Universal healthcare in the US
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30-03-2017, 04:48 PM
RE: Universal healthcare in the US
(30-03-2017 04:23 PM)Minimalist Wrote:  Strip the caps off the medicare and social security taxes so that rich motherfuckers pay it on their entire incomes and you will greatly solve the financing problems of medicare and social security.

No caps on Medicare/Medicaid contribution I don't think. SS cap at $120,000 or so does seem low. But my brother the actuary explained to me that the problem is that SS is a "defined" benefit calculated based on earnings history and to limit the maximum benefit you have to limit the maximum contribution. To do away with the contribution cap while still limiting the maximum benefit means it's no longer a defined-benefit plan but something else. So eliminating the cap really can't be done without completely replacing SS with something else. It requires much more than a simple tweak in the law like it sounds. It would have to look more like Medicare/caid. At least that's what I think he said. Others here are more qualified to comment.

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30-03-2017, 06:47 PM
RE: Universal healthcare in the US
(30-03-2017 03:09 PM)abaris Wrote:  Don't live under the delusion that US citizens have a less healthy lifestyle than Europeans. Not in this day and age if it ever was true.

If I'm living under a delusion about the healthiness of Americans vs Europeans it's because I've been misinformed by the CDC, WHO and OECD.

For example according to the WHO these countries have the following percentages of overweight adults over 30.

US - Men 87%, Women 83%
UK - Men 80%, Women 73%
Germany - Men 79%, Women 70%
Spain - Men 74%, Women 64%
France - Men 61%, Women 47%

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30-03-2017, 07:32 PM
RE: Universal healthcare in the US
(30-03-2017 04:23 PM)Minimalist Wrote:  Strip the caps off the medicare and social security taxes so that rich motherfuckers pay it on their entire incomes and you will greatly solve the financing problems of medicare and social security.

It would help, but it wouldn't fix the current system for the long term. I'll define the long term here as until most of us boomers die off. It wouldn't even come close to paying for healthcare for all of us. The problem is about 80% of personal income falls under the cap already. A 15.6% tax on the other 20% would raise a little less than $240 billion a year in additional revenue. To raise the $2.2 trillion we need to pay for what we have now we'd have to put a tax of 90% on the top 5% of households. That would put the after tax earning of 90% of them in the bottom 95% of households.

Taxing the shit out of rich people isn't going to provide healthcare for everyone in the US without reducing the cost of healthcare no matter how hard you want it to. There just aren't enough rich people, and they don't have enough money to pay for everyone at our current costs.

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31-03-2017, 05:25 PM
RE: Universal healthcare in the US
From VirtualEconomist today. (charts and graphs are telling)

"Sticker Shock

THE U.S. SPENDS MORE PUBLIC MONEY ON HEALTHCARE THAN SWEDEN OR CANADA

The Chart of the Week is a weekly Visual Capitalist feature on Fridays.

The underlying challenges in fixing U.S. healthcare may be multi-faceted and complex, but the overall diagnosis is clear: costs are out of control.

According to a 2015 health report using data from the Organization for Economic Co-operation and Development (OECD), per capita spending on private healthcare in the U.S. is $4,516 per year.

That’s 5x higher than that of the median OECD country, which pays $806 per year.

Of course, the high cost of private care makes sense, because the U.S. has a system that largely revolves around the private sector. If companies and individuals are covering most of their healthcare expenses, then public expenditures should be extremely low, right?

Here’s the kicker. The U.S. spends more public money on healthcare per capita than Canada, Sweden, Denmark, Germany, Switzerland, France, Japan, Australia, New Zealand, and the United Kingdom. In fact, each year the U.S. government spends $4,197 per person, while the OECD median spend is $3,677.

In other words, costs seem to be out of whack across the board in the United States, regardless of whether it is private or public care being discussed. Further, the above numbers are from before the recent double-digit hikes in premiums for most states under Obamacare.

NO BANG FOR THE BUCK

Combine public and private together, and it totals to 17.5% of GDP being spent on healthcare in 2015. This number is as high as it has ever been, and it dwarfs expenditures in other countries around the world.

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02-07-2017, 05:51 PM
RE: Universal healthcare in the US
(30-03-2017 02:22 PM)Popeyes Pappy Wrote:  Many here, including me, would like to see some kind of universal healthcare implemented in the US. The best way to do that is probably a single payer system administered by the government similar to what they have in Canada, Australia and (most of?) the EU.

No, the only thing that needs to be done is to expand Medicare to include all US Citizens and Legal Resident Aliens.

(30-03-2017 02:22 PM)Popeyes Pappy Wrote:  The problem with this is we simply can’t afford it without significant reductions in the cost of US healthcare.

You mean the cost of medical care. Currently, healthcare consists consist of the price of medical care plus the price of insurance. Note that "health insurance" costs are driven entirely by the cost of medical care.

(30-03-2017 02:22 PM)Popeyes Pappy Wrote:  Last year the US spent $3.3 trillion on healthcare.

One-third of the costs -- $1.1 TRILLION -- is what employers and employees and others pay for health insurance.

(30-03-2017 02:22 PM)Popeyes Pappy Wrote:  That means the government would need to raise at least another $2.2 trillion in taxes just to pay for what we have now. According to Full Circle’s tax spreadsheet raising that much revenue via individual income taxes would mean an average tax increase from 19.1% to 48.8% across all households in the US. A 29.7% increase. That’s 48.8% on top of 15.6% in payroll taxes, whatever state and local taxes we pay, and sales taxes. The total average tax burden for US households would have to go to somewhere in the neighborhood of 70%.

You can have Medicare-for-All simply by increasing the HI (Medicare) Payroll Tax from 2.9% to 26%.

Each employee would pay 13% while every employer would pay 13% for each employee.

A family of four with one wage-earner whose income was $50,000 would pay only
$6,500 per year.

(30-03-2017 02:22 PM)Popeyes Pappy Wrote:  The bottom line is we can’t get there from here without significant reductions in the cost of healthcare here. The question is how do we do that?

Create competition between hospitals instead of allowing hospitals to operate as monopolies and cartels.

The States granted hospitals monopoly status due to the fact that the hospitals continually argued and lobbied that the charity work the do offsets any harm caused by monopolization.

What is the percentage amount of charity work hospitals do against their gross revenues?

Good luck trying to find out that information.

The enemy numbered six hundred - including women and children - and we abolished them utterly, leaving not even a baby alive to cry for its dead mother. This is incomparably the greatest victory that was ever achieved by the Christian soldiers of the United States. -- Mark Twain
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02-07-2017, 05:55 PM
RE: Universal healthcare in the US
(30-03-2017 03:09 PM)abaris Wrote:  Lower life expectancy also because many people aren't covered.

Lower Life Expectancy due to the fact that the US has a heterogeneous population, while other countries have homogeneous populations, and due to the fact that the US has an inordinate amount of gun violence and traffic accident deaths.

(30-03-2017 04:23 PM)Minimalist Wrote:  Strip the caps off the medicare and social security taxes so that rich motherfuckers pay it on their entire incomes and you will greatly solve the financing problems of medicare and social security.

Um, there are no caps on the HI (Medicare) Payroll Tax and there never have been since its inception.

The enemy numbered six hundred - including women and children - and we abolished them utterly, leaving not even a baby alive to cry for its dead mother. This is incomparably the greatest victory that was ever achieved by the Christian soldiers of the United States. -- Mark Twain
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02-07-2017, 07:50 PM
RE: Universal healthcare in the US
(30-03-2017 02:22 PM)Popeyes Pappy Wrote:  The bottom line is we can’t get there from here without significant reductions in the cost of healthcare here. The question is how do we do that?

The answer is you would have to do it in stages over a LONG time. 10-15 years in my estimation, but I'm not an economist it may even take longer. The problem with doing it all at once is that you would put the economy into recession - and a pretty bad one at that - by suddenly making millions of jobs redundant overnight.

The number of jobs directly or indirectly reliant on the heath sector in the US would be around 50-60 million. Reducing the cost of healthcare by 30-40% to bring it in-line with OECD would mean at least 10% of those jobs become redundant, and of the other 90% most people would be either taking a pay cut or they would see their wages stagnate. And keep in mind only doctors and surgeons make good money, pharmacists, nurses, cleaners, etc make only modest wages.

So in my estimation, if you want universal healthcare you would need a policy that deals with the 5-6 million jobs that would be redundant, and a policy to make sure that those earning low incomes are not the ones that face stagnant wages and pay cuts.

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02-07-2017, 09:17 PM
RE: Universal healthcare in the US
(02-07-2017 07:50 PM)Aractus Wrote:  So in my estimation, if you want universal healthcare you would need a policy that deals with the 5-6 million jobs that would be redundant, and a policy to make sure that those earning low incomes are not the ones that face stagnant wages and pay cuts.

The problem is that even the skilled jobs like surgery will be lost to automation much sooner than we think. If we don't adapt we're looking at 40% unemployment. And we better get universal health care in place first or we'll be looking at the plague. The tech moguls realize this and hence their almost unanimous opinion on the importance of directing resources towards education and retraining.

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02-07-2017, 09:26 PM
RE: Universal healthcare in the US
(02-07-2017 09:17 PM)GirlyMan Wrote:  ...
their almost unanimous opinion on the importance of directing resources towards education and retraining.

... and getting off the planet.

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03-07-2017, 08:46 PM
RE: Universal healthcare in the US
(02-07-2017 09:17 PM)GirlyMan Wrote:  The problem is that even the skilled jobs like surgery will be lost to automation much sooner than we think.

So far robotic surgery still needs human surgeons to make decisions based on real time events they observe.

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