Income Tax in your countries

[sc94597]

Cobretti2 said:

sc94597 said:

Wow, I didn't realize German premiums went that high.

Even here in the U.S, 1.000 euros ($1,070) per month is very steep for what I am assuming is individual coverage. That is pretty much the monthly per capita spending on healthcare (including all costs) with no subsidies in the U.S (which is double what it is in the rest of the developed world), but most people get some form of subsidies (employer, medicare, medicaid, or ACA.) The average family coverage is about $1,100 per month to put things in perspective.

My roommate is self-employed and he pays about $250 /month (after subsidies, government pays $400 /month) for a $1,500 deductible plan with a yearly out-of-pocket maximum of $5,000. 

I get fully employer-subsidized premiums currently, but in my previous job I paid about $180 /month (employer paid $360 /month) for a $750 deductible plan with a $2000 out-of-pocket maximum. Before that I was on Medicaid my whole life, and that only had trivial $1-$5 per service copays. No other cost-sharing.

I generally look at the German model as a model the U.S could very easily transition to for universal healthcare, but I am now wondering if single-payer/medicare-for-all makes more sense anyway despite the political obstacles and difficulty of transitioning.

In Australia we do have medicare, however if you earn over a certain amount of money you have to pay a medicare levy surcharge of 1.5% on top of the base medicare levy.

To avoid the surcharge, you cat get a private health plan. Depending on what benefits you want, for a family, it can range from say $250/month AUD to $1000/month AUD.

Some states also charge the private health company additional state levy for health so it adds to that.

For example, when I worked in another state I was paying $80/month AUD for private health, which was far less than the surcharge levi, so made sense to get the private health cover.

When I moved interstate that jumped to $130/month AUD because the state had a $50 levy too. TBH I don't mind it as I can see how much better the healthcare system is here compared to the other state I was in.   Over time with inflation that went up. I now pay about $710/month AUD, but it is the best plan they had on offer back in the day. This used to cover me and my wife, now it also covers my child and costs the same, so effectively $236 per person.

In contrast if we didn't pay for private health cover, we would be out $340/month in surcharges between us, so it is effectively like us paying an extra $370 a month. The benefit of that $370 is we can skip public hospital queues and go to a private hospital, so over all I think it is worth it then paying a surcharge to go into the public system and wait for as long as required.

 

Yeah I am familiar with the Australian system on an abstract level. Listened to this podcast that compared two sisters during their maternal care: one who used the private system and the other who used the public one. Pretty decent podcast that gives a good idea about the system in general. 

https://cms.megaphone.fm/channel/impact?selected=VMP1376545152

It is impressive how cost-efficient the health-care systems are in the (non-U.S) Anglosphere, even for developed world standards. Many European countries seem to have either have much higher payroll taxes or higher premiums for the same results. 

A 2% Medicare levy is less than what Americans pay for Medicare, which is exclusive to 65+ year olds (~19% of the population) and has significant cost-sharing/premiums. Every American worker pays 1.45% of our income for Medicare, and our employers match it. Yet it isn't universal. 

This is largely because the biggest problem isn't necessarily who pays but the pricing structure. There is a lot of price-discrimination in negotiations between providers/drug-manufacturers and the payors, allowing for producer surplus to be maximized, akin to there being a monopoly and therefore creating a deadweight loss. There is also a lot of price-obscurity, where each hospital/insurer/etc have to employ data teams and pricing analysts or pay an outsourced data company to figure out what the maximum allowable payments should be. Making the system very bureaucratic and cost-inefficient. Basically any universal system would be better from a financial perspective, but seeing people paying 1000 euros/month for health-insurance does make me wonder if some universal systems are better than others. My stance was to just pick the one that required the least political capital to implement, but now I am more hesitant. 

Last edited by sc94597 - on 01 June 2022