how did the US screw up health insurance so bad?
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How bad it is is wildly over-hyped. If you’re an ordinary middle class person with a full time job, which is the overpowering majority of Americans, the health system will serve you just fine. If you’re a retired person using Medicare, the health system will serve you just fine.
Where the U.S. Health system falls apart is at the margins. Young people who never picked up insurance and got sick. People who can’t get hours because their employer can’t afford to pay benefits for the work they’re doing. Self-employed people who lack the bargaining power to get a decent price for coverage. Ultimately these gaps produce situations where your personal savings have to be demolished before you qualify for medicaid (the real NHS of the United States).
And, for what it’s worth, Obamacare did a **TON** to cover over a lot of those gaps. The health care exchanges make coverage more available to individuals, and there are subsidies for low income people to get covered. You can’t be denied coverage for pre-existing conditions anymore.
But what doesn’t get talked about is how much more people in countries with single-payer health care pay in taxes. Americans are taxed at a far lower overall rate than the OECD average, only 26.6% of GDP. By contrast, countries like Denmark, France, Austria, Italy, Finland, Sweden, Norway and Beligum pay north of 40% of GDP. And in case you’re under the impression that they only tax rich people, every single one of these countries levies a Value-Added-Tax upward of 20%. That’s a sales-tax to you and me.
So, for most Americans, if you pumped up your taxes by about 60% and zeroed out your insurance premiums, would you really come out ahead? I suspect that for the vast majority of people, that answer is no. That still might not dissuade you, and I’m not sure it does me, I’m generally in favor of improving health care accessibility, but much of our political discourse about Health Care costs is mediated by looking at European Health Care costs after all the subsidies and tax transfers have been applied.
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