Our taxes fund more public health dollars per capita than almost anywhere else in the world. Medicare and Medicaid spending is higher than DOD budget, and that’s before you include medical research funded by NIH and DOD or VA spending.
The issue is that our prices are out of control because of regulatory capture and downstream inability of the government to negotiate lower prices.
There's a lot of money to be made in making sure the US Govt isn't paying minimum dollar for goods and services, be it healthcare or military spending.
It’s about stealing everything they can between those that need and those that provide.
Insurance companies. Middle management. It’s everywhere. Needless spending that’s made up to create “industry”.
This industry should never have existed in the first place. It’s akin to fire departments standing in front of a burning home until the owner pays up, and if they don’t they get robbed while the place burns.
That was determined by the public to be greed driven, robbery and also fucking illegal.
But the insurance industry does it daily for generations, constantly creating scenarios where people die or become destitute and yet it’s legal?
look, your argument is fair but inaccurate. When the Insurance company’s negotiated rate on a heart attack is 14k, but the hospital bills you 300k, then the problem is we’ve allowed for private healthcare to make more sense and forced government funded healthcare to be overly complex.
Let me repeat this but in capitalism, we have DONE THIS PURPOSELY so that private healthcare companies can make money.
"The issue is that our prices are out of control because of regulatory capture and downstream unwillingness of the governmemt to negotiate lower prices."
It's not about unwillingness. Negotiating lower prices requires collective bargaining. In the US there are so many different insurance companies and each one has to negotiate prices for its relatively small pool. Contrast that with countries like Canada which have a single system, giving them the ability to negotiate prices for the whole country.
I wouldn't call it unwillingness, Obama did try to create a public option.
That's what happens if you don't have public health care.
A small insurer or even an uninsured person cannot bargain with large pharma companies. If they try to, the pharma company will just not sell the product, because it's more expensive for them to lower the prices for everyone compared to losing one small customer.
But if your whole country's health system bargains at once, it can get much better deals, because not taking a deal means for the pharma company that they'll lose access to millions of potential customers.
That's why for example in Europe Insulin costs about 10% per dose compared to what people in the USA have to pay.
Our tax dollars fund more corporations than other countries. The military spends so much because they pay private companies for their equipment, which is sold at inflated costs because they can. The US spends a shit ton on health care because private companies inflate their prices because, again, they can. The government/insurance companies don't even pay the full price that's listed on the bill, but they still use the original numbers.
You can't compare our spending to other countries. The US spends more because they pay inflated prices. Citizens spend less because we can't afford to get health care.
so if they put such a generous amount in, why isn't healthcare free then, like in Europe? if i have the flu and go to the doctor, even the medication they prescribe is subsidised, i pay max 6 bucks for everything
Insurance companies. Because of the way they operate, healthcare providers are forced to raise prices as high as possible so that they can actually afford to operate once the insurance companies negotiate the lowest price for care they can.
And then the insurance companies charge consumers high prices anyway and pocket the difference.
Indeed, what good is all that public health spending when health corporations and orgs are determined to maximize profit, and no authority is willing to curtail their efforts
It's not regulatory capture, it's a complete lack of federal regulatory guidelines in regard to the insurance industry.
for a medical service provider to be insured (and thus not be destroyed by the first malpractice suit they lose) they need insurance, the insurance companies have their own stipulations onto the healthcare provider, like all their stuff being certified, now guess who owns the respective certification companies? letting them charge whatever they damned well please...
I don’t like paying taxes, but holy hell not having the things they’re supposed to pay for sucks. You ever use a toll road or get caught in an intentional speed trap? Holy hell it sucks. And also we’re only kinda sure our food is safe and our medicine works. But the cops have tanks and the beef and gas are subsidized
I mean toll roads make sense, I'm not sure why we're expected to pay to use public transport but not roads, when roads are far more expensive to maintain and us driving literally causes them to be damaged.
If roads and parking are free then public transit should be free. Otherwise toll roads are fine by me, although they're technically a regressive charge in the US and Canada since you're kind of forced to use a car in most areas... I mean car dependence itself is a giant regressive charge so that's just one part of it.
But assuming we had actual functional transportation infrastructure, toll roads would actually be preferrable near more densely populated areas since it makes you think twice about using your car instead of taking a train or biking.
The way toll roads work in a lot of places is that they are built with public funds, then a private operator gets a lease for a set amount of time and gets the lion's share of the revenue.
It'll encourage the use of public transport over private vehicles (provided there is a good public transit network present). Public transport has got better efficiencies, and if it can supplant individual transit to a good degree, that's not a bad thing.
As far as 'overuse' goes: how many people do you know who just travel on public transport for the fun of it? Even in places where people can travel for a flat monthly fee, very few people spend any more time on public transport than they need to. I doubt that free public transport would substantially change that.
Few people just like to hang out on trains, although I do remember the one guy on Reddit who did all his coursework while cruising around Switzerland and then got trapped in a railyard. However, plenty of people will choose a long commute or to visit a more distant destination if it's cheap enough. Extreme example, but I once knew a person that drove a full 2 hours each way to work. Through a far more densely populated area.
I don't and couldn't really have empirical evidence that people would overuse free public transit, but the I think the theory is strong. Generally, people will travel less if travel is more expensive. If travel is provided at cost instead, they'll avoid it unless the value to them of the travel exceeds the cost to other people to provide it and bear the side effects.
Another thought: Flights In some places there's a government air carrier, and they fulfill the same basic function of getting people from point A to point B. Usually they're not considered public transport, but then you have cases like the small arctic communities in my country, which are filled with very poor people and can only be accessed by plane. Should we make an exception? That's where things might get complicated.
Why shouldn't you pay for using car infrastructure? You're damaging the environment and damaging the roads, it's a lot more sensical for the cost to be put on you, the driver, instead of burdening everyone else with higher income/sales taxes.
Funding for the development and maintenance of roads in the U.S. come from a variety of taxes such as vehicle registration fees, wheel taxes and taxes on gasoline and motor fuel. So , we do pay for using car infrastructure
Yes, but not nearly enough. Those kinds of taxes are extremely low (especially compared to e.g. the EU) and form only a fraction of the costs of car infrastructure.
All those hundreds of billions to trillions of dollars in infrastructure bills, all the regular car infrastructure maintanence costs, a large chunk is paid for by taxes that everyone gets regardless of how much they use a car. And all the extra non-tax costs (in both time and money) that non-drivers have to pay because car-dependent infrastructure fucks up transportation for everyone else, that is a massive charge.
I just said – you're burdening other people with taxes for damage that you cause. Car infrastructure meant for drivers destroys the fabric of cities/towns, destroys the environment, and costs a shit ton of money on top of that.
Using more toll roads and similar things means you can "tax" people a lot more proportionately to how much they use cars on public infrastructure, instead of punishing people that don't use cars or use them less than others. It would be entitled to assume that everyone else should pay more taxes because you want to use an expensive destructive and dangerous mode of transportation rather than just take public transport or bike.
I also find it hilarious how my state gives tax credit for using/owning an electric car, but not for not using any car at all... this kind of shit is representative of the norm across most of the US, car drivers are directly subsidized by non-drivers.
(It's obviously a lot more complicated than "make more toll roads" since some jobs actually need vehicles, plus it'd make sense to mostly do it around densely populated areas)
I pay for schools i dont go to, hospitals in places ill never go to, roads i dont use. The point of taxes is to pay for the things that better everyone even if you yourself dont personally use them.
Okay, but schools and hospitals don't destroy the fabric of cities and don't destroy the environment. Schools and hospitals actually improve society a lot and SHOULD be subsidized.
A majority of the money spent on car infrastructure does NOT go to improving society. In the current state of things, cars harm society, and the majority of people using cars don't need cars. Most of the money spent on car infrastructure should be put into actually making transportation not car-dependent, and as I said earlier car drivers should subsidize this.
It would be great if we could shift to a better system integrating better and much more robust public transit, but in much of the U.S. driving a car is the only option. I understand being upset with the system we have, but taking out your frustrations on many people who don't really have a choice is counterintuitive.
Wait but cars don't damage the road (much) - trucks do. We should all be mad we are so heavily subsidizing the cost of moving goods to our grocery stores, construction sites, and anywhere else.
The simple answer is to make commercial/industrial users pay fairly. Practical studies have shown that road damage is related to the fourth power of vehicle weight. The damage attributable to private cars is less than a rounding error compared to commercial vehicles, and commercial users have the most directly-atttibutable profit from road use.
Gas tax is pretty much nothing in the US... the minimum gas tax is about 3x higher in Europe (and it's usually much higher). The amount that people from areas prone to having high rates of driving (suburbs for example) pay in taxes is highly disproportionate to the amount car infrastructure costs.
Plus using things like toll roads means you can reduce the car infrastructure tax everyone pays a lot, currently if you're not a driver or don't drive that much you generally pay the same amount (or maybe slightly less with tax credits if you're eligible) as someone that drives constantly. Which is pretty terrible – using cars as the primary mode of transport is just bad for society, and it should be looked to reduce it as much as possible. My taxes shouldn't be going to funding unnecessary car deaths or mass pollution etc. etc., and cars are one of the largest causes of pollution on the planet.
Gas tax doesn't do much in that regard, sure it's a minor environment tax but those who don't drive are still subsidizing the people who do. Ideally it should be the other way around – people who drive who don't need to drive should be subsidizing those who don't drive.
Gas taxes generate only about $50 billion of revenue, when car infrastructure spending is in the hundreds of billions per year. At this point I pay more in regular taxes than someone who drives regularly pays in gas tax. Plus the gas tax is out of the picture when we consider EVs – which still have a majority of problems gas vehicles do, and cost individuals who don't drive a ton of money still, minus the constant pollution.
The € 0.867 is standard Consumer tax per liter on gasoline.
This is only the tax on gas, let's not talk about the tax you pay for your vehicle every month. I don't like it, but it beats being eternally in debt for breaking your finger. Or destroying my car in a pothole.
It's just a matter of how much they want to invest in what.
In many cases toll roads mean that the government didn't want to/wasn't able to invest in building a road, so they let a private for-profit company do it for "free" (meaning without tax money) and that company then recoups their investment using toll.
Some times toll roads are used to steer traffic. Some cities for example have a city toll that's meant to discourage commuters from using their car to get into the city and instead get them to use public transport.
The first case means the country doesn't raise enough tax, wastes too much tax money or has other priorities than road infrastructure.
The second case is totally valid since it uses tax to discourage unwanted behaviour.
A controversial take apparently, but yes. A big part of the reason everything was able to become car-centric is because we're effectively subsidising driving by providing the infrastructure for free, both parking and road.
You can also go the route of a hypothecated tax by mileage, which is probably more convenient.
One of my theories is that not only is it about how these taxes get used (as in the OP), but also in the US you have these constant reminders, it's not added to your restaurant bills or supermarket prices until the end, you have to calculate it yourself all the time and that keeps it front of mind. I never used to even think about tax until I started my own business (since now I don't have to pay it for business expenses). When something costs 100€ it costs 100€, you don't think about the fact 20 of them are tax because you, as a consumer, pay 100 and that's that. Same with salary, it gets taken at the source and once a year you just need to verify, and usually you get some money back making it a positive experience.
Yeah I never understand why tax is not included in the sales price, just seems arbitrary to exclude that. It is definitely been uncomfortable, back in the days when I used to use cash, and I would have just enough for like a burger or something,
Only to realize that I had enough for the price on the menu but I didn't have enough for the tax. It's just annoying
A society requires governance. Staff to set and enforce rules, staff and supplies to execute services which provide social and physical infrastructure.
Certain things every community needs: Healthcare, education, transportation, utilities, support services for special needs, safety, rehabilitation for rule breakers, etc.
A government can figure out how to provide these services (with in-house or out-sourced expertise) and provide you with one bill (taxes). Or they can privatize a service, meaning you still need it and they may regulate it, but you'll be paying someone else for that service.
The value of taxes should be considered in this light. How much do I pay for all the services me and my community needs, and what portion of that is taxes. Then compare to other countries to see how well our governance system is functioning.
Does privatization save cost? What balance of regulation keeps things affordable vs driving up expenses? What balance of in-house expertise vs outsourcing is the most functional? What is the cost to quality of life having to pay bills to 15 organizations vs one? Where is there an extra heavy burden of cost and what can we do through regulation to fix it? These are the questions we should be interested in when it comes to governance, an elected official's personality or opinions should be negligible factors.
I pretty much agree, taxation is only theft in america, and the only reason for that is because we are getting anything for our taxes outside of a bunch of dead third world children. Which doesn't really help me put food in my stomach, or treat the stuff in my brain that causes memory problems and could possibly kill me when I turn 40.
We also have a constant drumbeat about how taxes are evil coming from politicians and pundits that represent half the political spectrum, all because they've discovered it's a good way to turn people against the other half.
I know the point you're trying to make, but generalisations like these aren't helpful. After all, the UK have voted for the Tories for around 13 years, who are notoriously a low-tax party, and have a lot of support from wealthier people and self-employed people that don't like their money aiding others.
Arguably, the Conservatives under Boris were a populist party that exiled the vast majority of conservative MP's that still believed in traditional conservatism. Pair this with Brexit, and we ended up in a position where the only path forward is higher taxes or (further) financial ruin.
The party will always be one of low taxes, and conservative values, but not until Sunak is out, and the rats leave the ship. Funny enough, the skilled trades and southern professionals still see the Tories in that light, even though they're basically the Brexit Party right now...
We know what it's really all about, they are afraid of immigrants and foreigners. The taxes are just an excuse.
You don't see the temporarily embarrassed millionaire phenomenon over there. I mean the leftist party there is literally called Labor and is still much further to the left than the Democrats are, here A labor movement idea is too toxic to consider simply because too many dumbasses will happily lick boots leaving falsely, that they will be the ones wearing the boots someday.
It's not even a nice military though! Failed audit after failed audit showing billions of dollars not accounted for. When you enlist, one of the trainings you get is how to sign up for WIC, because they don't even pay you enough to feed a family (at first) if you lay down your life. This country is a joke from the outside, and a nightmare to live in.
In the 2000s, military applications were through the roof. I went to a poor urban school. And the promises of joining the military was discipline and support. We were already on WIC and couldn't find a job, what makes this any different?
A decade later, all my friends who joined the military are struggling in dead end jobs and constantly complain about the lack of support. And they're worse off than before... Just now with trauma.
They're referring to the original use of first / second/ third world countries which has nothing to do with economic prosperity or development, and just where they were in a war.
The doctor decides if you're ill and if so what treatment you get. If they want to brush you off and say you're fine, they can and do. Or they can decide if you get "treated" with a "take these painkillers and go home" rather than look at the cause of the issue.
If you're ill and turn to healthcare for help, but you get none, are you then recieving "universal healthcare"?
I suspect you understand this, but pretend otherwise.
I honestly had no clue what you were talking about when you said "Tell that to our doctors" in response to "Google says you have universal healthcare".
Honestly, what you describe that doctors do is the norm in the US and, as far as I know, most places. On top of that, we have to pay for health insurance out of pocket either partially or fully before receiving any treatment (premiums), when receiving treatments (copays), and after meetimg our deductible (co-insurance). Then they start to pay, but it starts all over again in the new year. So don't get sick if you have the budget insurance.
And then those insurance companies can limit the types of treatment the doctors can prescribe or make them jump through hoops before prescribing those treatments.
So .... Yeah. I'd like to have what Sweden's got.
Edit: I didn't even touch on PBM, private equity in clinics and hospitals, surprise billing, arcane rules to limit foreign trained doctors from practicing in the US, under funding of residency, not training enough doctors for our aging population and much much more
I would have joked that at least everyone can join the military but they said I was too fat to join back when I was 19 when I was only 25lbs overweight. Isn't it your job to whip my fat ass into shape? What the fuck am I paying you for?!
I always find it amusing when Americans can only come up with paying less taxes as the answer, then they don't understand why they get less services. It's almost like you should expect more from the tax dollars you already spend. But I guess that's the point of this post and I'm just beating a dead horse.
To be fair, more taxes is not the immediate answer to America's problems that people think it is. The average American already pays more in taxes than most Europeans. The real issues come from the fact that the US Govt. can not legally produce goods or services (only in very specific circumstances) and has to contract it out to private companies. See roadwork and infrastructure maintenance as one of the most obvious examples. Regional companies exercise an uncontested monopoly on these contracts, causing budgets and schedules to balloon several times past what they would if handled by a service that was directly funded and administered by public office.
Americans already do pay more. The problem is that they get less for their money than any other western nation. While I don't agree with the conclusion, it's not hard to see why so many people watch their country fall into disrepair- despite paying more taxes than ever- and say "to hell with it, I'd rather keep my money than throw it into the corrupt bureaucracy who won't even do anything."
what you’re missing is the fact that most of us pay for healthcare through our employer. Clearly a win, yes? no. no it is not.
For those of us “lucky” americans that did the FUKCING MATH, i pay more in healthcare + taxes when you account for the $12,000 deductibles annually and (AND!!!!) the cost of the privilege for having insurance of anywhere 600-1600 per month. Nevermind the fact the stupid private party insurance gets to decide if “I” am allowed to get a procedure. So i pay for someone else to make a decision that my doctor determines is necessary, which is declined (of course), then appealed (and denied), and now somehow i’m hooked on some fucking opiate because the pain is so great while I wait for Jim at statefarm to approve my necessary procedure. Oh, somewhere in there lets throw in a termination from my employer for showing up high on synthetically prescribed heroin (dilaudid) and now i’ve lost said insurance that i’ve paid 12000 into.
Or I could pay less in taxes by just hoping I will live longer that the conservative (and even some democrats) party dies a horrible death. All without the needed medication and coverage that is keeping me alive… am I winning yet?
So there you have it, those not paying for insurance are winning the war against… fuck, i don’t know anymore, what are we fighting? Right, right, the evils of socialized healthcare and “higher taxes”.
yes, i am ok. no the dilaudid story is true but it is not me, it was someone i knew… guy voted trump until he took care of his own mental issues permanently and fought you all the way.
For future reference:
Have your doctor write the literal phrase "medically necessary" on the order. If denied, contact the insurer and ask for the License Number of the Doctor who refuted the necessity. Keep in mind, if they're NOT a doctor it is ILLEGAL for them to make a medical decision.
If they actually get back to you with a license number, you can use that to pull the credentials of the person denying the claim. Present that information to your doctor and I'm sure they'll help write you up a nice paper to send into the medical review board of the state they're licensed in.
I've had to use this method twice with my wife's healthcare. Approvals came within an hour of requesting the license number of the person on their end making medical decisions. The key being the phrase. A doctor's order, or prescription, is a legal document. Your doc putting that phrase means "I believe in this treatment so much, I'm willing to bet my license that they need it."
YMMV as I've only had to deal with BlueCross and they hate when I call.
I always find it amusing when Americans can only come up with paying less taxes as the answer, then they don’t understand why they get less services.
The ones for whom "less taxes" are always the answer know that they'll get less services. They are fine with that as long as it means the minorities they hate will also get less services. Particularly if they suspect that those minorities can't weather the lack of services as well as they can.
These are the people who filled in municipal swimming pools with concrete instead of letting black people use them too.
That's my argument. There's no need to raise taxes. It's all scare tactics from the GOP. In Texas, a hot topic last election was our increased property taxes. The democratic nominee for governor proposed legalizing weed and using those tax dollars to lower property taxes. He lost the "moderates" when he proposed stricter gun control the last time he ran and they never got over it. Conservatives would rather pay extra money and complain about it than legalize the devil's lettuce.
Politics is theatre. They use buzz words to win the ignorant votes. I don't think we'll ever see a return on our taxes because of how much it would take to completely flip the system. Businesses would go bankrupt if we had access to socialized programs, and that goes against the capitalism that the country stands on.
Removing tax havens within the country would also do a fair bit, and people wouldn't notice any difference from that, except that there is a lot more money that the country could spend on more useful things.
As an American I’ve been taking a truly radical position of openly demanding higher taxes. Like fuck you none of us pay enough. It’s easy to say tax the rich, but they’ll get tax cuts real fast if we don’t break the taboo on raising taxes.
Unfortunately for the post, military is 3rd behind social securities and Medicare.
The issue is far more fundamental than "but ma military spending". And while military spending definitely contributes, the biggest problems are a hugely wasteful medical system and economy that pushes money away from the majority, away from taxes, and up to corporations.
Largely starving the country both in tax revenue, in political capital to make actual positive change, and the literal people as they stop living and start surviving more and more often.
Social security is not a tax though. It's a forced pension system.
We really need to separate that out in people's minds from a tax so that they get more angry when politicians try to make changes to make it pay out less. It's not that they aren't being nice anymore with our taxes, it's theft from our pension we contributed to.
I walked out in '03 when Bush ran the green screen and I put it together he was flat out lying. I ain't "serving" that one when there's no protection for anyone but the oil billionaires feasting in the des(s)ert of our deaths. I also had just discovered the 9/11 was completely fraudulent and that even AC predicted it. Sure, vague poetic shit but Back to the Future hit that shit with a bullseye spelled out a hundred times. Don't mind the pictorial art painted over the Cross of the dollar. I got refs if you're curious about any of that. Glad I'm not one of them and I feel zero regret at all for my choice.
Huge swaths of Southeast Asia, South America, the Middle East, Hawai'i, and even North America's own Indigenous peoples can all affirm that the US military is indeed very nice and only ever acts in self defense.
I mean if the 1% paid their share of taxes proportionate to their income we could live in a utopia :)... But nah... That one polical side that should not be named will continue making the poor poorer and pocketing the money for themselves.
Maybe the issue isn't private medicine. Like you said, both have private medicine but Germany doesn't have the same issues as the US. One difference is public insurance. I know there is Medicare, but that's only for older folks.
The difference, from what I can see across the pond, is that the medical industry in the US is a government supported cartel. No one can get into the industry to create competition and existing players can do whatever they want. The US government created a lot of regulations to prevent anyone joining the industry and completely deregulated day to day operations for established players.
Do you have do any examples of these regulations that exist in the US but not in Germany or other countries with better access to healthcare?
In terms of insurance, are you saying that Germany actually has more competition in that space compared to on the US side?
Competition can help lower prices with things like collective bargaining. It's the reason that Canada pays less for drugs, because they can negotiate prices on behalf of the whole country. However, the US has more competition and several private insurance companies, each are only able to negotiate on behalf of their relatively small groups and thus are not able to negotiate as good of prices.
Many countries outside of the US provide better access to healthcare for less and I'm not convinced it is because those systems have better competition in the ways you are suggesting, but I'd be happy to learn more.
Don't confuse government spending and GDP (like I did at first). This is the government budget, which is a fraction of the whole GDP, since taxes aren't nearly 100%.
I suspect you're both right, although it's closer to 4% of GDP IIRC.
Far too often, broad generalizations are made about hot button issues like taxes and regulation, calling them "bad" or "good" but it depends on implementation i.e. what is getting taxed, by how much, and where it goes. It would be nice if we had more say in where our taxes go, but unfortunately in the US, both parties are happy to jack up the military budget.
The problem here is that no one knows what the government does because government agencies, with one exception, aren't allowed to toot their own horn. That one government agency is NASA and everyone loves them
If you're interested you can read the book The Fifth Risk. The government isn't perfect but it does so much being the scenes that people just don't appreciate
IIRC most of the government's budget goes to food stamps and similar already. Which I guess are shitty dysfunctional programs in their own right (and that's probably a product of the same anti-government attitudes).
People seem to miss that defence, while huge both by proportional and absolute measures, is still like 4%13% of what the US government spends on. American services, where they suck, don't suck for that reason. And yeah, they don't all suck. Canada Post is kinda shit, while USPS sounds like it's universally loved, for example.
Edit: Point stands, but I mixed up GDP and federal budget at first.
They don't but they have poor people who can't buy food, like most countries. Wonders of trickle-down capitalism, I guess. There's a program that allows these people to buy groceries called "food stamps".
I'm not sure why this is downvoted. Someone posted a pie chart further down that actually shows the breakdown. Social programs are indeed a majority of the budget.
The US brings in 78% of what it spends. Period. So our taxes don't pay for what we get.
In fact, income tax is only a little more than 1/2 of the revenue.
So whatever. Lets stop pretending we have to be fiscally responsible in the US. We haven't passed a budget since 2008. It's just spending bills and continuing resolutions.
Give us healthcare. Don't bark about having the money. Just do it.
Is there some irony in the fact that the 13 colonies decided to rebel because they didn't want it pay tax back to England for services that they wouldn't get to see the benefits of and so started the American Revolution only to fast forward to now and have more or less the same thing happening?
I mean it's probably a bit more complicated than that but it seems like it's happening that way.
Nobody 'likes' paying tax, but at least here in Scotland we get to use the hospitals, universities, infastructure, prescription drugs and more (that are tax funded) at no extra cost
I feel sorry for Americans, who also pay tax but without these benefits
Oh I grew up in a German city where Scottish soldiers were stationed. They'd eat the north Koreans, not their words. I've seen with my own eyes one drunken Scot against 8 British hard-as-nails MP (military police) plus some German police, he was bleeding, but he was winning.
Scotland also pays more taxes. 20% for middle income, 40%+ for higher income (£46k+) If you make approximately the same (40k) in the US it’s 10% to 10k then 22% to 40k. However - the us tax rate doesn’t go up again until 95k, and then it’s only 24% for income above that, (more brackets follow, but…) and never even makes it above 37% earning above a half million a year.
Americans pay way less in income tax overall.
Edit: and get way less services for it, plus get fucked when it comes to medical costs, education costs, etc.
Not sure if I came across sounding like I support getting screwed by supporting Big Pharma’s profits and shareholders or something.
And? The American taxes added with the costs of insurance, prescriptions, hospital bills etc greatly outsize the "cost" of Scotlands tax - which already includes all of the above
Not sure what your point is. Scotland pays more in tax, but gets the same services Americans do for cheaper than Americans pay out in tax plus medical expenses in your statement?
I said we pay less in tax according to the approximated brackets I posted. Those brackets were from a 2023 tax site. Not sure what you’re trying to argue.
The irony is that western free nations owe their safety to America’s military, and by extension this sacrifice of the American people, if you follow the post’s logic
It’s really not debatable. Ukraine wasn’t under US protection… they got invaded. We’re now arming them and it’s helping them to put up a fight. There’s no debate that the US military doesn’t enable protection to a LOT of countries. The problem is that sometimes we protect the wrong nations… like Israel or Turkey. Countries which aren’t even culturally or strategically aligned, but are simply allies due to location.
Another point to this is how quickly the US deployed two carrier strike groups into the med and is preventing Yemen and Iran from getting involved in Israel freely bombing Gaza.
Turn to Asia and look at the power projection the US has with China regarding Taiwan and the Philippines. We just had another US military boat in waters “claimed” by China.
I’ll demand better of my country, but there is no denying our military power.
Nobody is denying it, but I'd argue the well-belabored point that the US military is overmatched against all others, astoundingly so.
We can and should slow down on military budgets a little, and use that money to better fund orgs like the GAO. Let's get a handle on where all our tax dollars are going. That we have so much excess supply of Bradley's and such to be able to sell them for pennies on the dollar to Ukraine is a sign we're doing too much.
It's really good at fucking a place up then leaving and making defense contractors very wealthy. All our broken ass Congress can agree on is increasing the defense budget, again, even though the Pentagon continues to fail it's audits like a kid walking down stairs with it's shoes tied.
There's a fairly easy thought experiment we can do. If the US cut back its military to what was only necessary for domestic defence, and NATO dissolved, what would the rest of Europe do? I think a lot of countries would bolster their defense spending significantly.
Defense contractors certainly get a lot more wealthy, but the rest of the West benefits considerably from the US military nonetheless.
Name three nations the US has couped to replace their democratically elected leader with a corrupt autocrat that sold gladly his people to US interest in exchange of power.
The benefits the grandparent commenter pointed out aggregate to North America, Western Europe and Oceania, while the costs you point out are imposed elsewhere.
What does that have to do with their point though? They're saying that the rest of the West enjoys their prosperity because of the American military, and I don't think they're wrong. The coups and corruption elsewhere around the world are what enabled the prosperity.
This trend starting to buck has provided more military engineering jobs than any bullshit the US military has ordered in decades. Come on Europe, get afraid. Buy some more weapons. Heh.
Everyone hates on The United States military, you know, until they are getting their asses kicked. I think the USA should only lend military support to those countries willing to pay for it.
I always hear this retort though, the wait times are insane which can be problematic for people with serious urgent ailments, anyone wanna share their experiences?
Edit: thanks for all the replies so far, keep em comin. I don’t personally believe this take but I never quite have substance to point to. Any statistic or polls would also be helpful!
The wait times in the US are currently consistently problematic. An orthopedic is like a 2 month wait, a psychiatrist is a wait-list if you even manage to find one accepting new patients to begin with.
Even with an MRI showing that my mom's breast cancer has likely metastasized to her spine, she has to wait 2 weeks to see the Orthopedist. Just for the consultation, not 2 weeks for surgery. America is fucking bonkers on wait times. Imagine being in debilitating pain with tens of lesions in your spine and being told you have to just deal with it for 2 weeks before you even know what it is for sure.
You can simply look at the data for avoidable mortality rates among OECD countries. This tells you the impact of healthcare access to early mortality that could have otherwise been avoided with better access to care. Time to care directly impacts these measures.
For 2022, the United States is only better than Latvia, Lithuania, Peru, and Mexico in avoidable deaths per 100,000 people. Every other nation in the data set with values is lower. Sometimes by more than half.
Every other western nation shits all over US stats in infant mortality as well, showing that when you remove obesity from the equation, you still get far worse quality of care from the start of life.
All this when paying 3X the amount to get the care in the first place.
The worst part is the US average person pays more than 4 times the amount of administrative care than then EU average. 4X for administrative costs.
It’s 9 times as much admin cost as countries like Italy who also have some of the shortest wait times to see a physician, or specialist, in the OECD data set!
Imagine paying 3X more per capita, waiting longer, and getting worse measured outcomes for decades… then still have people asking if they are getting a raw deal?
Prenatal classes, regular checkups, hospital delivery, overnight stay: Around zero dollars and zero cents. Birth of our second kid, also zero dollars.
My father's cancer treatment (bowel resection and colostomy, at least three different courses of chemotherapy and one dose of radiotherapy, complex resection of most of his liver, partial lung lobectomy, regular home visits by a palliative care Dr. And RN, hospice) cost my mom a bit for some dressing changes and incidentals, so maybe a couple hundred dollars worth of homecare supplies.
Four surgeries amongst immediate family requiring general anesthetic, about zero dollars.
At no point in time, during any of the above, did I ever have to consider if any of it was covered. No deductibles.
I always hear this retort though, the wait times are insane which can be problematic for people with serious urgent ailments,
That retort is from someone who has never shown up early for an appointment and had to wait until two hours after the appointment time just to see a Physician's Assistant. While watching pharma reps get casually buzzed in without an appointment. In a waiting room where you can't look in any direction without seeing some form of pharma merch.
Perhaps. Hell, such a person may have the same experience as I, but may never weigh that experience against the nightmare scenario conservative propaganda has presented to them as the horror of socialized medicine.
In grad school I was in Canada when I crashed my bike, nearly broke my jaw, broke a tooth in half exposing a root. A cop helped me bandage my face, I got a root canal the same same, X-rays, and pain killers. Didn't pay a cent.
In the UK on vacation I got a nasty eye infection and a corneal ulcer as a result. Went to the ER, was seen, treated, and given meds for the next two weeks within three hours.
I'm an American. If luck had been different, that could have been a lot of debt. In both cases neither country even had a method for me to pay them, they just took care of me.
Because it's the right thing to do, not because they thought they could bill me into poverty.
My father was discovered to have a shadow in his lung during an xray taken of his back, this was from a private healthcare provider. They referred him to the NHS because they specialise in treating serious conditions above all else, the private doctor even said that they are the best org for cancer care in the uk.
Within a week he was diagnosed with stage 1 lung cancer. Two weeks later they had completely removed the infected lobe of his lung, and around a week later he was released from hospital cured.
Apart from the initial, privately done xray for his back, this cost him exactly nothing. Within 3 weeks of a cancer scare he was completely cancer free.
It's admittedly psychiatric care not emergency medical, but I've been impressed by Norway this year.
After a decade or so of chaos after leaving high school, I had realised earlier this year that I had some issue and sought help.
Start to finish, from GP appointment -> psychiatric evaluation -> tests -> specialist -> testing meds -> follow up, took 6 months, and I'm $275 out of pocket, and meds for 1 month cost $6.5.
Two things worth noting are that they absolutely nailed identifying my issue first go, and that I responded well to the first thing they prescribed me, neither of which necessarily happen for everyone.
I needed a neurologist once, and the earliest they could see me was 6 months later. It snowed the day of the appointment, so they cancelled and rescheduled it ...ANOTHER 6 months out.
Anyone who says the US doesn't have outrageous wait times is talking out their ass.
Our taxes fund more public health dollars per capita than almost anywhere else in the world. Medicare and Medicaid spending is higher than DOD budget, and that’s before you include medical research funded by NIH and DOD or VA spending.
The issue is that our prices are out of control because of regulatory capture and downstream inability of the government to negotiate lower prices.
What we need are price controls.
It's working as intended.
There's a lot of money to be made in making sure the US Govt isn't paying minimum dollar for goods and services, be it healthcare or military spending.
It’s about stealing everything they can between those that need and those that provide.
Insurance companies. Middle management. It’s everywhere. Needless spending that’s made up to create “industry”.
This industry should never have existed in the first place. It’s akin to fire departments standing in front of a burning home until the owner pays up, and if they don’t they get robbed while the place burns.
That was determined by the public to be greed driven, robbery and also fucking illegal.
But the insurance industry does it daily for generations, constantly creating scenarios where people die or become destitute and yet it’s legal?
Somebody explain.
look, your argument is fair but inaccurate. When the Insurance company’s negotiated rate on a heart attack is 14k, but the hospital bills you 300k, then the problem is we’ve allowed for private healthcare to make more sense and forced government funded healthcare to be overly complex.
Let me repeat this but in capitalism, we have DONE THIS PURPOSELY so that private healthcare companies can make money.
"The issue is that our prices are out of control because of regulatory capture and downstream unwillingness of the governmemt to negotiate lower prices."
FIFY!
It's not about unwillingness. Negotiating lower prices requires collective bargaining. In the US there are so many different insurance companies and each one has to negotiate prices for its relatively small pool. Contrast that with countries like Canada which have a single system, giving them the ability to negotiate prices for the whole country.
I wouldn't call it unwillingness, Obama did try to create a public option.
That's what happens if you don't have public health care.
A small insurer or even an uninsured person cannot bargain with large pharma companies. If they try to, the pharma company will just not sell the product, because it's more expensive for them to lower the prices for everyone compared to losing one small customer.
But if your whole country's health system bargains at once, it can get much better deals, because not taking a deal means for the pharma company that they'll lose access to millions of potential customers.
That's why for example in Europe Insulin costs about 10% per dose compared to what people in the USA have to pay.
Our tax dollars fund more corporations than other countries. The military spends so much because they pay private companies for their equipment, which is sold at inflated costs because they can. The US spends a shit ton on health care because private companies inflate their prices because, again, they can. The government/insurance companies don't even pay the full price that's listed on the bill, but they still use the original numbers.
You can't compare our spending to other countries. The US spends more because they pay inflated prices. Citizens spend less because we can't afford to get health care.
so if they put such a generous amount in, why isn't healthcare free then, like in Europe? if i have the flu and go to the doctor, even the medication they prescribe is subsidised, i pay max 6 bucks for everything
Insurance companies. Because of the way they operate, healthcare providers are forced to raise prices as high as possible so that they can actually afford to operate once the insurance companies negotiate the lowest price for care they can.
And then the insurance companies charge consumers high prices anyway and pocket the difference.
Indeed, what good is all that public health spending when health corporations and orgs are determined to maximize profit, and no authority is willing to curtail their efforts
It's not regulatory capture, it's a complete lack of federal regulatory guidelines in regard to the insurance industry.
for a medical service provider to be insured (and thus not be destroyed by the first malpractice suit they lose) they need insurance, the insurance companies have their own stipulations onto the healthcare provider, like all their stuff being certified, now guess who owns the respective certification companies? letting them charge whatever they damned well please...
it's straight up duopolistic markets
I don’t like paying taxes, but holy hell not having the things they’re supposed to pay for sucks. You ever use a toll road or get caught in an intentional speed trap? Holy hell it sucks. And also we’re only kinda sure our food is safe and our medicine works. But the cops have tanks and the beef and gas are subsidized
Toll roads are a kind of tax.
True
I mean toll roads make sense, I'm not sure why we're expected to pay to use public transport but not roads, when roads are far more expensive to maintain and us driving literally causes them to be damaged.
If roads and parking are free then public transit should be free. Otherwise toll roads are fine by me, although they're technically a regressive charge in the US and Canada since you're kind of forced to use a car in most areas... I mean car dependence itself is a giant regressive charge so that's just one part of it.
But assuming we had actual functional transportation infrastructure, toll roads would actually be preferrable near more densely populated areas since it makes you think twice about using your car instead of taking a train or biking.
The way toll roads work in a lot of places is that they are built with public funds, then a private operator gets a lease for a set amount of time and gets the lion's share of the revenue.
And yes, public transport should be free.
Won't that encourage overuse of transport, which will actually make it harder to reach emissions targets and similar?
It'll encourage the use of public transport over private vehicles (provided there is a good public transit network present). Public transport has got better efficiencies, and if it can supplant individual transit to a good degree, that's not a bad thing.
As far as 'overuse' goes: how many people do you know who just travel on public transport for the fun of it? Even in places where people can travel for a flat monthly fee, very few people spend any more time on public transport than they need to. I doubt that free public transport would substantially change that.
Few people just like to hang out on trains, although I do remember the one guy on Reddit who did all his coursework while cruising around Switzerland and then got trapped in a railyard. However, plenty of people will choose a long commute or to visit a more distant destination if it's cheap enough. Extreme example, but I once knew a person that drove a full 2 hours each way to work. Through a far more densely populated area.
I don't and couldn't really have empirical evidence that people would overuse free public transit, but the I think the theory is strong. Generally, people will travel less if travel is more expensive. If travel is provided at cost instead, they'll avoid it unless the value to them of the travel exceeds the cost to other people to provide it and bear the side effects.
Another thought: Flights In some places there's a government air carrier, and they fulfill the same basic function of getting people from point A to point B. Usually they're not considered public transport, but then you have cases like the small arctic communities in my country, which are filled with very poor people and can only be accessed by plane. Should we make an exception? That's where things might get complicated.
Invalid feelings + wrong opinion
Based and accurate
Why shouldn't you pay for using car infrastructure? You're damaging the environment and damaging the roads, it's a lot more sensical for the cost to be put on you, the driver, instead of burdening everyone else with higher income/sales taxes.
Funding for the development and maintenance of roads in the U.S. come from a variety of taxes such as vehicle registration fees, wheel taxes and taxes on gasoline and motor fuel. So , we do pay for using car infrastructure
Yes, but not nearly enough. Those kinds of taxes are extremely low (especially compared to e.g. the EU) and form only a fraction of the costs of car infrastructure.
All those hundreds of billions to trillions of dollars in infrastructure bills, all the regular car infrastructure maintanence costs, a large chunk is paid for by taxes that everyone gets regardless of how much they use a car. And all the extra non-tax costs (in both time and money) that non-drivers have to pay because car-dependent infrastructure fucks up transportation for everyone else, that is a massive charge.
Even in the EU, car related taxes can't pay for all the car related infrastructure. Building and maintaining roads is crazy expensive.
People who don't drive don't pay any of those taxes that were used as examples. I'd love to see the numbers that you're basing your argument on.
Let me google that for you: https://frontiergroup.org/resources/who-pays-roads/
There are literally tens of thousands of articles like this one.
TLDR:
No, drivers pull their own weight in regards to car related taxes.
The point the seems to have missed you is that taxes should be what pays for the road
I just said – you're burdening other people with taxes for damage that you cause. Car infrastructure meant for drivers destroys the fabric of cities/towns, destroys the environment, and costs a shit ton of money on top of that.
Using more toll roads and similar things means you can "tax" people a lot more proportionately to how much they use cars on public infrastructure, instead of punishing people that don't use cars or use them less than others. It would be entitled to assume that everyone else should pay more taxes because you want to use an expensive destructive and dangerous mode of transportation rather than just take public transport or bike.
I also find it hilarious how my state gives tax credit for using/owning an electric car, but not for not using any car at all... this kind of shit is representative of the norm across most of the US, car drivers are directly subsidized by non-drivers.
(It's obviously a lot more complicated than "make more toll roads" since some jobs actually need vehicles, plus it'd make sense to mostly do it around densely populated areas)
I pay for schools i dont go to, hospitals in places ill never go to, roads i dont use. The point of taxes is to pay for the things that better everyone even if you yourself dont personally use them.
Okay, but schools and hospitals don't destroy the fabric of cities and don't destroy the environment. Schools and hospitals actually improve society a lot and SHOULD be subsidized.
A majority of the money spent on car infrastructure does NOT go to improving society. In the current state of things, cars harm society, and the majority of people using cars don't need cars. Most of the money spent on car infrastructure should be put into actually making transportation not car-dependent, and as I said earlier car drivers should subsidize this.
It would be great if we could shift to a better system integrating better and much more robust public transit, but in much of the U.S. driving a car is the only option. I understand being upset with the system we have, but taking out your frustrations on many people who don't really have a choice is counterintuitive.
Wait but cars don't damage the road (much) - trucks do. We should all be mad we are so heavily subsidizing the cost of moving goods to our grocery stores, construction sites, and anywhere else.
The simple answer is to make commercial/industrial users pay fairly. Practical studies have shown that road damage is related to the fourth power of vehicle weight. The damage attributable to private cars is less than a rounding error compared to commercial vehicles, and commercial users have the most directly-atttibutable profit from road use.
Gas tax is pretty much nothing in the US... the minimum gas tax is about 3x higher in Europe (and it's usually much higher). The amount that people from areas prone to having high rates of driving (suburbs for example) pay in taxes is highly disproportionate to the amount car infrastructure costs.
Plus using things like toll roads means you can reduce the car infrastructure tax everyone pays a lot, currently if you're not a driver or don't drive that much you generally pay the same amount (or maybe slightly less with tax credits if you're eligible) as someone that drives constantly. Which is pretty terrible – using cars as the primary mode of transport is just bad for society, and it should be looked to reduce it as much as possible. My taxes shouldn't be going to funding unnecessary car deaths or mass pollution etc. etc., and cars are one of the largest causes of pollution on the planet.
Gas tax doesn't do much in that regard, sure it's a minor environment tax but those who don't drive are still subsidizing the people who do. Ideally it should be the other way around – people who drive who don't need to drive should be subsidizing those who don't drive.
Average gas tax in the U.S. is 52 cents per gallon. Average consumption is 370 million gallons a day. That's not an insignificant amount of money.
Sure, it seems like a lot, but here's a quick read to explain why it's not:
https://frontiergroup.org/resources/who-pays-roads/
Gas taxes generate only about $50 billion of revenue, when car infrastructure spending is in the hundreds of billions per year. At this point I pay more in regular taxes than someone who drives regularly pays in gas tax. Plus the gas tax is out of the picture when we consider EVs – which still have a majority of problems gas vehicles do, and cost individuals who don't drive a ton of money still, minus the constant pollution.
In the Netherlands about 9% of the total price is actually profit.
If the price for gas is €0.80 per liter, we pay €2.017 per liter. There's this calculation with it:
€ 0.8 + € 0.867 = € 1.667 without tax € 1.667 x 21% = € 0.350 tax € 1.667 + € 0.350 = € 2,017
The € 0.867 is standard Consumer tax per liter on gasoline.
This is only the tax on gas, let's not talk about the tax you pay for your vehicle every month. I don't like it, but it beats being eternally in debt for breaking your finger. Or destroying my car in a pothole.
Canada doesn't have tolls. And, at least in BC, good transportation.
It's just a matter of how much they want to invest in what.
In many cases toll roads mean that the government didn't want to/wasn't able to invest in building a road, so they let a private for-profit company do it for "free" (meaning without tax money) and that company then recoups their investment using toll.
Some times toll roads are used to steer traffic. Some cities for example have a city toll that's meant to discourage commuters from using their car to get into the city and instead get them to use public transport.
The first case means the country doesn't raise enough tax, wastes too much tax money or has other priorities than road infrastructure.
The second case is totally valid since it uses tax to discourage unwanted behaviour.
We do have taxes on car ownership, though, at least where I live.
A controversial take apparently, but yes. A big part of the reason everything was able to become car-centric is because we're effectively subsidising driving by providing the infrastructure for free, both parking and road.
You can also go the route of a hypothecated tax by mileage, which is probably more convenient.
[Slaps hood]
This baby can bomb soooo many third world countries
The black community frowns on this flagrant attack against our neighborhood.
Lemme see them hands.
Notice that taxes don't have the same vile vitrol against them outside of America? They get something for their money.
One of my theories is that not only is it about how these taxes get used (as in the OP), but also in the US you have these constant reminders, it's not added to your restaurant bills or supermarket prices until the end, you have to calculate it yourself all the time and that keeps it front of mind. I never used to even think about tax until I started my own business (since now I don't have to pay it for business expenses). When something costs 100€ it costs 100€, you don't think about the fact 20 of them are tax because you, as a consumer, pay 100 and that's that. Same with salary, it gets taken at the source and once a year you just need to verify, and usually you get some money back making it a positive experience.
Yeah I never understand why tax is not included in the sales price, just seems arbitrary to exclude that. It is definitely been uncomfortable, back in the days when I used to use cash, and I would have just enough for like a burger or something,
Only to realize that I had enough for the price on the menu but I didn't have enough for the tax. It's just annoying
A society requires governance. Staff to set and enforce rules, staff and supplies to execute services which provide social and physical infrastructure.
Certain things every community needs: Healthcare, education, transportation, utilities, support services for special needs, safety, rehabilitation for rule breakers, etc.
A government can figure out how to provide these services (with in-house or out-sourced expertise) and provide you with one bill (taxes). Or they can privatize a service, meaning you still need it and they may regulate it, but you'll be paying someone else for that service.
The value of taxes should be considered in this light. How much do I pay for all the services me and my community needs, and what portion of that is taxes. Then compare to other countries to see how well our governance system is functioning.
Does privatization save cost? What balance of regulation keeps things affordable vs driving up expenses? What balance of in-house expertise vs outsourcing is the most functional? What is the cost to quality of life having to pay bills to 15 organizations vs one? Where is there an extra heavy burden of cost and what can we do through regulation to fix it? These are the questions we should be interested in when it comes to governance, an elected official's personality or opinions should be negligible factors.
I pretty much agree, taxation is only theft in america, and the only reason for that is because we are getting anything for our taxes outside of a bunch of dead third world children. Which doesn't really help me put food in my stomach, or treat the stuff in my brain that causes memory problems and could possibly kill me when I turn 40.
We also have a constant drumbeat about how taxes are evil coming from politicians and pundits that represent half the political spectrum, all because they've discovered it's a good way to turn people against the other half.
I know the point you're trying to make, but generalisations like these aren't helpful. After all, the UK have voted for the Tories for around 13 years, who are notoriously a low-tax party, and have a lot of support from wealthier people and self-employed people that don't like their money aiding others.
They shafted that notoriety by imposing the highest tax burden since the Black Death.
Arguably, the Conservatives under Boris were a populist party that exiled the vast majority of conservative MP's that still believed in traditional conservatism. Pair this with Brexit, and we ended up in a position where the only path forward is higher taxes or (further) financial ruin.
The party will always be one of low taxes, and conservative values, but not until Sunak is out, and the rats leave the ship. Funny enough, the skilled trades and southern professionals still see the Tories in that light, even though they're basically the Brexit Party right now...
Yeah but fuck Britain.
We know what it's really all about, they are afraid of immigrants and foreigners. The taxes are just an excuse.
You don't see the temporarily embarrassed millionaire phenomenon over there. I mean the leftist party there is literally called Labor and is still much further to the left than the Democrats are, here A labor movement idea is too toxic to consider simply because too many dumbasses will happily lick boots leaving falsely, that they will be the ones wearing the boots someday.
It's not even a nice military though! Failed audit after failed audit showing billions of dollars not accounted for. When you enlist, one of the trainings you get is how to sign up for WIC, because they don't even pay you enough to feed a family (at first) if you lay down your life. This country is a joke from the outside, and a nightmare to live in.
In the 2000s, military applications were through the roof. I went to a poor urban school. And the promises of joining the military was discipline and support. We were already on WIC and couldn't find a job, what makes this any different?
A decade later, all my friends who joined the military are struggling in dead end jobs and constantly complain about the lack of support. And they're worse off than before... Just now with trauma.
Me here in a third world country, you guys are getting stuff for your taxes.
Not in Sweden, no. But we are technically third world I guess
Hmmm , Google says you get universal healthcare coverage...
They're referring to the original use of first / second/ third world countries which has nothing to do with economic prosperity or development, and just where they were in a war.
Tell that to our doctors
The doctor decides if you're ill and if so what treatment you get. If they want to brush you off and say you're fine, they can and do. Or they can decide if you get "treated" with a "take these painkillers and go home" rather than look at the cause of the issue.
If you're ill and turn to healthcare for help, but you get none, are you then recieving "universal healthcare"?
I suspect you understand this, but pretend otherwise.
I honestly had no clue what you were talking about when you said "Tell that to our doctors" in response to "Google says you have universal healthcare".
Honestly, what you describe that doctors do is the norm in the US and, as far as I know, most places. On top of that, we have to pay for health insurance out of pocket either partially or fully before receiving any treatment (premiums), when receiving treatments (copays), and after meetimg our deductible (co-insurance). Then they start to pay, but it starts all over again in the new year. So don't get sick if you have the budget insurance.
And then those insurance companies can limit the types of treatment the doctors can prescribe or make them jump through hoops before prescribing those treatments.
So .... Yeah. I'd like to have what Sweden's got.
Edit: I didn't even touch on PBM, private equity in clinics and hospitals, surprise billing, arcane rules to limit foreign trained doctors from practicing in the US, under funding of residency, not training enough doctors for our aging population and much much more
I would have joked that at least everyone can join the military but they said I was too fat to join back when I was 19 when I was only 25lbs overweight. Isn't it your job to whip my fat ass into shape? What the fuck am I paying you for?!
I've seen how veterans are treated. There's no way I'd join the military even if I didn't find it ethically unacceptable.
https://www.youtube.com/watch?v=znfZnSRcaeY
Country Joe and the Fish - Fixin' to Die Rag
Come on mothers throughout the land
pack your boys off to Viet Nam
come on fathers don't hesitate
send your sons off before it's too late
and you can be the first ones on your block
to have your boy come home in a box
When I came back from Luang Prabang
I didn't have a thing where my balls used to hang
But I had a wooden medal and a fine harangue
Now I'm a fucking hero
Mourn your dead land of the free
If you wanna be a hero, follow me
Mourn your dead land of the free
If you wanna be a hero, follow me
Holy shit van ronk's not just the stonewall guy he's worth taking seriously. Thank you for this!
Veterans get that free healthcare the rest of us need. The inadequate, short-funded, free healthcare you get as an afterthought
I always find it amusing when Americans can only come up with paying less taxes as the answer, then they don't understand why they get less services. It's almost like you should expect more from the tax dollars you already spend. But I guess that's the point of this post and I'm just beating a dead horse.
To be fair, more taxes is not the immediate answer to America's problems that people think it is. The average American already pays more in taxes than most Europeans. The real issues come from the fact that the US Govt. can not legally produce goods or services (only in very specific circumstances) and has to contract it out to private companies. See roadwork and infrastructure maintenance as one of the most obvious examples. Regional companies exercise an uncontested monopoly on these contracts, causing budgets and schedules to balloon several times past what they would if handled by a service that was directly funded and administered by public office.
Americans already do pay more. The problem is that they get less for their money than any other western nation. While I don't agree with the conclusion, it's not hard to see why so many people watch their country fall into disrepair- despite paying more taxes than ever- and say "to hell with it, I'd rather keep my money than throw it into the corrupt bureaucracy who won't even do anything."
Even when they try to destroy the post office it outperforms private options. It's an incredible machine.
what you’re missing is the fact that most of us pay for healthcare through our employer. Clearly a win, yes? no. no it is not.
For those of us “lucky” americans that did the FUKCING MATH, i pay more in healthcare + taxes when you account for the $12,000 deductibles annually and (AND!!!!) the cost of the privilege for having insurance of anywhere 600-1600 per month. Nevermind the fact the stupid private party insurance gets to decide if “I” am allowed to get a procedure. So i pay for someone else to make a decision that my doctor determines is necessary, which is declined (of course), then appealed (and denied), and now somehow i’m hooked on some fucking opiate because the pain is so great while I wait for Jim at statefarm to approve my necessary procedure. Oh, somewhere in there lets throw in a termination from my employer for showing up high on synthetically prescribed heroin (dilaudid) and now i’ve lost said insurance that i’ve paid 12000 into.
Or I could pay less in taxes by just hoping I will live longer that the conservative (and even some democrats) party dies a horrible death. All without the needed medication and coverage that is keeping me alive… am I winning yet?
So there you have it, those not paying for insurance are winning the war against… fuck, i don’t know anymore, what are we fighting? Right, right, the evils of socialized healthcare and “higher taxes”.
yes, i am ok. no the dilaudid story is true but it is not me, it was someone i knew… guy voted trump until he took care of his own mental issues permanently and fought you all the way.
For future reference:
Have your doctor write the literal phrase "medically necessary" on the order. If denied, contact the insurer and ask for the License Number of the Doctor who refuted the necessity. Keep in mind, if they're NOT a doctor it is ILLEGAL for them to make a medical decision.
If they actually get back to you with a license number, you can use that to pull the credentials of the person denying the claim. Present that information to your doctor and I'm sure they'll help write you up a nice paper to send into the medical review board of the state they're licensed in.
I've had to use this method twice with my wife's healthcare. Approvals came within an hour of requesting the license number of the person on their end making medical decisions. The key being the phrase. A doctor's order, or prescription, is a legal document. Your doc putting that phrase means "I believe in this treatment so much, I'm willing to bet my license that they need it."
YMMV as I've only had to deal with BlueCross and they hate when I call.
yeah, thanks. I know most of the tricks now with cigna and bluecross. i just hate dealing with it and it shouldn’t be necessary.
feels good to vent though.
Great trick, thanks for this.
The ones for whom "less taxes" are always the answer know that they'll get less services. They are fine with that as long as it means the minorities they hate will also get less services. Particularly if they suspect that those minorities can't weather the lack of services as well as they can.
These are the people who filled in municipal swimming pools with concrete instead of letting black people use them too.
That's my argument. There's no need to raise taxes. It's all scare tactics from the GOP. In Texas, a hot topic last election was our increased property taxes. The democratic nominee for governor proposed legalizing weed and using those tax dollars to lower property taxes. He lost the "moderates" when he proposed stricter gun control the last time he ran and they never got over it. Conservatives would rather pay extra money and complain about it than legalize the devil's lettuce.
Politics is theatre. They use buzz words to win the ignorant votes. I don't think we'll ever see a return on our taxes because of how much it would take to completely flip the system. Businesses would go bankrupt if we had access to socialized programs, and that goes against the capitalism that the country stands on.
Removing tax havens within the country would also do a fair bit, and people wouldn't notice any difference from that, except that there is a lot more money that the country could spend on more useful things.
Too bad spending money is considered "free speech" and all those tax haven dollars are used to buyout the people with the power to fix that problem
What would be considered corruption in most of the world is just the modus operandi of US politics.
As an American I’ve been taking a truly radical position of openly demanding higher taxes. Like fuck you none of us pay enough. It’s easy to say tax the rich, but they’ll get tax cuts real fast if we don’t break the taboo on raising taxes.
We don't pay taxes to the UK so it's not all bad.
Fun fact, they were kinda paying us up until about 15 years ago. Last payment for the lend-lease program from WW2 was December 2006.
Unfortunately for the post, military is 3rd behind social securities and Medicare.
The issue is far more fundamental than "but ma military spending". And while military spending definitely contributes, the biggest problems are a hugely wasteful medical system and economy that pushes money away from the majority, away from taxes, and up to corporations.
Largely starving the country both in tax revenue, in political capital to make actual positive change, and the literal people as they stop living and start surviving more and more often.
Social security is not a tax though. It's a forced pension system.
We really need to separate that out in people's minds from a tax so that they get more angry when politicians try to make changes to make it pay out less. It's not that they aren't being nice anymore with our taxes, it's theft from our pension we contributed to.
Social security is self-funded. If it wasn't raided regularly to offset other budget shortfalls there would be plenty of money in social security.
At least, that's what I hear.
Yes, but Social securities and Medicare don’t immolate wads of cash over impoverished third world countries.
is it? they're never home, so we don't really know
Literally, in that most soldiers at "home" are homeless...in America anyway.
And can't afford the therapy that they need after the horrors the regime put them through.
I walked out in '03 when Bush ran the green screen and I put it together he was flat out lying. I ain't "serving" that one when there's no protection for anyone but the oil billionaires feasting in the des(s)ert of our deaths. I also had just discovered the 9/11 was completely fraudulent and that even AC predicted it. Sure, vague poetic shit but Back to the Future hit that shit with a bullseye spelled out a hundred times. Don't mind the pictorial art painted over the Cross of the dollar. I got refs if you're curious about any of that. Glad I'm not one of them and I feel zero regret at all for my choice.
Huge swaths of Southeast Asia, South America, the Middle East, Hawai'i, and even North America's own Indigenous peoples can all affirm that the US military is indeed very nice and only ever acts in self defense.
I mean if the 1% paid their share of taxes proportionate to their income we could live in a utopia :)... But nah... That one polical side that should not be named will continue making the poor poorer and pocketing the money for themselves.
That are the reasons why I like paying taxes. Because a functioning society is a great thing.
Americans have accepted this idea. To our detriment. And to the detriment of the underdeveloped world. It's a wicked system. God damn it we're foul.
Isn't the military like 3% of the gdp and Healthcare somewhere around 20% in the US?
Keep in mind, 80% of that is private spending on insurance premiums and out of pocket expenses.
Americans spend a lot on mediocre healthcare because we have to line the pockets of insurance companies and drug companies.
It's funny how Germany also has private medicine, but none of US issues...
Germany has a public option that is the basic insurance. The private insurance is something you can opt into if you wish to forego the public option.
Insurance and medicine are two different things. There are no public medical services in Germany, all practices and all doctors are private.
Maybe the issue isn't private medicine. Like you said, both have private medicine but Germany doesn't have the same issues as the US. One difference is public insurance. I know there is Medicare, but that's only for older folks.
The difference, from what I can see across the pond, is that the medical industry in the US is a government supported cartel. No one can get into the industry to create competition and existing players can do whatever they want. The US government created a lot of regulations to prevent anyone joining the industry and completely deregulated day to day operations for established players.
Do you have do any examples of these regulations that exist in the US but not in Germany or other countries with better access to healthcare?
In terms of insurance, are you saying that Germany actually has more competition in that space compared to on the US side?
Competition can help lower prices with things like collective bargaining. It's the reason that Canada pays less for drugs, because they can negotiate prices on behalf of the whole country. However, the US has more competition and several private insurance companies, each are only able to negotiate on behalf of their relatively small groups and thus are not able to negotiate as good of prices.
Many countries outside of the US provide better access to healthcare for less and I'm not convinced it is because those systems have better competition in the ways you are suggesting, but I'd be happy to learn more.
And yet you'll still go into debt forever to pay for your own healthcare.
But at least basically anyone can own a gun, so yay freedom, I guess.
Via https://www.cbpp.org/research/policy-basics-where-do-our-federal-tax-dollars-go
Id lump benefits for veterans as part of the military.
As well as the expenses of WIC for military families, since they don't get paid enough.
You see, it’s NASA wasting our tax money 😜
Don't confuse government spending and GDP (like I did at first). This is the government budget, which is a fraction of the whole GDP, since taxes aren't nearly 100%.
I suspect you're both right, although it's closer to 4% of GDP IIRC.
How high are the taxes in Scotland?
Looks like they're lower than The US, for the lower income me brackets, and comparable to the higher brackets
https://www.mygov.scot/income-tax-rates-and-personal-allowances
Same as US + health insurance premium
Nope, noticeably lower. In theory it should be similar, but the US system is (particularly) dysfunctional in a few ways.
Far too often, broad generalizations are made about hot button issues like taxes and regulation, calling them "bad" or "good" but it depends on implementation i.e. what is getting taxed, by how much, and where it goes. It would be nice if we had more say in where our taxes go, but unfortunately in the US, both parties are happy to jack up the military budget.
Strangely enough, it was an american economist that coined:
"Taxes are the price we pay for civilization." Oliver Wendell Holmes, Jr.
The problem here is that no one knows what the government does because government agencies, with one exception, aren't allowed to toot their own horn. That one government agency is NASA and everyone loves them
If you're interested you can read the book The Fifth Risk. The government isn't perfect but it does so much being the scenes that people just don't appreciate
NASA delivers. I guess USPS delivers too.
Both of which are severely underfunded in favor of new bombs.
Knowing scale of corruption in Russia, bombs in US seem even less funded than in RF.
IIRC most of the government's budget goes to food stamps and similar already. Which I guess are shitty dysfunctional programs in their own right (and that's probably a product of the same anti-government attitudes).
People seem to miss that defence, while huge both by proportional and absolute measures, is still like
4%13% of what the US government spends on. American services, where they suck, don't suck for that reason. And yeah, they don't all suck. Canada Post is kinda shit, while USPS sounds like it's universally loved, for example.Edit: Point stands, but I mixed up GDP and federal budget at first.
I didn't know US have food shortage
They don't but they have poor people who can't buy food, like most countries. Wonders of trickle-down capitalism, I guess. There's a program that allows these people to buy groceries called "food stamps".
I'm not sure why this is downvoted. Someone posted a pie chart further down that actually shows the breakdown. Social programs are indeed a majority of the budget.
I'm not getting the symbolism in relation to the post but this gif is great regardless.
The US brings in 78% of what it spends. Period. So our taxes don't pay for what we get.
In fact, income tax is only a little more than 1/2 of the revenue.
So whatever. Lets stop pretending we have to be fiscally responsible in the US. We haven't passed a budget since 2008. It's just spending bills and continuing resolutions.
Give us healthcare. Don't bark about having the money. Just do it.
Is there some irony in the fact that the 13 colonies decided to rebel because they didn't want it pay tax back to England for services that they wouldn't get to see the benefits of and so started the American Revolution only to fast forward to now and have more or less the same thing happening?
I mean it's probably a bit more complicated than that but it seems like it's happening that way.
Image Transcription: Twitter Post
Stu Cameron, @stucam7771
Nobody 'likes' paying tax, but at least here in Scotland we get to use the hospitals, universities, infastructure, prescription drugs and more (that are tax funded) at no extra cost
I feel sorry for Americans, who also pay tax but without these benefits
Nice military though...
That is the risk with taxes. You can't stop paying them, so politicians, in some circumstances, are able to use them for things you don't want.
Our military dick is bigger.
Maybe if you line them all up
Lol nobody fucks with Stu, not even america
Aye, but you'll eat those words when the North Koreans are parachuting into Glasgow.
Although the first thing they'll say is "fuck me, this is worse than Pyongyang".
Edgy take. Which is a shame, because the rest of the Western world is overreliant on the US military.
Oh I grew up in a German city where Scottish soldiers were stationed. They'd eat the north Koreans, not their words. I've seen with my own eyes one drunken Scot against 8 British hard-as-nails MP (military police) plus some German police, he was bleeding, but he was winning.
IIRC, he also said "cunt" in the subsequent interview on BBC news, but his accent was so thick they didn't catch it to censor it.
Scotland also pays more taxes. 20% for middle income, 40%+ for higher income (£46k+) If you make approximately the same (40k) in the US it’s 10% to 10k then 22% to 40k. However - the us tax rate doesn’t go up again until 95k, and then it’s only 24% for income above that, (more brackets follow, but…) and never even makes it above 37% earning above a half million a year.
Americans pay way less in income tax overall.
Edit: and get way less services for it, plus get fucked when it comes to medical costs, education costs, etc.
Not sure if I came across sounding like I support getting screwed by supporting Big Pharma’s profits and shareholders or something.
And? The American taxes added with the costs of insurance, prescriptions, hospital bills etc greatly outsize the "cost" of Scotlands tax - which already includes all of the above
And?
Not sure what your point is. Scotland pays more in tax, but gets the same services Americans do for cheaper than Americans pay out in tax plus medical expenses in your statement?
I said we pay less in tax according to the approximated brackets I posted. Those brackets were from a 2023 tax site. Not sure what you’re trying to argue.
I read your edit and yes, you did kinda come off as being "USA! USA!, fuck taxes!". Anyway, I guess we agree
Fair enough.
The irony is that western free nations owe their safety to America’s military, and by extension this sacrifice of the American people, if you follow the post’s logic
That's debatable whether the U.S. military does anything other than make defense contractors wealthier.
It’s really not debatable. Ukraine wasn’t under US protection… they got invaded. We’re now arming them and it’s helping them to put up a fight. There’s no debate that the US military doesn’t enable protection to a LOT of countries. The problem is that sometimes we protect the wrong nations… like Israel or Turkey. Countries which aren’t even culturally or strategically aligned, but are simply allies due to location.
Another point to this is how quickly the US deployed two carrier strike groups into the med and is preventing Yemen and Iran from getting involved in Israel freely bombing Gaza.
Turn to Asia and look at the power projection the US has with China regarding Taiwan and the Philippines. We just had another US military boat in waters “claimed” by China.
I’ll demand better of my country, but there is no denying our military power.
Nobody is denying it, but I'd argue the well-belabored point that the US military is overmatched against all others, astoundingly so.
We can and should slow down on military budgets a little, and use that money to better fund orgs like the GAO. Let's get a handle on where all our tax dollars are going. That we have so much excess supply of Bradley's and such to be able to sell them for pennies on the dollar to Ukraine is a sign we're doing too much.
It's really good at fucking a place up then leaving and making defense contractors very wealthy. All our broken ass Congress can agree on is increasing the defense budget, again, even though the Pentagon continues to fail it's audits like a kid walking down stairs with it's shoes tied.
Huh? A single carrier group influences an entire regional military balance when it rolls by. We have 11.
There's a fairly easy thought experiment we can do. If the US cut back its military to what was only necessary for domestic defence, and NATO dissolved, what would the rest of Europe do? I think a lot of countries would bolster their defense spending significantly.
Defense contractors certainly get a lot more wealthy, but the rest of the West benefits considerably from the US military nonetheless.
Name three nations the US has couped to replace their democratically elected leader with a corrupt autocrat that sold gladly his people to US interest in exchange of power.
The benefits the grandparent commenter pointed out aggregate to North America, Western Europe and Oceania, while the costs you point out are imposed elsewhere.
What does that have to do with their point though? They're saying that the rest of the West enjoys their prosperity because of the American military, and I don't think they're wrong. The coups and corruption elsewhere around the world are what enabled the prosperity.
This trend starting to buck has provided more military engineering jobs than any bullshit the US military has ordered in decades. Come on Europe, get afraid. Buy some more weapons. Heh.
Everyone hates on The United States military, you know, until they are getting their asses kicked. I think the USA should only lend military support to those countries willing to pay for it.
I always hear this retort though, the wait times are insane which can be problematic for people with serious urgent ailments, anyone wanna share their experiences?
Edit: thanks for all the replies so far, keep em comin. I don’t personally believe this take but I never quite have substance to point to. Any statistic or polls would also be helpful!
The wait times in the US are currently consistently problematic. An orthopedic is like a 2 month wait, a psychiatrist is a wait-list if you even manage to find one accepting new patients to begin with.
Even with an MRI showing that my mom's breast cancer has likely metastasized to her spine, she has to wait 2 weeks to see the Orthopedist. Just for the consultation, not 2 weeks for surgery. America is fucking bonkers on wait times. Imagine being in debilitating pain with tens of lesions in your spine and being told you have to just deal with it for 2 weeks before you even know what it is for sure.
That's only for elective surgeries, not emergencies. The average wait times in the US are actually worse.
You can simply look at the data for avoidable mortality rates among OECD countries. This tells you the impact of healthcare access to early mortality that could have otherwise been avoided with better access to care. Time to care directly impacts these measures.
For 2022, the United States is only better than Latvia, Lithuania, Peru, and Mexico in avoidable deaths per 100,000 people. Every other nation in the data set with values is lower. Sometimes by more than half.
Every other western nation shits all over US stats in infant mortality as well, showing that when you remove obesity from the equation, you still get far worse quality of care from the start of life.
All this when paying 3X the amount to get the care in the first place.
The worst part is the US average person pays more than 4 times the amount of administrative care than then EU average. 4X for administrative costs.
It’s 9 times as much admin cost as countries like Italy who also have some of the shortest wait times to see a physician, or specialist, in the OECD data set!
Imagine paying 3X more per capita, waiting longer, and getting worse measured outcomes for decades… then still have people asking if they are getting a raw deal?
Let's see...
Prenatal classes, regular checkups, hospital delivery, overnight stay: Around zero dollars and zero cents. Birth of our second kid, also zero dollars.
My father's cancer treatment (bowel resection and colostomy, at least three different courses of chemotherapy and one dose of radiotherapy, complex resection of most of his liver, partial lung lobectomy, regular home visits by a palliative care Dr. And RN, hospice) cost my mom a bit for some dressing changes and incidentals, so maybe a couple hundred dollars worth of homecare supplies.
Four surgeries amongst immediate family requiring general anesthetic, about zero dollars.
At no point in time, during any of the above, did I ever have to consider if any of it was covered. No deductibles.
I have no complaints.
That retort is from someone who has never shown up early for an appointment and had to wait until two hours after the appointment time just to see a Physician's Assistant. While watching pharma reps get casually buzzed in without an appointment. In a waiting room where you can't look in any direction without seeing some form of pharma merch.
Source: lived experience.
I think you're giving "someone" too much credit. I suspect the retort comes from someone who consumes too much conservative propaganda.
Perhaps. Hell, such a person may have the same experience as I, but may never weigh that experience against the nightmare scenario conservative propaganda has presented to them as the horror of socialized medicine.
Good guess but it was primarily heard from liberal Canadians I’ve played games with most of my life
Let me post two anecdotes.
In grad school I was in Canada when I crashed my bike, nearly broke my jaw, broke a tooth in half exposing a root. A cop helped me bandage my face, I got a root canal the same same, X-rays, and pain killers. Didn't pay a cent.
In the UK on vacation I got a nasty eye infection and a corneal ulcer as a result. Went to the ER, was seen, treated, and given meds for the next two weeks within three hours.
I'm an American. If luck had been different, that could have been a lot of debt. In both cases neither country even had a method for me to pay them, they just took care of me.
Because it's the right thing to do, not because they thought they could bill me into poverty.
I just had an appointment with a specialist. In December. I scheduled it in July. December was their first availability.
My father was discovered to have a shadow in his lung during an xray taken of his back, this was from a private healthcare provider. They referred him to the NHS because they specialise in treating serious conditions above all else, the private doctor even said that they are the best org for cancer care in the uk.
Within a week he was diagnosed with stage 1 lung cancer. Two weeks later they had completely removed the infected lobe of his lung, and around a week later he was released from hospital cured.
Apart from the initial, privately done xray for his back, this cost him exactly nothing. Within 3 weeks of a cancer scare he was completely cancer free.
It's admittedly psychiatric care not emergency medical, but I've been impressed by Norway this year.
After a decade or so of chaos after leaving high school, I had realised earlier this year that I had some issue and sought help.
Start to finish, from GP appointment -> psychiatric evaluation -> tests -> specialist -> testing meds -> follow up, took 6 months, and I'm $275 out of pocket, and meds for 1 month cost $6.5.
Two things worth noting are that they absolutely nailed identifying my issue first go, and that I responded well to the first thing they prescribed me, neither of which necessarily happen for everyone.
I needed a neurologist once, and the earliest they could see me was 6 months later. It snowed the day of the appointment, so they cancelled and rescheduled it ...ANOTHER 6 months out.
Anyone who says the US doesn't have outrageous wait times is talking out their ass.