Comment by mechanical_fish | Hacker News Reader

Comment by mechanical_fish | Hacker News Reader

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mechanical_fish

I'm not willing to pay an extra 10-20% taxes in order to have 'free" healthcare

And just what percentage of your income goes toward healthcare right now -- both for you and for other people?

My wife and I pay $600 per month in post-tax dollars for our health insurance, thanks to Massachusetts' healthcare plan which lets anybody buy group insurance through the state. (If it wasn't for Massachusetts, I'm not sure what we'd be doing for healthcare -- we're both independent contractors, and you can't buy health insurance through IEEE anymore -- so I consider myself lucky to get that rate. And if that sounds incredibly expensive to you -- well, congratulations on being 23 years old! But don't expect to be 23 forever!!)

The median annual household income in Massachusetts is 60K. (Source: http://projects.washingtonpost.com/elections/keyraces/census... ). That's in the 25% federal tax bracket. (http://www.moneychimp.com/features/tax_brackets.htm ) State income tax here is 5%. So $600 per month post-tax is $857 per month pretax. Thus, the median couple in Massachusetts can expect to pay $10,285 per year for their own health insurance, or about 17% of the median annual income.

Now, you could argue that your median couple might be getting their insurance "free" from their employer. In increasingly many cases this is not true -- fewer and fewer employers provide health insurance -- but even if it is true it merely raises the couple's real income to $70,285 -- of which 14.6% goes toward health care.

Now, that doesn't count the percentage of their federal taxes that goes towards health care for themselves and other people. As a quick estimate, a handy website (http://www.nationalpriorities.org/taxday2008 ) tells me that 22% of each Massachusetts resident's tax dollar went toward health in 2006. 60K * 30% * 22% is $3960, so that's another 6.6% of pretax income toward health care.

Thus, health care costs consume something between 20% and 24% of the median family income in MA. So, if you ask the median Massachusetts resident if they're willing to have taxes raised "10-20%" in exchange for free, guaranteed, universal healthcare the first-order answer is "hell, yes" -- even if you assume that the U.S. healthcare system would remain terribly inefficient relative to other systems worldwide. Which I would hope it wouldn't.

As I said below, I pay $270 a month for my family with a $5k deductible. Worst case, I'm out $8200 before my 100% coinsurance kicks in. I am self employed as well, so this is my total out of pocket cost, no employer contribution.

Without getting into specifics, $8,200 is less than 10% of my income. I realize I am not in the "average" spectrum, but realize thay my opinion on the subject is just as valid as those on the other end of the income spectrum.

When I was broke, sure I wanted the government to pay for everything (college, etc.). Now that I'm not broke, I don't want the government to pay for anything (for anyone) if it's going to cost me money. It's funny how things work like that :).

When I was broke, sure I wanted the government to pay for everything (college, etc.). Now that I'm not broke, I don't want the government to pay for anything (for anyone) if it's going to cost me money. It's funny how things work like that :).

I have friends with a) cancer and b) no insurance, because they can't afford it.

I'm not laughing.

I suggest your friend move to massachusetts, if possible. Last I knew, there was no pre-existing condition exclusion allowed in MA, and now rates are available through the state.

My sympathies to your friend.

a) that sucks for them b) they need a better job

Listen, life isn't fair.

You want the benefits of capitalism without the risks? How does that work?

>a) that sucks for them b) they need a better job

You have a complete lack of empathy. I don't think that's healthy.

>You want the benefits of capitalism without the risks? How does that work?

Government that truly cares about the interests of the people.

> How does that work?

See Canada, Europe and other countries.

So I'm going to piss off more people, but "see the list of places I don't want to live."

And I have lived outside the US so this isn't myopia.

Listen, running a business and being successful is significantly harder in those places vs. the US.

I want to live in a place where the limit to my future is me. Not what the government says is my limit.

I don't want to have to pay employees to not work, to work 30 hours weeks (and complain about it), 5-6-7 weeks of vacation. I have no idea how small businesses make it in the EU. It's silly how much they have to pay their workers between salary and benefits.

For all the drones out there, the EU is a great place. For people with aspirations it's a death spiral.

You're giving capitalism a bad name by calling the American health care system capitalist ( especially the system in Massachusetts). American healthcare is just as regulated as Europe. The difference is that while most European systems run on a system of price ceilings for care, America has a system of price floors. Since there are pretty steep diminishing returns to health care spending, price floors have the neat effect of making health care super expensive without increasing quality.

American capitalism has many advantages. Health care is not one of them.

I'm not saying that our system is capitalism. I'm saying that socialized medicine (which is what other countries have) and big government flies right in the face of what this country is based upon, personal liberty, responsibility and freedom.

And show me any place in history that price controls have been an effective fiscal policy.

Look at the third world and see how well it works for them.

I lived in a place where the price of a loaf of bread was fixed at x. Well when x was a fair price and provided profit to the baker everyone was happy. 10 years later, people were so used to bread being x that when noone could make bread any more because the cost of the ingredients had gone up so much there were riots. So what did the government do? They raised minimum wage and price controlled the ingredients for bread. So all the bakeries closed down. And now a bunch of other shops closed down or fired their employees. Then what? Laws making it impossible to fire an employee.

Price controls and fixing are not the answer.

I'd prefer a health care system with no regulations and no price controls.

But if forced to choose between the system in the US, and the system in France, I would choose the French system. France provides equal enough care for what I want, at a far lower price. I suspect that a completely unregulated system would be better than both. But the United States does not have such a system. The US system is not technically "socialized", but the regualations are so badly designed the outcome is far worse than a socialized system.

Libtertarians often get so caught up in the quantity of regulation that they do not care about the quality of regulation. There are many cases where outright socialism is better than a terribly misregulated private system. By reflexively defending the misregulated private system as the lesser of two evils, libertarians ruin the credibility of both themselves and of capitalism.

>I'm saying that socialized medicine (which is what other countries have) and big government flies right in the face of what this country is based upon, personal liberty, responsibility and freedom.

Well, you're probably correct there. As a entrepreneur though, it's rather dangerous to let ideology dictate a solution to a problem, especially if something else can do a better job.

You can certainly argue about whether social medicine is that something else, but to remove something from consideration simply because it "isn't how we do things here" sounds like a recipe for failure if you ask me.

You only responded to 50% of my argument though.

Canada is a good mix if you ask me. 40 hour weeks are the norm, small business is encouraged, but the understanding that people have lives and are not beholden to their employer has an overall positive impact on society as a whole.

Granted, I've never tried to operate a business in the US, so maybe I just don't know what I'm missing, but I'm certainly greatful that my son spent the first year of his life exclusively with mom.

Canada's great and all eh (sorry couldn't help it :), but there's a reason that what, 60%+ of the population lives within 20 miles of the US border.

But from what I know, the canadian system seems more likely to be what the US could transition to than, say the UK system.

FWIW, my understanding is that Canada's system is that the government acts like an insurance company, so rather than all medical facilities being government facilities, they are private and they simply bill the government. In the UK, all facilities are government run, so there is no billing at all [well I'm sure there is behind the scenes].

60% of Canada's population doesn't live within 20 miles of the border. 500 miles maybe. :)

The reason for this is though mainly lies in the weather, and really has nothing to do with anything else. Hell, not many people live in North Dakota either!

Basically, you're correct in your interpretation of how our Health Insurance works. There are caveats (no deductibles, bans on what a private clinic can do, caps on doctor earnings) but generally the system is a good compromise.

According to Wiki, http://en.wikipedia.org/wiki/Canada, 75% of the population lives within 90 miles. So I was off a bit :). You're likely right about the reason though! (climate)

>I have no idea how small businesses make it in the EU.

The governments outlaw the sort of things that large businesses do to drive small businesses out of business. Wal-Mart just pulled out of Germany because the government wouldn't let them abuse their employees. There's a downside though - try buying groceries after 8PM in Germany.

but how is having an expensive workforce keeping small shops in business? I mean the really small shops like mom and pop shops can do it, but the 10-20 employee businesses must be running much tighter than they could here.

I agree with goofygrin; this thread reminds me of this: http://www.latimes.com/news/opinion/la-op-orourke4-2008may04...

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