Euro Healthcare vs US Healthcare

[Tide1986]

You are certain that if we upped the top earners in the country to 90% tax we would not be able to afford universal health care? I am completely against that idea but disagree that our government would still be broke.

Some questions to ponder:
+ Who would be considered top earners? Adjusting for inflation since the 1950's, it looks like a 90% rate would apply to those making in excess of $3M per year, which appears to be a fraction of the Top 1%. It looks like the Top 1% begins at around $400K in annual income.
+ How much money would such a tax bring in? I've seen a couple of claims that taking all of the income from those making $1M or more would generate less than $1T per year. A Berkeley economist who collaborated with Picketty claims the Top 1% make up 20% of the national income, which is around $2.5T per year.
+ How much would single-payer cost the United States? I've seen three estimates that put the cost around $2.5T per year. Bernie Sanders' own estimates peg the cost at nearly $1.5T per year.

 

[uafanataum]

Some questions to ponder:
+ Who would be considered top earners? Adjusting for inflation since the 1950's, it looks like a 90% rate would apply to those making in excess of $3M per year, which appears to be a fraction of the Top 1%. It looks like the Top 1% begins at around $400K in annual income.
+ How much money would such a tax bring in? I've seen a couple of claims that taking all of the income from those making $1M or more would generate less than $1T per year. A Berkeley economist who collaborated with Picketty claims the Top 1% make up 20% of the national income, which is around $2.5T per year.
+ How much would single-payer cost the United States? I've seen three estimates that put the cost around $2.5T per year. Bernie Sanders' own estimates peg the cost at nearly $1.5T per year.

Sounds like we need to lower the cost of healthcare before trying to insure. 2.5T is unacceptable.

 

[LA4Bama]

Much of Europe is not only single payer. It is all publicly managed. Medical professionals are basically public services. It's more like a utility. Some places private competition is forbidden. How convenient. Just as Europe has greatly benefited from US spending on the military, so it has greatly benefited from the US market essentially paying for research. Lots of issues of justice are worth thinking about but before we have a European love fest we need to recognize that their system is propped up not only by our military spending, but also by our medical spending which drives research and product advances.

The European model should not be tried here because the European model is parasitic on the American system.

What we need to imitate from Europe is a very heavy expenditure in basic health care. But we need that at the sub- physician level. A nurse practitioner today knows more than a doctor in 1980. We need to stratify the medical profession so that basic care is rendered to people by professionals with degrees that took 2-4 years, not 6-8. The age of the family physician should be over. Doctors should all be specialists or "hospitalists" and people should only see doctors when they are really sick.

 

[Tide1986]

Sounds like we need to lower the cost of healthcare before trying to insure. 2.5T is unacceptable.

I wonder how one does that.

 

[seebell]

Some questions to ponder:
+ Who would be considered top earners? Adjusting for inflation since the 1950's, it looks like a 90% rate would apply to those making in excess of $3M per year, which appears to be a fraction of the Top 1%. It looks like the Top 1% begins at around $400K in annual income.
+ How much money would such a tax bring in? I've seen a couple of claims that taking all of the income from those making $1M or more would generate less than $1T per year. A Berkeley economist who collaborated with Picketty claims the Top 1% make up 20% of the national income, which is around $2.5T per year.
+ How much would single-payer cost the United States? I've seen three estimates that put the cost around $2.5T per year. Bernie Sanders' own estimates peg the cost at nearly $1.5T per year.

Sounds like we need to lower the cost of healthcare before trying to insure. 2.5T is unacceptable.

We spend 3.2Trillion a year on health care now. So what's the problem?

http://money.cnn.com/2016/12/02/news/economy/health-care-spending/index.html

The United States spent $3.2 trillion on health care in 2015, up 5.8% from the year before, according to new data from the Centers on Medicare and Medicaid Services.
That $3.2 trillion represents the combined amount spent on health care by all players, including the federal government, individuals, businesses, and state and local governments.

Seems like the money is already there.

 

[4Q Basket Case]

I would offer two thoughts:

First, a genetically homogeneous population might well enable the medics to concentrate money and efforts on a lesser range of maladies. It could therefore help with the overall costs of medical care at the macro level.

The problem there is that in Europe, national borders haven't been much more than suggestions for some time now. And that was before the Balkan and middle-eastern refugee issue that raise genetic diversity to an entirely different level.

Second, and in my opinion far more important: The faith that Eurpoeans have in their elected leaders.

In Europe in general, and Scandanavia in particular, the voting populace has faith that their elected leaders will generally do the right thing. Yes, there are scandals and abuse as there are everywhere. But they believe they have fewer of them, and that they are less severe when they happen.

For that reason, they're willing to pay the high tax rates necessary to fund universal healthcare.

And therein lies the difference between European thought on healthcare vs. American.

With infinite justification, we have no faith in our elected leaders to do anything other than line their own pockets.

If the American public felt that their government would be a good steward of the money, I have no doubt that we would have had universal healthcare long ago.

With good reason, however, we think they are thieves and charlatans, and that they would squander our money.

So we have the system we have.

 

[bama_wayne1]

You are certain that if we upped the top earners in the country to 90% tax we would not be able to afford universal health care? I am completely against that idea but disagree that our government would still be broke.

Well I don't think anyone will work for 10% of their income for long. Would you?

 

[CharminTide]

Well I don't think anyone will work for 10% of their income for long. Would you?

10% of $90 million is still $9 million in annual income. And yes, I would definitely work for $9 million.

 

[uafanataum]

Well I don't think anyone will work for 10% of their income for long. Would you?

I said in my post that I disagree with it but I think you may be surprised:
http://nordic.businessinsider.com/wef-countries-with-the-highest-tax-rat

 

[cbi1972]

10% of $90 million is still $9 million in annual income. And yes, I would definitely work for $9 million.

What happens in a global economy is that money gets moved somewhere it won't get confiscated. Ultimately, that money will cease to even be generated in the high tax regions, and those in the high tax region are either supported by other economies (European socialism subsidized by US military might), or they suffer greatly in terms of quality of life when industry and employment opportunities dry up (Detroit)

 

[CharminTide]

What happens in a global economy is that money gets moved somewhere it won't get confiscated. Ultimately, that money will cease to even be generated in the high tax regions, and those in the high tax region are either supported by other economies (European socialism subsidized by US military might), or they suffer greatly in terms of quality of life when industry and employment opportunities dry up (Detroit)

This makes sense. I wasn't advocating for a 90% tax rate on the highest earners -- frankly, I haven't studied the issue enough to have an informed opinion. I was merely saying that when you're talking about the top 400 U.S. earners, 10% of their gross is still an extremely comfortable annual income.

 

[TideEngineer08]

10% of $90 million is still $9 million in annual income. And yes, I would definitely work for $9 million.

Yes, 9 million is great. However, I have a feeling your attitude might change if this became your reality and you saw that you were actually grossing 90 million a year, and losing 81 of that to the state even if you loved the state. But especially if the state was a calamity.

 

[CharminTide]

Yes, 9 million is great. However, I have a feeling your attitude might change if this became your reality and you saw that you were actually grossing 90 million a year, and losing 81 of that to the state even if you loved the state.

I doubt it, but we'll never know. Studies have shown that a life of extreme privilege is required to break into that socioeconomic strata, so it's an inaccessible birthright to the vast majority of us.

 

[seebell]

Y'all know that 90% is a marginal tax rate? The entire 90 million is not taxed at 90%. Only the income that falls into the highest bracket would be taxed at 90%. You make an extra million in the highest bracket you get to keep $100,00. Would you work for an extra hundred thou. Answer is yes you would.

 

[TideEngineer08]

Y'all know that 90% is a marginal tax rate? The entire 90 million is not taxed at 90%. Only the income that falls into the highest bracket would be taxed at 90%. You make an extra million in the highest bracket you get to keep $100,00. Would you work for an extra hundred thou. Answer is yes you would.

Well, sure.

 

[Tidewater]

10% of $90 million is still $9 million in annual income. And yes, I would definitely work for $9 million.

As an aside, in 1942 FDR increased the top marginal tax rate to 100% by executive order (EO 9250)
Congress went back and "lowered" that to 97%.

 

[Tidewater]

And as for the opening post, I do not believe genetic diversity harms the healthcare system in the US or genetic homogeneity helps those of Scandinavia.
I do believe that Scandinavian countries have a cultural difference from Americans.
In Scandinavian countries, generally they teach people what good health decisions are (and the benefits to the individual and society) and what bad health decisions are (and the liabilities to the individual and society).
In Scandinavia, culturally, if you can work, you are much more likely to do so and much less likely to make a hammock out of the social safety net. In many corners of the US, if you can qualify for a welfare payment from the general/state government, but you don't take it, you're a chump.
Americans, generally, are much more liberty-minded (with all the good and bad that entails) and much less socially-minded than Scandinavians (with all the good and bad that entails).

I think that explains a big hunk of the costs of healthcare in the two societies.

 

[Tide1986]

Y'all know that 90% is a marginal tax rate? The entire 90 million is not taxed at 90%. Only the income that falls into the highest bracket would be taxed at 90%. You make an extra million in the highest bracket you get to keep $100,00. Would you work for an extra hundred thou. Answer is yes you would.

It all depends on where the top threshold is drawn. 90% of $89M is close to being 90% of $90M.

Regarding making an extra $100K for every million dollars above the top threshold, the utility of that extra money will depend a lot on the level of effort and/or risk required to generate the extra net income. The more difficult it is to generate the extra $1M, the less likely one is going to exert the energy and/or incur the risk to do so especially if one only gets to keep 10%.

 

[crimsonaudio]

Funny that people assume the wealthy wouldn't care if the government took even more of their money.

I find it amusing, as I literally know nobody who likes paying taxes, nor do I know anyone who so wants to give the government their earned income that they refuse the loopholes offered by the government.

So easy to discuss taking from 'those people'...

 

[seebell]

Funny that people assume the wealthy wouldn't care if the government took even more of their money.

I find it amusing, as I literally know nobody who likes paying taxes, nor do I know anyone who so wants to give the government their earned income that they refuse the loopholes offered by the government.

So easy to discuss taking from 'those people'...

I don't like paying taxes either. To paraphrase Huey Long: " Don't take from me, don't take from thee, Let's take from the one behind the tree!".