5 ms·

It would be shocking if it didn’t

ceejayoz 5y ago
No, it wouldn't. The European single-payer systems pay half what we do per-capita, factoring in private and public spending in both systems. The US system is wildly cost inefficient. See the chart at https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm
- rootusrootus 5y ago
  Of course it'll raise tax rates. That money does come from somewhere. The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit.
  - ceejayoz 5y ago
    If I pay $10 in tax to save me $20 in costs, I'm not inclined to see that as a tax hike.
    - endisneigh 5y ago
      It’s still a tax hike, regardless of your rationalizing
      - ceejayoz 5y ago
        Then a focus on tax rates instead of total cost is entirely disingenuous.
        endisneigh 5y ago
        Not really, there are people who get great health care for free from their employer, and others who get a greatly discounted rate. Their employers will not necessarily savings with their employees. The result for these employees could be more taxes for the same or worse care they’re already receiving. In aggregate I believe it’s the right move but let’s not act like everyone wins here.
        DaveExeter 5y ago
        > Not really, there are people who get great health care for free from their employer It is not 'for free' it is part of your compensation! It's like saying your employer pays 6.2% + 1.45% in SS/Medicaid taxes 'for free'. That is part of your compensation.
        endisneigh 5y ago
        I meant free in that you don’t pay a premium, but fair point.
        ceejayoz 5y ago
        > Not really, there are people who get great health care for free from their employer, and others are a greatly discounted rate, who will not necessarily share savings with their employees. Then require that savings be shared. Make it a legal requirement that any company that has employer-provided healthcare must rebate employees the premium costs if they opt-out.
        endisneigh 5y ago
        That makes no sense, salaries would simply be adjusted to compensate. The kind of bureaucracy you’re proposing is why things are already so complicated to begin with.
        ceejayoz 5y ago
        > That makes no sense, salaries would simply be adjusted to compensate. If you cut the salaries of employees who opt-out, but not those who don't, you'd be in very clear violation of the law I'm suggesting.
        endisneigh 5y ago
        No, what I’m saying is that they wouldn’t offer an alternative to the state run health care, as why would they anymore? No incentive.
      - throw0101a 5y ago
        > It’s still a tax hike, regardless of your rationalizing You're already paying for health care coverage via monthly/annual premiums and via reduced salaries where your employer's portion is part of the 'total compensation' you get (but doesn't show up in your pay check). Even if the amount at the end stays exactly the same it may be an improvement because (a) there are no "in network" worries about going to the "wrong" hospital or getting the "wrong" doctor", and (b) it is universal coverage so (i) you may not have to worry about losing your job and losing coverage as well as (ii) you can change jobs and have the same (universal) coverage.
    - rootusrootus 5y ago
      That assumes you get the cost saving. If my company stopped paying for my insurance benefit and instead gave that money to me directly, and then I bought the cheapest plan I could find on the insurance exchange ... I'd be paying more, not less. By a fair amount.
      - ceejayoz 5y ago
        That seems readily fixable; make it a legal requirement that companies that provide employer-provided healthcare pay the premium to the employee if they opt out.
        rootusrootus 5y ago
        In my case the premium wouldn't even come close to the marketplace cost. I'd be losing overall.
        ceejayoz 5y ago
        https://www.peoplekeep.com/blog/which-health-insurance-costs-more-employer-coverage-or-aca-plans https://www.peoplekeep.com/blog/which-health-insurance-costs... > Nationally, the analysis found that individual ACA Marketplace premiums are 10 percent lower than the average employer-sponsored insurance premium, after the adjustments. (Which makes sense; it's a very large risk group.)
        rootusrootus 5y ago
        Okay, then congratulate my employer for beating the odds, I guess.
      - mypalmike 5y ago
        Numbers, please. This kind of claim is just mythology unless you have numbers to back it up.
      - mattmcknight 5y ago
        Is this because your employer is paying part of the cost for the plan?
  - daenz 5y ago
    >The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit. I don't think that's even a question. The answer is no, they won't.
  - xienze 5y ago
    > The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit. Spoiler: they won’t. They’ll spin not having to pay a premium as a pay raise.
- donatj 5y ago
  I think the idea that anything that worked in Europe would work here as well as there without inherent corruption and rent seeking is laughable.
  - ceejayoz 5y ago
    The idea that the US is uniquely corrupt and rent-seek-y seems laughable. There's no corruption in Italy? Eastern Europe?
- endisneigh 5y ago
  The amount paid per capita and whether you would pay more taxes are not exclusive things. I’m not sure why people keep bringing up Europe - the USA is not Europe. For one doctors are paid more in the USA compared to Europe, medicine is more expensive here, more of the R and D originates here, etc
  - Ekaros 5y ago
    Maybe good question to ask is what makes it more expensive? Is it bloated administration and insurance system? Or is there some fundamental other difference?
    - deleted 5y ago
      [deleted]
    - _-david-_ 5y ago
      One reason is it is expensive to fund the research and testing and so the companies need to recoup that cost. They cannot in Europe and Canada due to price controls which means people in the US offset the cost. The US is basically subsidizing other Western countries.
      - nceqs3 5y ago
        ^This guy gets it. Also, in nearly every parliamentary system the state's ability to quickly invalidate patents by an act of parliament gives them even more leverage in the negotiations with drug companies.
  - heavyset_go 5y ago
    A lot of that R&D is already funded with our taxes via the NIH.
    - bdzr 5y ago
      A significant portion is not. Clinical trials are unbelievably expensive, see https://www.science.org/content/blog-post/drugs-come-comprehensive-look https://www.science.org/content/blog-post/drugs-come-compreh....
- newaccount2021 5y ago

No, it wouldn't. The European single-payer systems pay half what we do per-capita, factoring in private and public spending in both systems. The US system is wildly cost inefficient. See the chart at https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm

rootusrootus 5y ago
Of course it'll raise tax rates. That money does come from somewhere. The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit.
- ceejayoz 5y ago
  If I pay $10 in tax to save me $20 in costs, I'm not inclined to see that as a tax hike.
  - endisneigh 5y ago
    It’s still a tax hike, regardless of your rationalizing
    - ceejayoz 5y ago
      Then a focus on tax rates instead of total cost is entirely disingenuous.
      - endisneigh 5y ago
        Not really, there are people who get great health care for free from their employer, and others who get a greatly discounted rate. Their employers will not necessarily savings with their employees. The result for these employees could be more taxes for the same or worse care they’re already receiving. In aggregate I believe it’s the right move but let’s not act like everyone wins here.
        DaveExeter 5y ago
        > Not really, there are people who get great health care for free from their employer It is not 'for free' it is part of your compensation! It's like saying your employer pays 6.2% + 1.45% in SS/Medicaid taxes 'for free'. That is part of your compensation.
        endisneigh 5y ago
        I meant free in that you don’t pay a premium, but fair point.
        ceejayoz 5y ago
        > Not really, there are people who get great health care for free from their employer, and others are a greatly discounted rate, who will not necessarily share savings with their employees. Then require that savings be shared. Make it a legal requirement that any company that has employer-provided healthcare must rebate employees the premium costs if they opt-out.
        endisneigh 5y ago
        That makes no sense, salaries would simply be adjusted to compensate. The kind of bureaucracy you’re proposing is why things are already so complicated to begin with.
        ceejayoz 5y ago
        > That makes no sense, salaries would simply be adjusted to compensate. If you cut the salaries of employees who opt-out, but not those who don't, you'd be in very clear violation of the law I'm suggesting.
        endisneigh 5y ago
        No, what I’m saying is that they wouldn’t offer an alternative to the state run health care, as why would they anymore? No incentive.
    - throw0101a 5y ago
      > It’s still a tax hike, regardless of your rationalizing You're already paying for health care coverage via monthly/annual premiums and via reduced salaries where your employer's portion is part of the 'total compensation' you get (but doesn't show up in your pay check). Even if the amount at the end stays exactly the same it may be an improvement because (a) there are no "in network" worries about going to the "wrong" hospital or getting the "wrong" doctor", and (b) it is universal coverage so (i) you may not have to worry about losing your job and losing coverage as well as (ii) you can change jobs and have the same (universal) coverage.
  - rootusrootus 5y ago
    That assumes you get the cost saving. If my company stopped paying for my insurance benefit and instead gave that money to me directly, and then I bought the cheapest plan I could find on the insurance exchange ... I'd be paying more, not less. By a fair amount.
    - ceejayoz 5y ago
      That seems readily fixable; make it a legal requirement that companies that provide employer-provided healthcare pay the premium to the employee if they opt out.
      - rootusrootus 5y ago
        In my case the premium wouldn't even come close to the marketplace cost. I'd be losing overall.
        ceejayoz 5y ago
        https://www.peoplekeep.com/blog/which-health-insurance-costs-more-employer-coverage-or-aca-plans https://www.peoplekeep.com/blog/which-health-insurance-costs... > Nationally, the analysis found that individual ACA Marketplace premiums are 10 percent lower than the average employer-sponsored insurance premium, after the adjustments. (Which makes sense; it's a very large risk group.)
        rootusrootus 5y ago
        Okay, then congratulate my employer for beating the odds, I guess.
    - mypalmike 5y ago
      Numbers, please. This kind of claim is just mythology unless you have numbers to back it up.
    - mattmcknight 5y ago
      Is this because your employer is paying part of the cost for the plan?
- daenz 5y ago
  >The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit. I don't think that's even a question. The answer is no, they won't.
- xienze 5y ago
  > The real question is whether employers will raise salaries enough to compensate for the additional taxes, once they're no longer providing insurance as a benefit. Spoiler: they won’t. They’ll spin not having to pay a premium as a pay raise.
donatj 5y ago
I think the idea that anything that worked in Europe would work here as well as there without inherent corruption and rent seeking is laughable.
- ceejayoz 5y ago
  The idea that the US is uniquely corrupt and rent-seek-y seems laughable. There's no corruption in Italy? Eastern Europe?
endisneigh 5y ago
The amount paid per capita and whether you would pay more taxes are not exclusive things. I’m not sure why people keep bringing up Europe - the USA is not Europe. For one doctors are paid more in the USA compared to Europe, medicine is more expensive here, more of the R and D originates here, etc
- Ekaros 5y ago
  Maybe good question to ask is what makes it more expensive? Is it bloated administration and insurance system? Or is there some fundamental other difference?
  - deleted 5y ago
    [deleted]
  - _-david-_ 5y ago
    One reason is it is expensive to fund the research and testing and so the companies need to recoup that cost. They cannot in Europe and Canada due to price controls which means people in the US offset the cost. The US is basically subsidizing other Western countries.
    - nceqs3 5y ago
      ^This guy gets it. Also, in nearly every parliamentary system the state's ability to quickly invalidate patents by an act of parliament gives them even more leverage in the negotiations with drug companies.
- heavyset_go 5y ago
  A lot of that R&D is already funded with our taxes via the NIH.
  - bdzr 5y ago
    A significant portion is not. Clinical trials are unbelievably expensive, see https://www.science.org/content/blog-post/drugs-come-comprehensive-look https://www.science.org/content/blog-post/drugs-come-compreh....
newaccount2021 5y ago