago

What if you get a stroke tomorrow and you can't work anymore? > In the end, the poor will benefit greatly "The true measure of any society can be found in how it treats its most vulnerable members." -Gandhi.

AlexTWithBeard 5y ago

That $300 per month you're paying for the whole family - does it include employer's contribution? From my experience, a decent insurance for the family is somewhere in $20k-ish range per year, which is closer to 10% of your income. This lines up with 10% UK National Health Services charges HM's subjects. It will not have a similar level of quality though, forget it. The lines will get longer and the definition of "medically necessary" will become way more frugal. And for your income level it probably won't cost you less. Neither for mine. Nor for that of many HN users. But it will solve SO MANY annoying problems for so many people at once that I still think it's justified. First, losing job does will not mean you're losing your medical coverage. You probably have not lost a job for a prolonged period of time. Neither did I. But the fact that it might potentially happen gives me uneasy feeling. If (when?) I lose my job, medical insurance will be the single biggest charge on my account, probably more than all other stuff combined. Second, all these infamous cases when someone with insurance was admitted into the hospital, but then it suddenly turned out some junior aide to the senior anesthesiologist is out of network, therefore the insurance won't pay him. This doesn't happen often enough for most people to start pestering their congressmen, but it nevertheless happens. Third, it will make the gap between salaried employees and contractors smaller. There are a lot of talks about whether such-and-such is actually not a contractor, but a salaried employee. And usually it all drills down to the benefits the person receives. One of the ways of solving this problem is making the benefits the same for contractors and for the employees. While it will not close the gap completely, it will make it more palatable. Fourth, those willing to get a higher level of service will be able to buy private insurance. In countries with national healthcare private medical insurance is cheap - may be 10% of what we're paying now. I can keep going. The trick is that none of these cases on its own is big enough to affect the majority of population, but combined I'm sure each of us will eventually be hit by one of them.

simonh 5y ago

You also pay for Medicare, Medicaid, CHIP, health care exchange subsidies and lots more through your general taxes. This comes to $1.5 Trillion in Federal health care spending per year, or 8% of GDP funded by your taxes. It turns out 8% of GDP is almost exactly what the UK spends on health care in total, including public and private spending. So your taxes to the federal government are paying about the same proportionately that we are for health care here in the UK, and you are also paying thousands of dollars a year for private health care on top. There's no way to spin this, you are getting utterly and completely shafted. As it happens I also get private health care through my employer in the UK, but it only costs me £380 per year because the vast majority of my health care needs are met by the NHS promptly and to an excellent standard. The private top-up care only matters in truly exceptional situations, and even then it's mainly about comfort and maybe bypassing a queue for non-urgent care. Bearing in mind all the care I and my family have received over the years, and the zero stress I have ever had about affording it, I pay my taxes to the NHS with a happy heart.

runako 5y ago

For non-Americans reading this: $300/month is not a health insurance cost for a family anywhere in the United States. Either a) the employer is eating most of the cost or b) this is not what you have in mind when you think "health insurance". A typical health insurance plan for a family of 4 costs closer to $1,500-$2,500 per month in the US if you are looking for something close(r) to the level of coverage available in socialized medicine countries (or in the parts of the US medical system that are socialized). That cost is on top of the automatic taxes we pay to cover Medicare, Medicaid, and the VA medical system (these 3 together account for a majority of US healthcare spending).