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Originally Posted by Radii
Could you share which article that came from?
Tax rates definitely have to go up in any medicare for all plan. I guess I need to see the source for myself to believe that Bernie's tax plan raises income tax on the $75k-$118k dramatically and then drops it significantly for the $118k-$230k portion of one's income.
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Here's what the tax code would look like if Bernie Sanders got everything he wanted - Vox
The increase is basically a sort of "payroll tax" to help pay for universal health care.
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Originally Posted by ISiddiqui
Employer subsidized health care is a disaster. Just about every economist agrees on this point (whether left or right). It hides the true cost of health care from most people for one.
Now, I do get like $150 a month taken out of my paycheck for health care. I don't know if my employer (the US Government) would give that back to me. I suspect a number of employers would give some of that back (because it was a garnishment based on a choice for insurance made above an employement contract signed). The lower wage jobs likely would not.
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It's not a disaster, it just helps offset the cost to the employee by having their company shoulder a chunk of it (and get a write off in the process). If we went to a single payer plan tomorrow, it going to cost nearly the same - it's just a matter of who pays most of the bill. Let's look at an example - say a person makes 100K for simplicity. Their taxes would go up around $8,000 a year under Bernie, but they would get their $150 a paycheck in health care premiums back. So, they would get $4,000 back, but pay $8,000 in taxes and end up with worse coverage. Plus, that $150 is currently tax free, so they would actually get less back since their AGI would go up by that $4,000 they get back by not paying premiums. Currently, employers pay a big portion of a person's medical premiums because it is a write off for them (they cover about 70% at our company). You can see that by looking at the explanation of benefits from your company each year.
I don't understand how the left gets so made at corporations for not paying enough, yet wants to have them stop paying one of the major advantages they give their employees (paying a large portion of their health care cost). It's not like everyone is going to get a 10% raise if employers stop paying for their health care - they employee will just have to pay 100% out of their pocket then (instead of the 30-50% they pay now). The companies will just be off the hook and make slightly more money (I say slightly because covering health care expenses is a form of a write off for them right now - so they wouldn't get all that money back).
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Originally Posted by ISiddiqui
A few ways and it depends on what you'll replace it with. Right leaning economists would argue that employer sponsored insurance encourages workers to buy the most expensive insurance coverage and then use it as often as they can (and not caring about the medical providers they use).
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I think that is starting to change. People are leaving PPO/HMO for HSA "high deductible" coverage in droves right now. We've had over 40% switch in the last two years and it makes a lot more sense to just put your $300-$400 a month in premiums into your HSA account instead and pay cash until you hit your deductible (ours is around $3,000). These HSA plans also do a pretty good job of curtailing excessive visits. When a doc visit costs $90 instead of a $30 copay, people aren't as excited to use it. These plans are the future, IMO.
As to the broader question, it really doesn't impact the cost whether the government or private companies setup the plans. The government does a ton of health care coverage for older people (Medicare) and lower income (called Access here in Arizona). Costs are still equally high for services geared towards those plans. If the US goes to a single payer system, many middle-upper class families and higher will purchase a supplemental plan and we will be in a similar position to where we are now from a health care cost standpoint (the supplemental plans will get overcharged while the rank and file still pay high costs on the government plan). The only difference is people will now foot the entire bill (instead of the employer paying for 50-70% like they do now).
I just don't see how this is a good idea. We have a factory worker that makes $75K a year and has our HSA plan ($3000 deductible) that doesn't have a monthly premium (since it is a high deductible). If he puts his normal $300 a month in premiums into the HSA, he would have $3,600 (tax free) in his HSA to cover the full deductible and some extra coinsurance costs after. Chance are he would roll a bunch of that $3,600 over into next year and have a savings account for health expenses. Now, let's say Bernie is president and that plan is no longer available. The US plan would have a higher deductible and not as good coinsurance (ours is 90%). He would be paying $5,000 - $6,000 more in taxes for a worse plan. So, then his option would be to either put more in his HSA (to cover the higher costs) or buy a supplemental policy that makes up the coverage gaps (and costs yet more money). Chances are that person would be out $7,000-$9,000 in real money to be part of this new system where he gets worse health coverage.
It is just amazing to me that people think getting rid of employee subsidized health care is going to be good for most people. Its like saying an employer pays 50% of all rent expenses for 10,000 employees in a small town and gets a tax write-off from the local government for doing that. So, a family in one of these employer subsidized rent control apartments is paying $1,500 a month for a place that should cost $3,000. The government then decides to ban the employer from subsidizing apartments in this city (and takes back the write-off) and forces this family to either live in much worse place for their $1,500 or pay the going rate of $3K for that place. While the majority of this town would face a massive increase in expenses, the government thinks that years down the road the rent will decrease in this city to where small percentage of people not employed by this company would be able to afford a better place. That is basically the argument to get rid of employer subsidized health care. Soak all people with employer covered health plans for the next 5-10 years on a hope (that has never happened with Medicare for seniors, FYI) that costs will eventually decrease.