For mums in America...just curious!

[Piper84]

Yes, but what kind of tax rates did/do you pay in those countries? See, here in the U.S., one of the founding ideas is that you should get to keep that which you earn. The government would tax a nominal amount in order to help pay for things like the military and certain kinds of infrastructure. You get to keep the rest and are responsible for taking care of your needs such as food, shelter, clothing, education, medical, etc. This allows you, the citizen, the maximum amount of freedom of choice to meet these needs in the way YOU see fit. Also, it allows private citizens to create businesses offering goods and services so that they can earn an income to then meet their needs in the way they see fit. The government would stay as hands off as possible, only getting involved when there was criminal activity. So while you are responsible to meet your own needs, you also have the maximum amount of freedom and financial means by which to do so.

In the systems set up in the UK and other European countries, the government has taken on the responsibility of making sure that these kinds of needs are met and, in order to do so, must tax income at a significantly higher rate. Unfortunately, this also leads to a decrease in the freedom you have to pursue the educational, medical, and other such services that you choose both because of your decreased financial means and also because government regulations may restrict what, when, why, or where you can have access to.

So really it's a matter of what your priorities are. Personally, I favor a system that allows maximum freedom and personal choice, despite the fact that it also comes with a certain amount of risk and personal responsibility. These are the circumstances under which the U.S. was able to become such a prosperous and powerful nation in such a short amount of time. The more we move away from those principles (which really began in earnest in the early 1900s), the less prosperity we see. So then the government tries to compensate by increasing their involvement in private lives and industry, which is taking us even farther down the road away from prosperity and freedom.

I get why people are so attracted to the systems in Europe and even Canada. On the surface it seems great. All I have to do is give up more of my income and I get the "guarantee" of all these free services. The problem is that nothing is really free, and frankly, the quality of care in these countries is not as high as it has historically been in the U.S. (which, again, was more true when the private sector was more in charge than the public sector).

I understand that low taxation is a priority in the US, but your taxes go to more than the military and certain kinds of infrastructure. Taxes pay for roads, the postal service, education, local government, law enforcement, emergency services, political representation on a local and federal level, transportation, etc...

In Germany, you pay roughly 8% of your salary for healthcare and your employer pays the other half. Health insurance is compulsory. The government spends 11% of GDP on healthcare. I'm not sure of the exact percentage in the UK because it is part of your National Insurance contribution (like Social Security in the US, I think), which depends on how much you earn and whether you're retired or not.

There does seem to be quite a difference in how much doctors make. A family doctor in the US earns $149,751 a year https://www.payscale.com/research/US/People_with_Jobs_as_Physicians_/_Doctors/Salary, a GP in the UK earns an average of $120,000 https://www.telegraph.co.uk/health/...re-not-paid-six-figure-sums-figures-show.html, in Germany it's $265,000 https://www.t-online.de/wirtschaft/...zte-haengen-fachaerzte-beim-einkommen-ab.html. In both the US and Germany, the doctors' lobbies are very powerful and they are keen to protect their earnings. I think this plays a huge role.

No-one thinks their healthcare comes for free, but it is a set amount you pay for whatever crisis you're having. Health inequality in the US is a massive problem. While some clinics offer world-class, one-of-its-kind treatment, you get the other end of the scale, with Doctors Without Borders style intiatives being set up so people can go and have a mammogram or get their teeth fixed.

 

[chicka.chicka]

It's true that in the U.S. our taxes go to more than the military and certain types of infrastructure. What I meant is that it was intended - set up by the Constitution - for the government to collect a minimal tax to pay for the military and certain types of infrastructure. It wasn't until the early 1900s that the government started, at least to a large extent, subsidizing things like education, health care, retirement funds, transportation, etc. As I said, the more we have moved towards government involvement in those kinds of programs, the farther away from freedom and prosperity we have moved. Yet we keep trying the same solutions, spending even more on these kinds programs, and yet things just keep getting worse for the private citizen.

Currently, the U.S. government spends more than 50% of its budget on social programs such as welfare and subsidies to the above-mentioned programs. And yet we still continue to see poorer and poorer outcomes in these areas. At some point, doesn't it ever occur to anyone that IT DOESN'T WORK?? If we would just go back to the private sector and cut the government back to the size it's supposed to be according to the Constitution, then maybe, just maybe, we might see some different results.

 

[Piper84]

We're roughly speaking the same language, but I don't agree with your definition of "freedom"

Don't you agree that what was intended when the US constitution was drafted isn't necessarily relevant for a population which has increased from a couple of million to 310 million?

Don't get me wrong, I'm not telling you what the US needs to do to improve its health provision, but it seems to be making it a lot more complicated and expensive than it needs to be. And unless health provider companies are being scrapped and replaced by a government department, healthcare in the US is remaining private.

 

[Pink Flowers]

How much as a percentage in the USA do you pay tax on your earnings? and what does it cover? Do you pay something similar to council tax?

I am just wondering because our taxes on wages pay towards healthcare etc etc

and our council tax pays police, fire, ambulance, council, schools etc etc

 

[special_kala]

Isnt it national insurance that goes towards the NHS?

What happens if a baby needs to go into NICU? The cost of a few months of a preemie must go into the 100,000s surely.

 

[chicka.chicka]

We're roughly speaking the same language, but I don't agree with your definition of "freedom"

Don't you agree that what was intended when the US constitution was drafted isn't necessarily relevant for a population which has increased from a couple of million to 310 million?

Don't get me wrong, I'm not telling you what the US needs to do to improve its health provision, but it seems to be making it a lot more complicated and expensive than it needs to be. And unless health provider companies are being scrapped and replaced by a government department, healthcare in the US is remaining private.

I absolutely believe that what was designed by the Constitution is still relevant today. If anything, it is more relevant today than ever. The principles of government outlined by the Constitution are scalable - they work whether the population is 10 or 10 million - and the Founders knew it. The thing is, we didn't stick with it long enough to find that out.

Technically speaking, private insurance companies are still considered private, but there are so many regulations put upon them by the government that it's not really private. Plus, there are more people on the state programs of Medicaid and Medicare than there are on private insurance, so the private companies are not playing as much of a role in the industry anyway. And with the ACA (Obamacare), more and more people are moving to the state insurance programs as well.

 

[chicka.chicka]

How much as a percentage in the USA do you pay tax on your earnings? and what does it cover? Do you pay something similar to council tax?

I am just wondering because our taxes on wages pay towards healthcare etc etc

and our council tax pays police, fire, ambulance, council, schools etc etc

Taxes in the U.S. are currently based on a percentage of your income. The bottom 50% approximately of wage earners pay nothing in income tax (they do contribute to Social Security and Medicare, however, as well as pay state and local taxes). There is money withheld from their paychecks, but at the end of the tax year they will get a complete refund plus extra money thanks to things like the Earned Income Tax Credit and other things like that.

The more money you make (after deductions that can be made for things like mortgage insurance, charitable donations, child credits, etc.), the more of a percentage of your income you pay.

Here you can see where the money gets spent.

 

[Pink Flowers]

Isnt it national insurance that goes towards the NHS?

What happens if a baby needs to go into NICU? The cost of a few months of a preemie must go into the 100,000s surely.

I was talking about all the tax you pay on your wages NI and income tax, didn't word it right. x

 

[special_kala]

Im sure my husbands NI payments is less then 200 a month, cant imagine having to pay the amounts some of the US people do for medical care.

How does it work for kids in the US? What if their parents dont have insurance? Anyone under 16 gets free prescriptions, dentist and optical care here.

 

[chicka.chicka]

Im sure my husbands NI payments is less then 200 a month, cant imagine having to pay the amounts some of the US people do for medical care.

How does it work for kids in the US? What if their parents dont have insurance? Anyone under 16 gets free prescriptions, dentist and optical care here.

Most states have a children's health insurance plan, which are also subsidized by the federal government. The income levels are pretty generous for being able to qualify for it in most states as well, as it is intended to help provide coverage for those who make too much to qualify for Medicaid.

 

[Piper84]

I absolutely believe that what was designed by the Constitution is still relevant today. If anything, it is more relevant today than ever. The principles of government outlined by the Constitution are scalable - they work whether the population is 10 or 10 million - and the Founders knew it. The thing is, we didn't stick with it long enough to find that out.

Technically speaking, private insurance companies are still considered private, but there are so many regulations put upon them by the government that it's not really private. Plus, there are more people on the state programs of Medicaid and Medicare than there are on private insurance, so the private companies are not playing as much of a role in the industry anyway. And with the ACA (Obamacare), more and more people are moving to the state insurance programs as well.

Really? You think the US healthcare model should be based on principles thought out when life expectancy was 35 and people regularly died of infected wounds, typhoid, TB and smallpox and the nearest physician could charge whatever they pleased?

All private industry is regulated to some extent by the government, so healthcare shouldn't be seen any differently, surely?

 

[chicka.chicka]

The Constitution makes no provisions whatsoever regarding health care. That's not something that was ever intended to be regulated or governed by the federal government. It was to be left to the private sector or, at the most, the local and state governments. Same with education and welfare.

I completely understand that we're not going to agree this. We are coming from much too different places. I feel that the discussion is not being productive and venturing too far off the OP's intention. And frankly, I don't have the time or patience to beleaguer the point further. So I'm content to agree to disagree and step away. Thanks for the engagement.

 

[Piper84]

The US constitution explicitly states that the federal government will regulate commerce, so I'm not really sure what you're getting at.

Thanks for the interesting discussion!

 

[Missy08]

Question on the hospital bill part of the discussion...

When my daughter was born in 2008, I had been making monthly payments to my midwife for my prenatal care. Then after we left the hospital, I started getting bills for everything there. I had everything paid off within a few months but wasn't asked to pay anything at the hospital. Now it seems like I'm hearing people are being asked to pay up front (before even being discharged)...is this the case? How could they have even had time to bill our insurance yet? I'm worried I'm going to be asked to pay a couple thousand dollars when I leave the hospital...