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Comment by geofft | Hacker News Reader

That doesn't explain why people who can't afford health insurance are opposed to universal, government-funded healthcare, which is what the comment above you was about.

Meanwhile, I (SRE at a hedge fund) and all my liberal coastal elite friends can absolutely afford private doctors in an emergency without having to think about cost up front, and we do support universal healthcare—and we know it would be a larger tax bill for us.

(BTW, in practical terms, putting liberal elites in well-paying, politically-connected industries on your healthcare system is a great way to make sure it doesn't turn into the VA. America cares deeply about our happiness. It doesn't care about our veterans and sort of wishes they hadn't survive, so we could just remember their sacrifice instead of actually facing up to what we did to them.)

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for a lot of deep-seated structural reasons, the US tends to be pretty bad at implementing most citizen-facing services. it doesn't seem unreasonable to think that we would also do much worse at universal healthcare than the europeans. for the services that the US does actually offer, we tend to spend more money and produce worse outcomes.

> (BTW, in practical terms, putting liberal elites in well-paying, politically-connected industries on your healthcare system is a great way to make sure it doesn't turn into the VA. America cares deeply about our happiness. It doesn't care about our veterans and sort of wishes they hadn't survive, so we could just remember their sacrifice instead of actually facing up to what we did to them.)

this is a pretty common talking point, but I don't really see this happening with the systems that already exist that wealthy people have to use. I, an upper-middle class white person, still have to take at least a half day of PTO any time I need to go to the DMV. my dad, wealthier than me, still had to spend a whole day at city hall disputing a $40,000 water bill (the city doesn't even have a functioning water meter on his property because DPW paved over the access; it's been "estimated" for twenty years).

>and we know it would be a larger tax bill for us.

It would quite possibly be a net saving. The UK, for example, spends less public money on healthcare than the US. There's no necessary reason why you should end up paying more in taxes for universal coverage than you pay currently for insurance.

convert your USD salary to pounds and then do a UK tax calculator. compare the UK NHS tax to your yearly premiums and copays plus the employer contribution (should be on your W-2). when I did this, I found that I would pay about $2k more for the UK tax than my total healthcare costs in the US (including the portion paid by my employer). I'm sure lots of people on this forum make even more than I do.

there are definitely some good arguments for universal healthcare, but software devs should not delude themselves that they will do any better than break even in most cases.

edit: probably not true, I didn't investigate the UK tax system enough.

What is the UK NHS tax? There is no such tax, as far as I'm aware. You may be thinking of "National Insurance", but that is not specific to the NHS (and nor do all NHS funds come from National Insurance).

I'm sorry, it's actually called national insurance. am I making an incorrect assumption? I'm just going off this tax calculator: https://www.moneysavingexpert.com/tax-calculator/

Yep, incorrect. National Insurance is not an NHS tax.

sorry to be obtuse, did I just call it the wrong name or is it completely different? I'm american and I just assumed that NHS is the government org that handles healthcare and a mandatory contribution is pretty similar to a tax.

See my comment above. Not all of National Insurance goes to the NHS, and not all NHS funds come from National Insurance. There exists no special tax whose revenue is earmarked for the NHS. Thus, there is no easy way to see how much of your pay you are contributing to the NHS. Similarly, someone in the US can’t easily see how much of their pay goes to the US military or to the National Science Foundation.

edit: On an individual level, a lot will depend on your income, and how expensive your US health insurance is. Here is an informative post:

https://www.quora.com/If-you-make-100-000-in-UK-what-percent...

That works out to about $560/month for someone with a salary of $100,000. If you take into account employer contributions, that's still less than a lot of Americans are paying. If you're on a lower income, you're likely to be paying significantly less in the UK for much better coverage.

And I almost forgot - copays! The amount you're paying in taxes in the UK really is paying for virtually the full cost of your treatment when you're sick.

understood, ty for the explanation.

>That doesn't explain why people who can't afford health insurance

It's because doctors et al don't want to work for less than $x/hr and there are people who don't produce enough to trade with doctors or prefer to spend their money on other things. There's no way to get a free lunch out of this.

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