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Comment by ChrisMarshallNY | Hacker News Reader

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And yet, the average American pays more in taxes for public healthcare (medicare, medicaid) that they don't receive any of, than the average European pays in taxes for (some kind of) universal healthcare.

It's so bizarre seeing Americans in the debate not wanting "crazy high taxes like in Europe", because the US already spends twice as much public money per capita as the OECD average.

The dirty secret of course is that healthcare as a good is much more expensive to produce in the US than elsewhere, and a large chunk of that is because the private insurance system adds a ton of unnecessary overhead. And yet all the healthcare insurance companies in the US talk about making healthcare "affordable for all". Yeah, no, they're leeches. They're rent-seekers. They drive up the cost of everything.

The US has a massively progressive tax system. On a net tax basis about 50% of the country pays nothing. Sure, they pay sales tax and employment taxes, but they also receive some mix of earned income tax credits, child tax credits, snap, medicaid, housing, etc. There is no real way for the US to have a single payer tax system without more people actually becoming net tax payers.

You can't just ignore the money people are spending on healthcare right now. Every expenditure on private healthcare (insurance, copays, etc.) would be collected as tax going forward. That would be roughly $10-$20k annually?

Many more people would become net tax payers overnight without actually spending more money.

Yeah this is something people in favor of single payer healthcare in the U.S. don’t want to acknowledge. In most other countries, the middle 50% of taxpayers pay a much higher percentage of their income than in the U.S. Everyone somehow thinks we can make it work just by raising taxes on “the rich” (where that is usually defined as anyone making more money than them). But if it was that easy, then why does Canada and most European countries have so much higher taxes on the middle class?

Now I’m not inherently against increasing taxes (for all) if it gave us a much better healthcare system, but you have to be intellectually honest about who would have to pay those higher taxes. It’s not just Elon Musk.

I'm curious what the actual number is. I have health insurance through my work and I pay over $1,500 a month for that (and still have out of pocket costs). That's $18,000 a year. That's a substantial percentage of my income which essentially is just a tax going to the insurance company instead of the government. Now if it cost a couple thousand more a year and I didn't have to worry about getting claims denied for random reasons, I'd take that deal. If it's $5,000-10,000 more a year? Then I'd have qualms.

The US spends more money on healthcare than any other country (per capita and in PPP-adjusted terms), with the lowest life expectancy out of all of its peers [1].

Make of that what you will, but that tells me that after cutting out all the corporate abuse and inefficiency, the average person should be spending about the same for similar standard of care, except without all the bureaucracy and stress.

[1] https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

While it’s true that the U.S. spends way too much on healthcare (more than any other country as you said), the fact that it has a mediocre life expectancy is almost entirely due to things that have little to do with the quality of health care. Much more driving than most other countries resulting in more auto accidents and thus deaths, way more guns resulting in more murders and suicides, etc. Drug overdoses, in particular opiates, are probably the biggest one than can arguably be linked to healthcare.

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