this post was submitted on 19 Feb 2024
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I'd like to know other non-US citizen's opinions on your health care system are when you read a story like this. I know there are worse places in the world to receive health care, and better. What runs through your heads when you have a medical emergency?

A little background on my question:

My son was having trouble breathing after having a cold for a couple of days and we needed to stop and take the time to see if our insurance would be accepted at the closest emergency room so we didn't end up with a huge bill (like 2000$-5000$). This was a pretty involved ~10 minute process of logging into our insurance carrier, and unsuccessfully finding the answer there. Then calling the hospital and having them tell us to look it up by scrolling through some links using the local search tool on their website. This gave me some serious pause, what if it was a real emergency, like the kind where you have no time to call and see if the closest hospital takes your insurance.

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[–] [email protected] 2 points 9 months ago* (last edited 9 months ago) (4 children)

Among the many problems we have in heading there is that vice taxes are implemented at the state and tribal (for tobacco) levels, so it’s impossible to have a consistent policy.

Cigarettes are a perfect example with a wide range of taxes depending on the state, and last I knew, sales on reservations were tax free.

Looking it up, I see

  • lowest is Missouri at 17¢/pack
  • highest is New York at $5.35/pack

That is such a huge difference: how do you turn that into a national policy?

You can also lol at life expectancy by state and see how each values its citizens

  • lowest is Mississippi at 71
  • highest is Hawaii at 80

How the heck can there not be an uproar at that life expectancy difference? How can some states keep following the same pattern despite such clear impact on life? Sure, a lot of it is likely poverty rates, but it’s the same set of policies, not just one particular vice tax

Edit: before anyone credits simply the tropical paradise of Hawaii for too much of that life expectancy, Washington, Minnesota, and Massachusetts are right up there without the weather advantage

[–] ThanksForAllTheFish 1 points 9 months ago* (last edited 9 months ago) (3 children)

The UK also has much higher income taxes. Comparing US and UK income taxes:

  • in the US, for someone earning 578,126+ USD (£457,000) it's 37%
  • in the UK, for earnings over £50,000 (~65,000 USD) its 40% , equivalent US earners only pay 22%
    • and when over £125,000 (~157,000 USD) this increases to 45% in the UK

US income tax is ferarally controlled. I don't have exact numbers but increases in income tax for the highest earners should be able to fund a public healthcare system, at least for the lowest earners in the US.

https://taxsummaries.pwc.com/united-states/individual/taxes-on-personal-income https://www.gov.uk/income-tax-rates

Edit: There are also state income taxes, which vary for some reason, I'm sure theres also county and city based taxes as well, processing them must be a nightmare. Is the US just 52 countries in a trench coat?

[–] [email protected] 1 points 9 months ago (2 children)

Is the US just 52 countries in a trench coat?

It seems that way sometimes.

There’s variation between states as a form of competition. For example Texas might attract people by claiming no state income tax, whereas Massachusetts might attract people with 100% medical insurance coverage, best education, highest quality of life.

When someone compares income tax rates and claims US is lower, I really don’t believe it because I know there are many taxing entities that are all separate from each other. I have no idea what other countries’ tax situation is, but are you really picking a fair comparison, if your taxing model is simpler? I’m cynical enough to expect we’re probably worse off than a simple comparison would show

[–] ThanksForAllTheFish 1 points 9 months ago (1 children)

You're probably right about being worse off overall, just so much unnecessary complexity. We do have council tax here, but that depends on how big a house you live in and how expensive the area is to maintain for the council. And its a fixed rate per household, owed monthly while you're at the same address. But I know the councils get most of thier funding from the state budget and other income streams like selling land. Theres also national insurance too which I guess is like social security. https://www.gov.uk/national-insurance

I have no idea ehich one is better, or costs more, but the UK does seem to offer more in return. Admittedly I only see the bad news stories about the US so have no idea what its like "on the ground". I've been to Florida, New York and Vermont, so I see how states are very different places with different needs, understandible why theres not a lot of state unity on issues.

[–] [email protected] 1 points 9 months ago

Yeah, I do want to say that nothing is as bad as our bad news highlights. Even all the crazy”Florida Man” stuff, at least some of that is from laws favoring transparency in the legal system over other places favoring privacy of the accused. A lot of the political craziness is just posturing for points. Gun violence may be twice that of other developed countries but it’s still pretty low and most people do not live in fear. Etc etc.

I’d even claim some of what you hear is good, in that it’s a good value to criticize your own society. That’s how we get better.

Then again, most of it is probably outrage headlines and clickbait.