4 ms·

Someone has to pay for healthcare. If not the employer directly, then they’ll pay for it through higher wages. Are you suggesting employees stop paying for heal

Someone has to pay for healthcare. If not the employer directly, then they’ll pay for it through higher wages. Are you suggesting employees stop paying for healthcare altogether?

kingnothing 1y ago
The US pays more per capita for healthcare than any developed nation. We should redirect those funds to more taxes to pay for Medicare for all. Costs will go down and your healthcare will no longer be tied to your employment. As a bonus, everyone gets healthcare.
- barbazoo 1y ago
  Sure but that’s not gonna happen. Workers mostly ever only get things taken away these days. It wouldn’t mean that money is available somewhere else all of a sudden to pay for healthcare.
  - kingnothing 1y ago
    If Congress could decide to agree on something, they announce taxes are being raised by X% to provide Medicare for all next year. Next year, employers stop providing healthcare via insurance companies and everyone signs up for medicare. Done.
    - coredog64 1y ago
      One of the huge fights about ACA from the left was so-called "Cadillac Plans": Unions negotiated excellent medical insurance coverage in lieu of wages for their members. If you suddenly axed employer-provided coverage, nearly every union in the US would want to renegotiate contracts to account for that.
- andrei_says_ 1y ago
  But what about billions in profit for healthcare insurance companies and their business model to collect money and deny benefits?
- nradov 1y ago
  Don't be naive. Medicare reimbursement rates are artificially fixed below the market rate in order to hold down the federal budget. This kind of works right now because Medicare ends up with a hidden cross subsidy from commercial health plans with higher rates (often explicitly set as a fixed multiple of the Medicare rate). If we put everyone on "Medicare For All" then those subsidies will disappear and queues will get much longer. So not everyone "gets" healthcare if they have to wait a year for an elective procedure. Also, original Medicare Part A/B doesn't cover certain types of healthcare at all such as prescription drugs. So not everyone on Medicare "gets" healthcare today. That's why many Medicare beneficiaries choose to pay out of pocket for Drug Coverage (Part D), Medicare Advantage, and/or Medicare Supplement (Medigap) insurance.
prasadjoglekar 1y ago
Healthcare thru employment began as a perk for employees. Everyone else just paid out of pocket for regular care. And yes, it was priced into wages. Even today, most people will pay several hundred dollars a month for insurance; the employer will pay several hundred dollars and the plan will still have a $2K or so deductible. That's a lot of money that most people make no use of at all.
- mothballed 1y ago
  If you pay out of pocket it is post-tax. If your employer pays it is barely at all taxed. If you accept higher wages to pay it for yourself, it's a bad deal, either to the employer or to you or possibly to both.
  - prasadjoglekar 1y ago
    Not if it is an HSA like setup which is pre tax. But you're right, this taxation intertwine is another tangle that shouldn't exist. Too much energy is spent by everyone trying to optimize take home pay, coverage etc.; and lower wage workers who just don't have the mental cycles to do any thinking get shafted.
  - deathanatos 1y ago
    > it's a bad deal, Not necessarily: I gain the ability to switch insurances (imagine, for example, a "free market" where insurance has to compete…), job losses or changes don't affect my insurance, etc. Actual competitive pressure and lower switching costs should, in theory, drive the price down. Also, IIRC, insurance premiums paid with post-tax dollars are deductible, so they're not really post-tax. However, that deduction is part of the itemized deduction — while currently most people are not itemizing (as they do not have enough itemized deductions to hit the "it is worth it" threshold), my napkin math says that throwing HC premiums in there — since HC is so damn expensive — tips the scale / breaks the threshold for basically any normal income level. But this is also an "imagine if" thread. Imagine if we made healthcare premiums outright deductible to alleviate the problem you've identified?
    - 1y ago

Someone has to pay for healthcare. If not the employer directly, then they’ll pay for it through higher wages. Are you suggesting employees stop paying for healthcare altogether?

kingnothing 1y ago

The US pays more per capita for healthcare than any developed nation. We should redirect those funds to more taxes to pay for Medicare for all. Costs will go down and your healthcare will no longer be tied to your employment. As a bonus, everyone gets healthcare.

barbazoo 1y ago
Sure but that’s not gonna happen. Workers mostly ever only get things taken away these days. It wouldn’t mean that money is available somewhere else all of a sudden to pay for healthcare.
- kingnothing 1y ago
  If Congress could decide to agree on something, they announce taxes are being raised by X% to provide Medicare for all next year. Next year, employers stop providing healthcare via insurance companies and everyone signs up for medicare. Done.
  - coredog64 1y ago
    One of the huge fights about ACA from the left was so-called "Cadillac Plans": Unions negotiated excellent medical insurance coverage in lieu of wages for their members. If you suddenly axed employer-provided coverage, nearly every union in the US would want to renegotiate contracts to account for that.
andrei_says_ 1y ago
But what about billions in profit for healthcare insurance companies and their business model to collect money and deny benefits?
nradov 1y ago
Don't be naive. Medicare reimbursement rates are artificially fixed below the market rate in order to hold down the federal budget. This kind of works right now because Medicare ends up with a hidden cross subsidy from commercial health plans with higher rates (often explicitly set as a fixed multiple of the Medicare rate). If we put everyone on "Medicare For All" then those subsidies will disappear and queues will get much longer. So not everyone "gets" healthcare if they have to wait a year for an elective procedure. Also, original Medicare Part A/B doesn't cover certain types of healthcare at all such as prescription drugs. So not everyone on Medicare "gets" healthcare today. That's why many Medicare beneficiaries choose to pay out of pocket for Drug Coverage (Part D), Medicare Advantage, and/or Medicare Supplement (Medigap) insurance.

prasadjoglekar 1y ago

Healthcare thru employment began as a perk for employees. Everyone else just paid out of pocket for regular care. And yes, it was priced into wages. Even today, most people will pay several hundred dollars a month for insurance; the employer will pay several hundred dollars and the plan will still have a $2K or so deductible. That's a lot of money that most people make no use of at all.

mothballed 1y ago
If you pay out of pocket it is post-tax. If your employer pays it is barely at all taxed. If you accept higher wages to pay it for yourself, it's a bad deal, either to the employer or to you or possibly to both.
- prasadjoglekar 1y ago
  Not if it is an HSA like setup which is pre tax. But you're right, this taxation intertwine is another tangle that shouldn't exist. Too much energy is spent by everyone trying to optimize take home pay, coverage etc.; and lower wage workers who just don't have the mental cycles to do any thinking get shafted.
- deathanatos 1y ago
  > it's a bad deal, Not necessarily: I gain the ability to switch insurances (imagine, for example, a "free market" where insurance has to compete…), job losses or changes don't affect my insurance, etc. Actual competitive pressure and lower switching costs should, in theory, drive the price down. Also, IIRC, insurance premiums paid with post-tax dollars are deductible, so they're not really post-tax. However, that deduction is part of the itemized deduction — while currently most people are not itemizing (as they do not have enough itemized deductions to hit the "it is worth it" threshold), my napkin math says that throwing HC premiums in there — since HC is so damn expensive — tips the scale / breaks the threshold for basically any normal income level. But this is also an "imagine if" thread. Imagine if we made healthcare premiums outright deductible to alleviate the problem you've identified?
  - 1y ago