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Comment by wskinner | Hacker News Reader

I'm not sure where you're getting the $20,000/year healthcare spending number, but that looks like it is too high by an order of magnitude. See e.g. https://www.commonwealthfund.org/publications/issue-briefs/2..., which puts median annual household spending on healthcare between $1,500 and $5,540 in 2019. If you're talking about total annual healthcare spending, that is largely paid by employers so should be accounted for as increased gross earnings for employees, which translates to lower effective tax rates.

And yes, the effective federal rate is not the total blended rate paid in the US, but it's not in the UK, either. For example, far as I know, no US region has a sales tax close to the UK's 20% VAT - sales tax is set locally but in most places is around 5-10%.

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> I'm not sure where you're getting the $20,000/year healthcare spending number, but that looks like it is too high by an order of magnitude.

Certainly not by an order of magnitude.

In the US if you are single and work for a well-funded company (e.g. FAANG types) they will probably cover 100% of the health care premiums monthly and your deductibles will be low, so a couple thousand out of pocket is realistic.

Any other scenario though, it's going to be much more. Very few companies cover all the health care costs for the family of the employee. I've paid anywhere between $1K/mo to $2K/mo for full-family coverage while employed, with the employer covering the rest (total cost is over 40K/yr).

Good employers usually pay 75% or more. My family health insurance costs $28500.

That median number also includes people without coverage or with Medicare and Medicaid, which aren’t accounted for that way.

>which puts median annual household spending on healthcare between $1,500 and $5,540 in 2019.

I'm guessing that doesn't include employer subsidies. I pay (as an individual) ~$940/month for health insurance, plus a $600 deductible and $40/visit copays for doctors, $150 copay for emergency room visits and $1000 copay for hospital admisisons.

Assuming I don't need an emergency room or a hospital admission, that's over $10,000/year just for healthcare.

This article is specifically limited to people with employer-sponsored healthcare plans. $20k is a reasonable estimate for a family trying to get decent health insurance independently.

You mentioned this earlier

> In the US, someone earning $155,000 USD...

Later you say

> $20k is a reasonable estimate for a family trying to get decent health insurance independently

So are we talking about people who have full time jobs and employee sponsored healthcare or are we talking about people getting health insurance independently?

> $20k is a reasonable estimate for a family trying to get decent health insurance independently.

That's on the low side. I'm currently taking a break between jobs and thus paying for health insurance out of pocket. For a family of 3 in California, I'm paying $42,000 annually.

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