Its not who immigrated to what country.

It's which country would a person want to immigrate to if given a choice.

The vast, vast majority of wanna-be-migrants would pick the US even with all the bad stuff going on.

I'm sure people in the Western Hemisphere would like to stay in that hemisphere near family and people of their ethnicity. Not a surprise that the only 2 highly developed countries are 1 and 2.

Regardless, net immigration per capita is higher in those European countries and they beat us in virtually every statistic related to quality of life. Face it, we aren't really good at much anymore.

Europe is extremely aggressive with their tax rate. If you make 60-70K or more in places like Belgium, Sweden or Denmark, you will pay close to 60% of what you earn in taxes. In the UK and France, you have higher thresholds but a lot people pay over 50% when you factor in everything.

Most people in the US have effective tax rate of less than 15% (if you make less the. 200K). Is it worth paying 4-5X more in taxes to get the European system? I would say no, but maybe I’m in the minority.

A single person making $60k a year, the tax wedge on just income is 32%.

Now throw in property tax (average $2,300 a year)

Now throw in sales tax.

Then we have to factor in things we don't actually get in this country compared to those others.

Throw in health insurance. Premium for an average person is $400/month or $4800 a year. That doesn't include your co-insurance or co-pays.

Now if you went to college, on average you will have close to $40,000 in loans when you leave (not to mention what you spent to go). Average student loan payment is $400/month so another $4,800 a year.

So for the best case scenario where you have absolutely no need for a doctor and live in a state with no sales taxes of any kind while somehow avoiding all government fees, you'd be at 45%. Realistically over 50% since you'll need medical care and pay government taxes/fees.

We actually pay a lot in taxes when you factor in that we have to pay exorbitant amounts for education and health care that are mostly free in those other countries. We just do a better job of making it seem like we don't.

Its pretty clear the US pays a lot less taxes than Europe. But what benefits/welfare are provided for the taxes is a good question.

I did some googling this morning and was not able to find a comparison. Searched on terms-like "US vs Europe Taxes Benefits/Welfare". If anyone knows of an analysis, I would be interested in reading it.

You are underestimating what we pay.

In the US, FICA taxes alone are 12.4% if you earn under 100k. Federal income taxes will be single digit, probably, for those same earners. Then there are state and local taxes. For most, a sales tax. If you own property, there's a property tax. And on and on for other fees and taxes. The average person pays more than 15%, even if we pay less than many European countries.

The best way to look at taxation is %of GDP. In 2015 the OECD had us at 27% and the EU average at 40%. There were no EU countries at 50%, although there were three between 45-50%

Indeed. It's hard to find a like for like due to this. For example: I know that I pay over $200 a month for health insurance (individual - my wife gets insurance through her work, but we should probably look at what would be best for costs there...) and I pay $800 a month for student loan repayments. Perhaps in a society where health care and schooling is mostly paid by the state my taxes would go up significantly.. but would they go up more than $1000 a month? Because if they don't, then I would have been better off financially (and, of course, the health care costs don't cover cost sharing).

For a visual

How do US taxes compare internationally? | Tax Policy Center

What is the job market like in Europe? (obviously that varies a ton between countries like France and Italy v. wealthier countries like Denmark).

I always got the sense it was stagnant. Their classes of income and wealth are closer because there's fewer super-rich, but, it is truly easier to get from say, entry level to $80k+ than it is in the U.S.? Or is there kind of a glut of people under 50 that basically all have the same lifestyle - fewer poor, fewer rich. Their medium and average income levels seem to be lower than the U.S.

Not saying any of this is better or more desirable, I think free healthcare is maybe the most important thing any country should do. But I wonder if it's better to be an educated professional in IT, law, engineering, etc, in the U.S.

No one pays 32% in Federal income tax. If you are single, you pay this:
10% on the first 10K, 12% on 10-39K, 22% on 39-82.5K and 24% on 82-150K
If you are married and file together, you pay:
10% on the first 20K, 12% on 20-77K, 22% on 77-165K and 24% on 165-315K
Then, you take out deductions. Even if you do a standard deduction only, that's 12K off for individuals and 24K off for married. So, let's say you are single and make $75K a year. You can deduct your 410K investments and heath care, but let's keep it simple and just take off the standard deduction (63K taxable). Your fed taxes are $8,500 and your social security/medicare tax is $5,738 (7.65% of 75K). Your state taxes are a % of federal, around $1,800 in this case. So your total fed+SS/Med+state = $16,038 (21%). But that's saying you don't deduct any for health care, 401K or any itemized deductions. For most individuals, it would be closer to 18% after deductions.

Now, let's say you are married and make $140K combined. After the standard, you are at 116K. Your fed taxes are $17,237 and your social security is $8,240 (max) and your medicare is $2,030 (1.45% of gross). Your state taxes are a % of federal and about $3,600. So your total fed+SS/Med+state = $31,107 (22%). But that's saying you don't deduct any for health care, 401K or any itemized deductions. Again, most families would be closer to 18-20% at that range.

I didn't count sales tax because I wasn't counting the VAT tax in Europe. You can also deduct property tax off your return as well. Most families with a 401K, employer provided health care, that pay for day care (deductible) and use the standard (or own a home and itemize) probably pay in the 17-19% rate for fed+state+SS+medicare+property tax. That's a far cry from what Europe pays.

It's a good question. In places like the UK, Belgium and most Scandinavian countries, it really makes no sense to make more than 100K. You are basically paying 45-60% in taxes over that amount. And most of these countries also have their own form of social security tax in addition to income tax. Take Denmark (often listed as one of the top countries in Europe to live in). If you make the equivalent of 120K US in Denmark, you would pay 55K of that in taxes (take home 65K). If, instead, you made the equivalent of 60K US, you would pay about 20K in taxes (take home 40K). So is it really worth working the stress of a 120K a year job over a 60K job when you really only bring home an extra 25K in real money? In the US, the 120K person would bring home around 95K compared to the 60K person, who would bring home around $47K. That's basically double the take home pay so it is worth working that higher stress job.

This would make sense if there was any correlation between pay and stress/work. If anything I'd argue that most folks in the US making $30K are typically working harder and under more stress than those making $100k plus.

Depends, a lot of those jobs are harder to find. So, if a 60K a year guy loses his job, he can find another fairly easily. If a guy making 120K loses his job, a lot of times he's making that because he's been at his current company for a long time. Going back on the market, he may find it tough to get a new job at that rate. The stress may be more "I can't afford to lose this job" more than the difficulty of the job. Also, most 120K jobs are salaried and involved more hours. Whereas a 60K job is either hourly or not as demanding on weekly hours. If I'm in Denmark and working 50-60 hours a week in a salary job paying 120K and I could drop down to a 40-hour a week hourly job paying 60K and only lose 25K of real money, I would think that would be an attractive option.

In that case, you are drastically inflating effective European tax rates:

https://www.businessinsider.com/worl...x-rates-2013-1

For people making $100k USD, the highest effective tax rate on income is ~42% (Germany), if you add in income and employee based social security (payroll tax, basically), the highest is Belgium at ~47%.

The effective rates are lower because it is extremely punitive to higher wage earners. Take Denmark, there's 0 tax on the first 8,000 US, 39% from 8,000 to 83,000 US and 56.5% above 83,000 US. There is also an employment tax and local tax rate that applies to many. Finally, there is 12% tax on investment. And, remember, these are flat rates so no deductions apply. You are going to pay 40+% in taxes anywhere in Europe and it could be as high as 50% based on the country and your salary. Again, most people in the US pay under 20% of their Gross income in combined Fed+state+SS+Medicare+property taxes. That's a massive change in tax rates.

I don't quite buy the idea that higher paying jobs are necessarily more stressful than lower paying ones. Almost all of the lower paying jobs I've had were way more stressful than the higher paying ones.

I would say it's more the time investment in your job and the stress of staying at that pay rate. The actual job activities are probably not more stressful.There is a bonus to just working the 40 hours you are paid for and leaving your work at the place. Take our manufacturing plant I work out. We have some hourly guys making $22-25 an hour. With bonuses and occasional paid overtime, they probably gross $55K. We have salaried support staff (QA, engineers, IT) who make $70-75K - but they usually work closer to 50 hours a week and have to be on call over the weekend if things break/have issues. So, the physical effort for the hourly guy is a little more during his 40 hours - but he gets to leave work here and has an extra 10-15 hours a week to spend doing what he wants outside of work. And, if he's asked to work an extra 10 hours, he gets paid for that.

So the two charts literally say effective tax rate for those making $100k (USD) and $300k (USD).

I agree this is one factor in "stress" (e.g. living paycheck to paycheck). I think other factors include work environment/working conditions, poor managers, low growth potential etc.

If level of stress is limited to just the actual work someone has to do (e.g. flipping burgers, Macy's retail clerk etc.), IMO higher paying jobs have more stress. If you factor in all the other stuff, I'd lean towards lower paying jobs have more stress.

For countries like Belgium and Italy, 100K is already over the max rate. So, it makes sense there isn't a big difference. But compare 50K to 150K and you would see a big difference. But if you look at France or the Netherlands, you go from paying 42% and 40% at 100K to 54% and 48% at the 300K gross. These are extremely high flat rates compared to the US at either level. Someone who makes 100K in the US pays under 20% after deductions. I'm not sure people understand the massive difference between paying 19-20K in taxes and 40K in taxes for a 100K job. If you are paying that much in taxes, you better not have to pay anything for health care, college, day care, etc. The reality is if people want European options, they could pay the extra 20K that would go into taxes to get supplemental health insurance (tax free, but most people wouldn't need it with employer subsidized plans), a college fund for your kids (tax free), a retirement account (tax free) and the best day care out there (also tax free). What's nice is we have the option to make that call. In Europe, that decision is taken from you and you get little future benefits from all that money.

I can speak to both working QA on salary and flipping burgers, and let me tell you nothing can touch the immediate stress of a busy dinner rush in a 130 degree kitchen. That said, you don't ever have to carry any of those stresses home with you (other than the crushing poverty that comes from working in a kitchen).

While you think it to be nice, the rest of us have horror stories with our employer subsidized plans, and the crippling amount of student loan debt. Not to mention those below the $100k line (US median income is much less) who would have even harder time. They don't get a "choice". They just get fucked. And go without decent health care, or college education, or day care (which sometimes precludes job opportunities that can help with other things).

I'd far rather pay an extra $20k in taxes for government subsidized health care and college that would benefit all people, and especially the poor and lower middle class.

I get it. If paying more in taxes guaranteed us to fix health care costs, rising tuition and other US issues - it would be tempting. The problem is it won't. If you want to have more of the European system, the key is price caps. Set limits on what companies can charge for prescription drugs or medical services and set caps on what a public university can charge for tuition. That fixes all the issues and doesn't involve raising taxes a ton. But, I just can't see the US government ever doing that given the lobbies out there for pharmaceuticals and the state boondoggles that Universities offer.

Sticking it to people making 100-200K to pay for a single-payer health care system (that still will have issues with cost, we will just paying with our taxes instead of our out of pocket money) and subsidizing college for people making less (while those who make over 100K still have to pay extremely high tuition costs) doesn't really solve anything. Atleast with the current system, we have a choice on where to spend money, how to plan our kids going to college and which company to work at to get the best health care. If we go to single payer and free tuition for people making under 100K, those making over 100K still have medical expense issues and have to pay for their kids college - they just have less money to do it. Capping what people can charge is really the only guaranteed solution. We do it for other state-involved monopolies like utilities, why should health care and tuition be any different?

Seems like it would solve quite a bit (especially in health care, where employer sponsored health care is a farce - especially considering the vast levels of cost sharing and insurance negotiation that go on). In addition why wouldn't a Medicare for All system not cap costs? Isn't that something people complain about - Medicare can pay less to providers than private insurance does. And allowing people who make under $100k to see doctors without working about cost or being able to go to college to get an education solves a whole Hell of a lot. It would help equalize opportunities for those on the lower end (as we like to say we are for equality of opportunity, right?) especially those who don't have generational wealth to fall back on.

My point is that if you want the European system, capping costs on prescriptions/medical services seems like the best way to make that happen. That's exactly what Europe does and why a drug that costs $500 here only costs $40 in Europe. Even if we go for medicare for all, that doesn't guarantee capped costs. It just means that instead of one individual paying $500 for a drug, we just share that $500 cost across a bunch of taxpayers who don't use the drug.

You are (again) completely ignoring the significant effect of removing the entire insurance industry from the equation, even if nothing else were to change.

I have referenced it here before, but my wife is a VP/GM of sales for a Warren Buffet owned company we have all heard of and use their product daily. She is the 2nd highest ranking woman in the company. Her job can be crazy stressful and disruptive. We have been on vacation the last 2 weeks and just about every day she has had to do some level of work. You can truly never leave the job behind. She has about 50 people working for her and decisions need to be made. She also travels a ton and has to go to work dinners, etc...there is no leaving the job behind. There is also the stress of many other peoples livelihoods at stake. She doesn't deliver her numbers people get less bonuses, etc...

now the trade off is an amazing salary, retirement, benefits, upward mobility, etc...but at times it doesn't feel worth it and she has no desire to climb the ladder any higher now that we have young kids. She was recently offered to head up another Buffet company and she turned it down.

There are a ton of health insurance companies in Europe right now. Supplemental insurance is big business. Companies like Allianz, Generali and AXA do massive business and we would have a similar situation here. To get the same level of response most employer-provided care does today under a single payer, you would have to pay for supplemental insurance. If you want to get an ACL tear fixed in 2-3 weeks, you will need better care than the national single payer.

It's not removing the insurance companies that makes the difference, it's setting the price caps. Insurance companies don't want to pay $500 for a prescription drug, they would love to only pay $40. Whether we have private insurance companies or not, the price caps are the only thing that is guaranteed to control costs. If you removed the price caps from Europe tomorrow, their entire system would fall apart (even within the state-provided plans).

Complicating the issue of work stress is the fact that high paying work and low paying work tend to deal with different kinds of stress. Low paying work generally seems to come with immediate stressors, both in terms of timing and presence, whereas high-paying stress seems to be more shadowy and omnipresent. I don't imagine either version is all that much 'better' or 'worse' for the human brain.

Physical laborers, on average, die younger. Our desk stresses don't compare.

A person making $100k already pays more than $40k when factoring in health care, property taxes, and sales tax.

To get this stuff, we probably wouldn't even have to raise taxes on the middle class. Just tax wealthy people at the same rate the middle class pays. And companies who make $12 billion on US soil have to pay some taxes in for the the infrastructure they benefit from so greatly.

I don't necessarily agree or disagree with your reasoning about caps, but I am thoroughly confused as to how it fits into your argument that you don't want the government controlling your healthcare? Yes Europe can do universal healthcare at much cheaper costs than the US can run it's private system, but only by capping pharmaceutical prices, which you're not sure that the US will implement properly, so you 'd rather continue to pay effectively double for health care as long as your tax bill doesn't rise?

The 10 most stressful jobs and their median salaries:

Enlisted military personnel of three or four years: $26,802
Firefighter: $49,080
Airline pilot: $111,930
Police officer: $62,960
Broadcaster: $62,960
Event coordinator: $48,290
News Reporter: $39,370
Public relations executive: $111,280
Senior corporate executive: $104,700
Taxi driver: $24,880

There's certainly more "danger" in physical labor, but I wouldn't necessarily say more stress. If you take out the military, fire and police, most high stress jobs aren't that physically taxing.

Lowering drug prices through Medicare could be done very easily if the government was allowed to negotiate. They wouldn't even need to set a price, something like the average of your lowest three prices would work wonders.

It's not just about dangerous conditions on the job. If you look at life expectancy from retirement, generally, laborers live significantly fewer years than do professionals.

When I was living in Guelph I tore my ACL and had surgery 2 weeks later. The wait was only because the surgeon wanted swelling to go down and me to do some rehab beforehand because it speeds up recovery.

I never noticed much difference in the two countries outside of price. I had to wait a month just to see a surgeon for a consult to remove my gallbladder months back in the US. Specialists have long wait times too.

We also do have a single payer system working with Medicare. I don't see people dying often from wait times on that.

You can also reduce wait times by not allowing the AMA to act like a cartel limiting doctors.

Most property taxes are under 3K and can be deducted off your gross. So, you are talking about an extra $1.5-2K per year in actual money, it's not that much. I didn't include sales tax or VAT tax in Europe, they pretty much cancel each other out. In terms of medical expenses, most plans have an out of pocket max so that even if you have a big expense, it's not costing 20K. Recent studies have found that families spent on average $714 or 1.6 percent of their take-home income on out-of-pocket health care spending.

There's just no way you are getting to even half what people pay in taxes in Europe.

I look at this like I look at unions. I like free markets, but some industries that work in the "public good" sectors need a union. I think Police and Fire unions are extremely important given the need to society. A software developer's union? Not so much. I think you could make the argument that capping prescription drug and medical costs is required for the health of the population. That's exactly what Europe has done and why everything is so cheap compared to the US. Now, there are negatives in terms of the US basically subsidizing world health research with the costs they pay, but maybe it's time to start sharing that burden. Either way, I would much rather make a massive change that I know will fix the issue (price costs) as opposed to one that may just end up costing tax payers a ton without any significant cost solution (single payer).

The average monthly premium for a family is $1,168 a month. So just over $14,000 a year plus that $714 in out of pocket expenses.

We haven't even touched sending those kids to college someday.

When no one pays for medical services, people tend to want to use it more often. So, it makes sense that wait times are much longer in Canada and the UK. If we went to a single payer, our wait times would grow to what Canada has (if not worse given we don't really have the infrastructure for the massive increase in requested services).

I have had a hell of a time and multiple months wait any & every time I want to see a specialist and I'm on the best/platinum tier of insurance. You literally can't find mental health care in this town, regardless of any kind of insurance or urgency. When I hear folks talk about how awesome American private health care is I wonder if they've ever been to a doctor/hospital, and/or where they live, so I can make an appointment there.

Its completely disingenuous to compare our own situations to what they might look like in a country that takes care of their less fortunate. Basic healthcare, a basic education without crippling debt, and so on... my income is in the top 10% of people in the US (low 6 figures). Even someone making half what I make is still in the top 30% of earners. These conversations read like we somehow expect to provide those basic services to all citizens without making any changes to someone who makes more than 90% of the nation. That's an unreasonable starting point that makes entire conversation meaningless.

I wonder if any of that has to do with lifestyle?

In general physical laborers are lower paying ( yes I know there are some well paying jobs). I wonder if they tend to eat more processed foods, etc...

In my experience, and it's purely anecdotal, physical laborers tend to drink a lot. A buddy of mineis an iron worker and has some crazy stories.

You realize that a lot of the cost capping is only done because the government as a single payer has massive negotiation power, or they mandate what the cost will be and providers cover it due to the government being single payer. Simply trying to mandate cost caps for services and drugs without having the government being the single payer makes little sense.

In addition, costs likely wouldn't nearly come down enough for the poor to afford good health care.

And man, do I completely disagree with you on unions. A software developer's union is multiple times more important to society than a police union.

dola (maybe, lots of people in here) - I'm not saying we shouldn't have the conversations we're having, by the way. I'm just saying that we should be looking at the entire picture to frame the conversation in a way that more matches the full reality of the differences.

How does someone who supports a free market not support unions?

That's for familes without employer-sponsored coverage and doesn't factor in state subsidized coverage for lower income people. If you factor in people with employer sponsored care and state "Access" subsidized care, the premiums actually paid by families are much lower. Very few people actually paid $1,100 a month. Most pay closer to $450 a month if you consider employer-sponsored plans for workers and state-subsidized plans for lower income:

I agree with this completely. Switching to a dermatologist from my GP, my wait for my first dermatologist appt was 4 months. Not life threatening in any way, but holy damn.

I recently discussed switching to a psychiatrist instead of using my GP to try to find the right meds to deal with some issues there. GP wrote me a referral and said "if you're even thinking about making this change, call them today and make an appointment, you can always cancel but it will likely be 3 months minimum before you'll be seen".


Neither are life threatening, but... damn.

The other thing is just getting sick in general and needing to see your primary care doc. If I don't want to wait a week to see the doc - and often I don't because I don't make an appointment when I feel something coming on, I wait until I'm sure I have to go - I just go to Urgent Care.

That's true. I remember when I first made an appointment to get a doctor. It took me 3 months before the first 'physical appointment' was open for new patients. And if I want to see my doctor, it's at least a week if I go through official channels (if I contact him directly, he squeezes me in - usually by double booking).

My doctor wanted me to get a endoscopy. It was 4 months until the first opening. I called around and at a farther out location it would only be a month (though only because someone had juuuust canceled).

I support unions in fields where the market will not balance out the compensation. There is no revenue brought in by police or fire, so local areas could vote to cut their salaries until they were non-existent with no checks or balances. For a software developer, the company they work for either generates products for sale or their skill has a value to the company at a certain rate. If a company cuts a software developer's salary 30%, there are dozens of other companies willing to pay them a market rate. If a city cuts a policeman's salary 30%, his options are to either move to another city/state or find a new profession. Plus, you have the city safety aspect of having all the police officers leave.

This isn't Upton Sinclair's jungle when it comes to most jobs in the US. But, we do still need unions for public good professions to protect the workers and ensure they get a wage that keeps good people doing those jobs. I'd even classify Teacher's unions in the police/fire as needed areas.

That's true in a lot of states, but wildly low in other states. My fairly modest home includes 8k in property taxes. It's very easy for middle class folks to have 10k or more in property taxes.

The employer portion is part of your compensation.

Mine are almost 11K. In Oregon they were just as high.

Perhaps, but being a part of the working poor generally sucks. There's a reason basically everyone in that situation wants a better life for their kids. For those of us relatively healthy and uninjured, it's hard to imagine living every day in pain, but that's common for laborers.

So an employer can leverage the market but an employee shouldn't be able to? That's fine if it's your belief but don't claim you support a free market. Free market is about leveraging your position to get the best possible rate for yourself or company.

Agreed, but you don't get taxed on that compensation - nor does it take away from your take home pay. If we went to a single payer tomorrow, not only would I lose that 72% my employer pays, but I guarantee I wouldn't get a raise to make it up. Employers get tax breaks for providing health care so if they lose that tax break (if we went single payer), they aren't just going to give everyone a raise to make up that lost compensation for benefits.

The truth that no one who supports single payer wants to admit is that if employer sponsored coverage went away, you wouldn't make any more money in salary (for the most part). Plus, you would be paying a much higher tax rate to get worse coverage than you had before. So while it may help a percentage of under-insured or uninsured, it would also hurt a vast majority of workers with employee sponsored health care.

My GF has had horrible tooth pain related to her wisdom teeth. Needs them extracted. Given prescription Norco and an antibiotic. Has called at least 8-10 oral surgeons over the past two weeks. The shortest wait time has been 5 weeks and that's for the consultation even though she has told them her situation and she knows she needs them removed.




(posted initially in the wrong thread)

We will just have to agree to disagree here. Having an electrician union (as some states do) to artificially inflate wages and require paying high wages to under-performing workers isn't what I would classify as free market.

That goes completely against economics. Why wouldn't your salary go up? If a company could reduce your compensation right now, they would. But you're saying there is a secret form of compensation that doesn't count as compensation?

My half-baked theory is that folks in the rural and sub-urban areas of the US might be getting a radically different healthcare experience than folks in the cities (at least in terms of wait times), which muddies the issue a bit.

88% of total jobs and 94% of private sector jobs don't have unions. Yet, companies aren't constantly reducing compensations. For a vast majority of jobs, the market ensure people are properly compensated. My point is that there is a small subsection of jobs where the market can't do that (police, fire, teachers, etc), often because they are more "public good" type jobs. In those situations, you do need unions. But unions for private company jobs really aren't needed outside of extremely rare situations.

Some would probably make more money in salary as employers tried to compete for workers (as they couldn't entice them with better health care options anymore).

And, I think we've gone over this, but it's better coverage, not worse. If you think single payer (or universal mandated non-profit insurance) health care is worse, we just don't even have the basic agreement to have a conversation on this.

I think you probably just need to come to the realization that the Democratic Party just isn't the place for libertarian ideas (and probably never has been). You may have had some of it in the Republican Party, but they decided they didn't care about that stuff either.

And if there is an abundance of electricians in an area, companies will pay less than market rate because they can. They have leverage. I don't see why it's bad for employees to use leverage too.

Just seems odd that only certain people should be allowed to utilize leverage in a free market.

Real wages have stagnated in the last 40 years. Asymmetrical information prevents workers from being able to adequately negotiate in the marketplace against employers. Workers combining their negotiating power evens the scales and prevents abuses (as does governmental regulation). Re: software developer - there are rampant abuses of overtime rules and regulations. And those workers can be and sometimes are mass laid off after a project is completed. Part of that is because software developers are not unionized and so can be treated poorly as they don't have individual bargaining power.

Markets generally treat workers as cogs in a machine. They don't care about them as long as their abuse contributes to the bottom line. Unions and regulation elevates people over profits and that's a view I think our society should have. Fuck the Market-uber-alles viewpoint.

But once the tax break for providing health care goes away and a single payer system exists, no company would provide health care anyone. So, it would be an equal playing field for all companies. The main reason employers cover 71% of employee health care premiums is because they get a tax break for doing so.

Right now, people at the company I work for can have the plan I have:
Get paid $25 a month in your HSA to be on it (no premium)
Have a $2700 family deductible where once that is met, the plan pays 90% coinsurance across the board. There's also an out of pocket maximum of $7,000 (including deductible).

So, if you put $300 pre-tax in a medical savings account each month, you would have $3,600 at the end of the year (plus the $300 from the company). Even if you spent to your deductible, that would be an extra $1200 to cover the 10% coinsurance. We are by no means the only company to offer this plan (it's a pretty standard plan from Blue Cross Blue Shield of AZ).

But you are saying that increasing my (or any other of our employees) taxes for a single payer would get them a better plan than 90% coinsurance with a pre-tax cost of $3,600 a year? There's no way.

This gets back to my point of being a homeless voter with socially liberal and (somewhat) fiscally conservative leanings. There's definitely no space on the religious right republican side, but I'm always hopeful for a more moderate democrat (maybe I'm fooling myself here too).

I've had boring phone conferences for the past 2-3 days, so I've been able to be more active here. Usually, these types of discussions can get pretty nasty - so I'm thankful that you guys have kept everything civil. I realize I am coming off as if I know it all - and that's simply not the case. I'm just speaking from my own experiences and my real fears of a single payer system being a pretty big negative impact on the cost and coverage for many people with employee-sponsored care. But, there are a lot of people who don't have great coverage - so I get this could rub them the wrong way.

I'll probably be dropping back to lurker status on the political stuff, but I do appreciate the perspectives on this forum. (End of my PSA)

The part your company covers is part of your compensation. If your company didn't offer health insurance, your compensation would be shifted toward take home cash or other benefits.

Employers cover health insurance because it gives them leverage over employees. Turnover rate is much lower which saves them a lot of money. It also acts as a motivator because losing your health insurance can be more destructive to someone with sick family members than their salary.

Trust me, if there weren't laws and advantages to offering health insurance, companies would much rather just give you the cash and avoid the administrative costs.

If the argument is that money corporations get from reduced taxation/regulation won't go to workers, seems like we should just tax them at higher rates and use the money to pay for some of this stuff.

I don't take any of this personal, it's just politics. Debating stuff is part of life whether its about health insurance or who the best QB in the NFL is.

My views have changed over the years on a lot of these issues so I keep an open mind toward things.

Most single payer plans have lower coinsurance. You pay increased income (or payroll) tax. There would be no preexisting condition exclusions, lifetime or annual limits, etc (which the ACA banned, but if that is repealed, they are all back) and you would be able to get the care your doctor thinks you need. Do you realize how many times insurance refuses to pay for procedures your doctor is adamant that a Participant requires? Denials for claims deemed medically necessary by a doctor (including ER doctors mind) would not occur. Speaking of Blue Cross and Blue Shield, they have been in the news recently because of 'surprise billing' - they have told people that when they went to the emergency room it wasn't a 'true emergency' and therefore nothing will be covered and they are on the hook for all of it (and is being sued by some State Department of Insurances about it). That is something that single payer healthcare would not do.

So yes, it'd be a much, much better plan. Because all of the bullshit that insurance companies do to prevent paying for procedures that doctors think is medically necessary won't happen.

Here's part of your entire problem. You are ONLY looking at cost and not a quality. And even in looking at cost you are saying it's worse for me-me-me with a cadillac sort of plan that has no premiums and then extrapolating it to say it's a worse financial system for everyone (99% having worse health care plans than that - the vast majority of people pay premiums). And you are simply not looking at the horror stories people have had in dealing with insurance carriers.

You are literally not talking about health coverage. You are talking about cost.

Seriously why do you think so many people are complaining about health insurance? Some of them are uninsured or underinsured, but a lot of them are those that had to deal with health insurance companies that just didn't give a shit about them and tried to deny medically necessary procedures which would have put those Participants in the poor house.

That's not hard to imagine. That's me. I nearly died last year. I have a laundry lists of aliments, with congestive heart failure and stage 3 kidney disease at the top, along with arthritis in my neck and back. The problems mostly exacerbated because I was without insurance for years. My work did not offer it, and the ACA plans were horrible and too expensive in my area. I racked up tens of thousands of dollars in medical debts for very limited care. Starting this tear, I picked up a ACA plan. I pay a lot, it pays out next to nothing. By the actuary tables, the probability I have more than 10 years left is less than 50%. Yet, I am still working a very psychical job in the sun, because if I don't my family will lose everything.



I am for a public option very selfishly (probably the opposite of Arles who is against it selfishly). Even though I am seeing 3-5 doctors every 3 months at great expense out of pocket, I constantly have to turn down test and procedures because I just don't have the money.


Of course, the GOP would tell me to shut up and die quietly in the corner. Or ask why I didn't pull myself up by the boot-straps to become a millionaire. If you aren't smart, and you aren't lucky, you should suffer while cheering on tax-breaks for the wealthy.

That sounds frustrating, sorry GD.

If Biden isn't moderate enough for you, I'm not sure you're being realistic. I mean, we're not going to nominate Manchin.

How does this go against economics? They would have to renegotiate with all employees. I do not see most companies doing this. Now the intelligently run businesses might extend this proactively, but I would be surprised if many companies do it.

If they can cut compensation without anyone caring, why aren't they doing it now?

All this.

I can't speak to whether single payer will be lower or higher cost (anyone with links to that?).

I have been on a company plan or another for most of the past 15 years, and if that is someone's experience and they have been relatively healthy, then I can see why they would see company insurance going away as a bad thing. Especially with what it's like going through ACA, which I have also done.

The problem is that government has handed too much power over to health care providers, health insurers and Big Pharma, who all conspire to keep medical costs high, and thus premiums high-- most of which are paid by companies through their plans. We're all being fucked over, more or less, and the current government isn't doing anything to protect us.

If single payer forces the health care industry to be more honest and open with their costs and forces them to accept medically necessary procedures, then I am all for it.

There is a reason we're behind in health care to so many other developed nations. It's not because of our ideology on paying for public services (free market vs socialism), but because in our country, health care is the biggest grift going on.

Considering here at FOFC we're mostly sedentary desk jockeys heading into our 40s, 50s and 60s, this subject should be of the highest importance to us. Our very lives (and the quality of them) are the chips on the table in a game heavily rigged to benefit the "house."

Also wouldn't businesses be lobbying as hard as they could for universal health care if that were the case? If they could just cut their costs per employee that much with a simple bill, I think they'd be all over it.

This. Providers, Payers, Pharma & Med Products, all need to be reworked in a new model. I would toss out individual expectations and responsibilities also need to be defined as part of this debate.

Robert Reich: Is America Becoming a Third World Country? - YouTube


Wasn't sure whether to post this here or in the Trump thread. Its a very short overview but a worthwhile one IMO.

A fascinating interview with Raj Chetty, one of the top economists in the country.

Raj Chetty: the American dream is alive in Canada, fading in America - Vox

That's a good read. The financial stuff has been around for awhile. That it's cheaper to provide services than pay for it on the back end. But we have a weird sadistic element of society who enjoys it.

"If you’re in a lower-middle-income family, you’re more likely to climb the income ladder in those countries."

Why are more people dropping down income brackets in those countries? How exactly does that manifest? Are they losing their jobs? Are their wages decreasing as they get older?

You're ignoring the fact that people age. As you get older, you generally get more money and move up the income ladder. You aren't kicking someone out of your new bracket, people die, people are born. The problem in the US is that that movement isn't happening as much as in the past. Wealth is being concentrated in the hands of fewer families and their children start rich and end rich. The movement over time isn't happening.

There's 2 types of mobility that Chetty studies - absolute and relative. Absolute has been declining, relative has been relatively stable.

No doubt we need to invest in kids, seems pretty logical its a sure fire return. The question is how and what. I'd toss out another often stated position of mine, increase highly educated immigrants and that's a pretty sure fire return also. The US is not making enough babies, we are below the replacement rate.

So won't income mobility be better if more people are worse off than their parents? Those seem like competing concepts. We want people to move up relative to others, but we also don't want anyone doing worse than their parents that they're replacing. And not just the super rich. From someone to move up from the 2nd 20% to the 3rd 20%, someone, or someone's child who they are replacing, had to drop down from the 3rd to 2nd. Someone's upper middle class kid has to be worse off than their parents (relative to others), and drop down below someone's lower middle class kid who greatly exceeds his parents. I think that's fine, a country is better off if we recognize the talent in the lower classes. But I don't see a lot of attention paid to that necessary part of the equation.

I think standard of living is a more important concept than wealth and income relative to others. If we nuked the top 10% and their wealth from the face of the earth, our income equality and mobility numbers would look better. But we wouldn't be any better off, and we'd be deprived of a lot of tax revenue. There's not a fixed amount of money in the world. Capitalism creates wealth. I think the super-rich are an asset that should just be taxed much, much, much more.

Edit: I also wonder if the difference between the 2nd 20% and the 3rd 20% in income and/or wealth someplace like Sweden or Denmark is so small because so many people are basically in the same boat financially, that it might not take much at all to drop or rise one bracket. Where in the U.S., a similar increase relative to others would be much more statistically unlikely, but much more noticeable to your standard of living.

Chetty's definition of the American Dream is

Maybe its how one define's the American Dream.
Most say American dream is within reach for them | Pew Research Center
Most say American dream is within reach for them | Pew Research Center[/url]

It doesn't have to work that way. Take three people, 18, 40, and 80. Eighty is in the top quintile, forty is in the fourth, and eighteen is just entering the work force in the third quintile. Eighty year old dies, forty year old gets a promotion and moves up to the top quintile.

Forty year old has moved up, but nobody has dropped, people have exited and entered the workforce. A lot of income mobility is of this type.

Why doesn't that happen in the U.S.? When the 80-year old in the first or second quintile dies, who replaces him?

There are certainly factors of people dying and being born, but I think that downward mobility promotes upward mobility. If rich and upper-middle class families and their children retain their wealth relative to others, then it's going to be much harder for people below them to move up, relative to others. I think we'd all agree that someone born lower-middle class has a tougher road to upper-middle class than someone who is born upper-middle class. But if the economy and law and society were such that someone born upper-middle class could more easily fall down relative to others, than it makes it easier for achievers to move up. But economically, and legally, and society-wise we're so trapped into the idea that children are entitled to not only stay in the class they were born into, but to actually exceed their parents.

That's not what I would consider the "American Dream" at all. It's not a competition with your parents, it's whether you have a work-family balance, make a good living and provide for your kids, and can somewhat comfortably retire when you hit a certain age. Whether my parents made 50K or 300K a year, that doesn't really matter. Parents just give you a better (or worse) starting point, but gauging your wealth against what they've made seems a little silly. So, if someone's dad made $300K and he only makes 150K - he's failed to grab the American dream? On the flip side, if someone's dad made 40K and they make 60K - they've completely attained the American Dream and are set for life?

I think you're cherry picking part of the point and taking it directly at face value rather than looking big picture.

As mentioned above, the American Dream is going to be something different for everyone. However, nearly everyone will measure it as some sort of financial success. Maybe not what we'd consider true wealth, but "freedom of choice in how to live", "good family life", and "retiring comfortably" are the most popular things listed. Guess what a good education and good job does? It greatly increases the chances for those those things. Guess what taking the advantages given to you by your parents and building off of it does? Increases those chances. Thus, the best way to measure that across 350+ million people is took measure children's earning against their parents. Is it not telling that until the middle of the 1950s 90% of children would outearn their parents and that number has dropped to 50%?

Economic and Social mobility are hallmarks of what everyone would consider the American dream. Read the interview, look at the studies listed and noted and you see that the American Dream is dying in this country. The statistics show it. It doesn't matter if people feel the American Dream is within their reach because the facts do not bear that out.

One of the primary reasons I posted the interview, though, was because of the discussion on healthcare and the impact being wealthy has on your health. Based on the data we have, creating a healthcare system that's available to everyone would likely have a more positive impact on life expectancy in this country that curing cancer. If that doesn't actually move people to realize that the privatized insurance system is broken beyond repair then they very likely fall in the group with the extra 15 years of life expectancy and don't want to risk that dropping a little by giving the peasants similar access.

There is absolute and relative mobility. I think relative mobility gets lost in this discussion.

Absolute compares Parent & Child $ adjusted for inflation. Chetty's tax data does show that a Child has significantly reduce chance to make more than Parent.

Relative compares Parent & Child relative positioning. If are Parent is in the 3rd quintile, the odds of you staying in the 3rd quintile has been "stable"

Absolute:


Relative:

I don't think Chetty was trying to define the American Dream. I think all he was saying is his analysis is one factor into understanding achieving the American Dream is trending downward. Its one (and a significant) data point.

Criticisms of Chetty's analysis re: absolute mobility. I think both authors will agree absolute mobility has decreased but they have issues with Chetty's methodology.

Misconceptions in Raj Chetty’s “Fading American Dream� | Cato @ Liberty
https://freopp.org/the-new-chetty-bo...e-3b7e60d93b24

A key counter:

Chetty said children born in 1940's had a 90% chance at better absolute mobility and children in born in 1980's now have a 50% chance. The beef with this is 1940's was after the Depression and it makes sense that the 1940's cohort had a higher %. Therefore, is it valid to say 90% is the benchmark?

One of the links (former Pew researcher) also has several other quibbles. He agrees it is lower now but not at 40% points. He puts absolute mobility in mid-70's.

Re: Vox link on Canada vs US. In Chetty's own words

Runtime Error

So is the American Dream alive? Guess it depends on how you define it but yes. The absolute mobility is an important input into American Dream but not the key indicator and not the best way IMO.

I'm sure a large factor why I disagree with others on this board who say the American Dream is dying is because I see it from the lens of an immigrant. Warts and all, best country for a new immigrant.

Using Hispanics as the largest immigrant group and on the low end of the spectrum ...



Toss in Asians also.

Asian Americans | Pew Research Center

The problem with continuing to cite polls in this what people feel is not reality. Me thinking I have a strong chance at waking up a billionaire tomorrow doesn't make it true.

And I'd argue that you see it through the eyes of someone that immigrated to America and have had some level of success here. That creates bias in your viewpoint. We have a million or so legal immigrants each year. I'm sure nearly every single one feels they made the best decision. Again, feeling something doesn't make it true and it would be easy to cherry pick the most successful out of those million and claim the American Dream is alive, but doesn't actually tell us much.

It comes down to the definition of the American Dream which is personalized and not just am I making more $ than my parents.

Yes, definitely biased having immigrated and having seen opportunities the US provides vs in many other parts of the world. This gives me and the vast majority of immigrants the perspective of glass is half full vs half empty.

We'll agree to disagree.

Scratch Jay Inslee from the race

2020 election: Seth Moulton to drop out of race - POLITICO

Seth Moulton we hardly knew ye.




Seriously though, who are you?

And now this...

The Hill on Twitter: ""Imagine what would have happened if, God forbid, if Barack Obama had been assassinated after becoming the de facto nominee. What would've happened in America?" Biden asked town hall attendees. https://t.co/i5IsNvJO3b"

Joe Biden in Keene, New Hampshire: "I’ve been here a number of times...I love this place. Look, what’s not to like about Vermont in terms of the beauty of it?” pic.twitter.com/YZBP4ybQ3z

— Steve Guest (@SteveGuest) August 24, 2019



Something is wrong.


And it’s just a tapestry of vulnerability. Somebody step in and stop this.

Biden is a failure. He's never been anything short of a doting idiot.