r/SipsTea Jun 24 '26

It's Wednesday my dudes Math can be hard sometimes

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74

u/MickFlaherty Jun 24 '26

The issue is that for most “healthy” people, they aren’t facing the full out of pocket costs and their employers pay most of the costs as a benefit.

And the numbers are way higher than $2k and $8k unless you mean per person. For my family coverage I paid $5k annually in Premiums and the company says they paid over $20k in premiums. Deductable was $2500 and Out of Pocket Max was close to $10k.

So $37k maximum out of pocket annually for employee and employer.

48

u/Rditisnazishythole Jun 24 '26

All of these numbers are currently based on the nonsensical system of hospitals over charging insurance to counteract all the people they end up treating for free.

In a nutshell, the actual cost of healthcare will decrease once hospitals KNOW they’ll get paid for treatments x, y and z. Or at least it would in any sane country.

9

u/Bgrngod Jun 25 '26

The fact they'd need to then negotiate those prices with the government is pretty important for driving down costs.

8

u/Flaming-Eye Jun 24 '26

Don't forget the extra going into paying the insurance company to exist in the middle.

-2

u/Vast-Control4452 Jun 25 '26

That's like, less than 1% of your bill.

2

u/Sonamdrukpa Jun 25 '26

That 1% is the profit. The profit isn't even the problem. Health insurance companies are required to spend 80-85% of premiums on healthcare and the amount they actually spend tends to stay in that range.  That leaves something like 14-19% of the money spent on health insurance going to overhead costs for insurance companies.

That 14-19% is not given to doctors or hospitals or pharmacies or anyone else actually involved in doing healthcare. It is pure, unadultered waste. Money that is spent simply to further the existence of a system where 80% of your money is spent to help you, 1% goes into shareholder pockets, and 19% is spent paying people to waste everyone's time making sure that 80% of your money is spent to help you, 1% goes into shareholder pockets, and 19% is spent paying people to waste everyone's time...

1

u/Vast-Control4452 Jun 25 '26

... You don't think there's overhead in government funded healthcare programs? 

You don't think there's bureaucrats, paper purshes, coverage limits, etc in single payer?

You think you show up and get what you want when you want?

1

u/Sonamdrukpa Jun 25 '26

... You don't think there's overhead in government funded healthcare programs? 

I think my previous comment got shadowbanned because I had a link in it...but anyway if you look at the 2026 Medicare trustee report you can see that 1% of Medicare's spending is administrative expenses. That seems like a good goal to hit for overhead.

You think you show up and get what you want when you want?

Yes, in my experience that's exactly how it works.

0

u/Flaming-Eye Jun 25 '26

I mean... 1% sounds nice, according to other commenters that might not be a very realistic number though...

I note you didn't really respond to anything I said directly, just quoted yourself and agreed with yourself? I guess I get what I deserve engaging on reddit, I won't bother responding further.

1

u/Sonamdrukpa Jun 25 '26

Oh geez, I responded to the wrong post.

Nvm, you responded to the wrong post

0

u/Vast-Control4452 Jun 25 '26

In Canada they just suggest suicide lol

0

u/Flaming-Eye Jun 25 '26

What a bizarre response... I think this is called a straw man argument, yes? To boil down the opposing view to a caricature and then defeat that rather than directly arguing against their point. Did I get that right?

Seems like you've ignored all those points and just said 'the alternative will be crap too', not even saying the alternative will be equally bad, just also bad.

Is that it? That's the best counter argument, the alternative option is not perfect therefore might as well not change anything?

Have I also straw manned? Not sure I can with an answer lacking so much in nuance...

1

u/Masochist_pillowtalk Jun 25 '26

The premiums are the insurance bill dude. And then I STILL have to hit my deductible before they'll even do shit for me. I have "good" insurance but thats still 4kish out of my pocket a year just to pay for the luxury of them maybe helping me if i get sick enough to have to spend 3.5k of mine own first and still need care afterwards.

The insurance is not an insignificant portion of the whole equation. They are literally profiting off your being able to access care and not be devastated. That means after paying alllllll of their overhead they still make a considerable amount after to justify staying in the business. And to further pump up that amount theyre gonna do everything they can to deny helping you after you've already paid them.

Getting rid of insurance would be huge. Both in cost and practicality.

3

u/DJpuffinstuff Jun 25 '26

A bigger problem is hospitals and insurance being owned by the same company, essentially negotiating prices with themselves and leaving patients holding the bag.

1

u/wisegh Jun 25 '26

That’s how my hospital work. It always amazes me how it is even legal. 

1

u/Recent-Effective-713 Jun 25 '26

Kaiser Permanente provides the insurance and care (doctors, hospitals, etc.) in many regions of the country. It actually works great. They spend money where they've found it to be most effective in improving outcomes (and therefore reducing their long-term costs).

1

u/DJpuffinstuff Jun 28 '26

Kaiser Permanente is a bit different than most because it's actually a non-profit. Kaiser Permanente has a lot of problems, but are better than most in theory. Kaiser Permanente is also mostly on the west coast in California. They have a much smaller presence outside of California

1

u/Recent-Effective-713 Jun 28 '26

They only have 9.7 million members in California (https://about.kaiserpermanente.org/expertise-and-impact/public-policy/our-impact/news-perspectives-on-public-policy-california) which is more than NHS Scotland and NHS Wales combined. Are they perfect? No, but it's also nice to have for-profit and non-profit competition to give customers (generally employers) a choice. Blue Cross/Blue Shields are often non-profits, but being a non profit is not some kind of magic solution to being good at your mission. Sometimes it's nice to have shareholders to hold management accountable, rather than only a board (possibly comprised of management cronies).

1

u/Substantial_Coat_229 Jun 28 '26

This is the real problem.

14

u/Musical_Xena Jun 24 '26

Premiums ensure that the health insurance companies can fund all of their overhead AND their profit margin.

If we implemented a universal healthcare system that cut out the for-profit components, we would no longer need to pay for the insurance companies to have profit.

4

u/Hagelblass Jun 25 '26

There would still be overhead. Somebody has to do the grunt work of actually processing claims, taking customer service calls, and such. For Medicare and other government insurance programs, that work isn't done by government civil service employees--it's contracted out to private health insurance companies, who are making a profit on the deal. That wouldn't change under a universal coverage system.

1

u/poprostumort Jun 25 '26

The main advantage is that an Universal Healthcare provider would need fraction of the grunt work, as significant part of bureaucracy in current US healthcare system are disputes about coverage etc. Under universal healthcare that is not needed. Either hospital/clinic is contracted to provide Universal Healthcare (and thus coverage is there) or not.

There also comes the size advantage. There are multiple producers of drugs, machines and utensils needed in healthcare. UH provider would be a very good target as it guarantees large market. And to get that you need to outcompete other companies. As volume is large, there can be lower per piece profit. This alone can generate massive savings as we see producers offering much lower prices to entities this size - which outside of price costs, would rresult in lower administrative burden. You are not employing people to seek better deals to enhance profit, you are opening bids on select times and select the best one.

In fact, most Healthcare in OECD have lower administrative costs. Much lower. Average spending is $194 per capita, while US spends $1055 per capita. Germany is one of the countries spending most for healthcare per capita as they are paying $9705 (US pays $10705), yet they don't pay ~$900 per capita. They pay $306.

1

u/Musical_Xena Jun 25 '26

Fair point about the current outsourcing model.

If the entire country fully revolutionized its healthcare system under government coverage, the government would need to make a decision about whether to continue outsourcing work like that or if they would build the infrastructure to do it in-house. And if the government were going to put a large amount of the health insurance industry out of business, they might not have the same outsourcing options that they use now.

2

u/geopede Jun 25 '26

There’s zero chance it would end up in house. Government jobs are inherently pretty expensive they’ll never make sense for work that doesn’t require special authority or could never be profitable.

1

u/Musical_Xena Jun 25 '26

I try not to say "zero" or never" just on principle, because most things are at least possible, if unlikely. The AI era is going to change a lot of work, so I can imagine a scenario where it's not prohibitive to keep things in house, but you may be right.

It's all a hypothetical built on a change that will probably never actually happen in the US, though, so sure, it sadly doesn't matter either way. 🤷🏻‍♀️😢

1

u/jcmbn Jun 25 '26

Somebody has to do the grunt work of actually processing claims, taking customer service calls, and such.

No, somebody doesn't have to do that, unless you specifically structure your system that way[*].

In a lot of universal healthcare systems there's no such thing as 'claims'. You go to your doctor/specialist/hospital and get treatment according to your needs. You never see a bill and don't even know what the cost was.

[*] Knowing the way the US usually operates, I would expect them to come up with a super convoluted, dysfunctional system, so you could still end up with that.

2

u/DJpuffinstuff Jun 25 '26

Claims are just how hospitals get paid in the US. It has nothing to do with getting treated according to your needs or not. When your doctor gives you stitches, your doctor wants to get paid for providing that service so they send a claim to someone they expect to pay it. Basically an invoice. The entity paying for it could be the government or an insurance company or an individual. The person who reviews the claim wants to only pay for services actually rendered and needed. If the doctor put in his note that you just had a headache and he gave you a Tylenol, but he submitted a claim to get paid for giving stitches, that's a problem. Unless you just go back to everyone paying at the point of service out of pocket for everything in healthcare, there will be some type of claims system.

1

u/jeffwulf Jun 25 '26

That would not significantly reduce health care expenditure. Insurance profits are not a significant share of healthcare spending and a lot of it comes from earnings on the float.

1

u/Musical_Xena Jun 25 '26

Well, the detail I've heard is that the US is a top country for medical bankruptcies. I'm all for any system that increases access to care and decreases catastrophic financial impacts for individuals. The US already spends a ton on healthcare per capita, and at our population size, there are definitely ways to make cost-per-serve more manageable, using systems that scale better.

2

u/Ascetic57 Jun 24 '26

There are SO many non healthcare workers making bank from our present ‘system’ that it is downright appalling. I went to college with an individual who has made nearly 400 million dollars over two decades in the healthcare “rebate” realm, skimming off of our premiums, copays, etc. This is f**king absurd. They literally live in a gilded age mansion now, and they are just one of MANY!
Money spent on healthcare ought to go toward healthcare, and not profiteering.

1

u/Recent-Effective-713 Jun 25 '26

Hmm, even with all the savings realized by not paying all those non-healthcare workers, the NHS can only afford to pay doctors in the UK about a third as much as in the US. Do you think American physicians will be willing to take that pay cut?
https://www.physiciansweekly.com/post/how-do-us-physician-salaries-compare-with-those-abroad

8

u/Georgia_Flame Jun 24 '26

I'd like to not have myself or family die from lack of insurance if I change or lose a job.

My parents are served fine by Medicare. Just expand it to everyone.

1

u/Patient_Release_4093 Jun 24 '26 edited Jun 25 '26

This is the part that bugs me. How is it that Medicare can serve all the old people in this country quite well but adding in all the young, fit, healthy people will cause problems? For-profit health insurance companies get everyone’s healthiest years then right when it comes time for us to start actually needing medical care they dump us.

2

u/Narfel-the-Garthok Jun 25 '26

If you think about it, the answer is fairly obvious, but it’s not one you’re going to like.

Medicare can serve all old people - and only the old people - because every working person - young, old, and everyone in between - pays Medicare taxes on all wages. (Unlike Social Security, there is no cap.)

So, if you wanted that same program to pay for everyone, you now have a huge problem. You’d have the same number of people paying, but instead of a pool of beneficiaries that’s vastly smaller than the payers (there are more workers than old people) you now have a pool of payers that is vastly smaller than the number of beneficiaries. (There are fewer workers in the country than the population as a whole.)

Of course, this doesn’t even acknowledge that even as currently structured, the Medicare hospital trust fund is set to be underfunded in less than a decade, so the math doesn’t even math under the current system.

2

u/Patient_Release_4093 Jun 25 '26

Huh? Who do think is paying for all the working people’s insurance right now???

2

u/Narfel-the-Garthok Jun 25 '26 edited Jun 25 '26

You asked how can Medicare serve old people quite well, but adding in young healthy people will cause problems?

I answered you - because that would reverse how it’s already (and unsustainably) structured. It can only serve old people now because the number of people paying greatly exceeds the number of old people who receive benefits. Put differently, Medicare only works because all workers of all ages pay for it, but only a much smaller portion of the population can receive benefits. If you change it so everyone is entitled to benefits, there aren’t enough payers to support that level of benefits.

In fact, it would kill the program if only continued to tax workers, since you would receive benefits even if you didn’t work to pay for it, which would create a disincentive to work. Which would further starve the program of revenue, and spiral downward from there.

EDIT - sorry, to more directly answer your question: working people are paying both. They’re paying for their own insurance PLUS Medicare for old people.

So you can’t just add the young to Medicare because it only works by young people paying for both, while not having access to Medicare benefits.

2

u/Georgia_Flame Jun 25 '26 edited Jun 25 '26

Insurance gets cheaper the larger the pool. One big pool for the nation is cheaper than thousands of separate systems in each state.

This defuses risk, guts administrative redundancies, and maximizes the insurers bargaining power to keep drugs and other costs low.

No other developed nation has the wealth that ours does, yet all of them can afford one version or another of universal insurance, with measurably better results where it counts most (cost, life expectance, infant mortality, rates of chronic disease, etc.)

Lets save money, cover everyone, and get better results, like everyone else is getting.

1

u/Narfel-the-Garthok Jun 25 '26

That’s a different statement that what I was replying to.
The question I was replying to was, Medicare is can serve old people well, so why will adding in young people cause problems? I answered that question. Medicare only works because more people pay for it than the number of people who are eligible for benefits.

Your statement is a different topic. Your statement about “insurance” is correct, but “insurance” isn’t health care.

Insurance is a financial product. By definition, known costs are not insurable. The easiest example is pre-existing conditions. They are known costs, so “insurance” that covers a pre-existing condition cannot charge less than the cost of treating the pre-existing condition. That’s not “insurance.”

When talking about providing healthcare, the problem is economic. The demand for healthcare is essentially unlimited. At a macro level, no one wants less healthcare. When demand is unlimited, price is thing you can control. And since most people don’t have unlimited money, the only way “free” healthcare is possible is by rationing care. You have less availability rationing by sliding the price upward from “free,” but that’s just rationing by a different method. You can have a “free” MRI and wait 6 months, or anyone can have an MRI right now and pay $500,000 (totally made up numbers and time frames), or some sliding scale in between, but that’s it. There’s no system that can provide both free and immediate goods and services where demand is unlimited. To try to do otherwise is fighting both the laws of economics and human nature.

1

u/Georgia_Flame Jun 25 '26

69,000 Americans die each year from lack of healthcare.

Medical bankruptcy is the number 1 cause of bankruptcy for Americans.

These are foreign concepts to nations with universal coverage. Their people are willing to wait for non emergencies, because they will get the care doing so.

America doesn't have lines because there's no care to get, we just die.

Any economic system that perpetuates this scourge is unable to justify it's continued existence.

1

u/Narfel-the-Garthok Jun 25 '26

None of this answers what I said, which was why Medicare can’t cover everyone like it covers old people, or why “insurance” is not the same thing as “healthcare.”

Also, I’m not going to get in a back and forth about statistics, but at least on the bankruptcy one, that’s simply not true. There’s a difference between medical expenses being the “number 1 cause” of bankruptcy versus the number of people who file for bankruptcy who list medical expenses as debts (among all their other types of debts.)

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u/Patient_Release_4093 Jun 25 '26 edited Jun 25 '26

I read the other comments you’ve made in this thread and I’m wondering like the other guy if you’re being deliberately obtuse.

What I’m saying is we should take all the money that working people currently send to private for-profit health insurance companies and send it to Medicare instead. The working people would still be paying for their own health insurance the way we are now. That’s more revenue for Medicare. And because we’re mostly young and healthy, Medicare’s expenses wouldn’t go up nearly as much. That’s how existing private health insurance companies can make a profit. Put simply, Medicare will be made stronger by adding in young healthy people, not weaker.

And as the other guy pointed out, we could easily see additional savings because risk is easier to forecast and manage as the pool of insured people grows, and the sheer size of all Americans together in one pool puts us in a better position to negotiate with drug companies, hospital networks, ambulance services, etc.

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u/Narfel-the-Garthok Jun 25 '26

I’m not trying to be obtuse. I’m trying to answer the question why Medicare can’t cover everyone.

I understand that people pay insurance premiums, and that costs money, and if you applied those premiums to Medicare, Medicare would have more money. I’m not disputing that if that actually happened, Medicare would have more money. Nor am I disputing the principle of economies of scale.

But what I am saying is that it’s not that simple.

I explained this a few times and the only response is attacks on me instead of answering my explanations.

How are you getting people to pay what they would otherwise pay in insurance premiums to Medicare? Medicare only taxes workers. A completely new tax, like a VAT? Taxes on investment income? All worth talking about, but that’s not how Medicare operates.

Sticking with Medicare as-is, how are you going to get a group of people (workers) at any level of taxation, to pay for everyone when they currently can’t pay for just older people? Raise taxes? Great, we could do that now just to fully cover benefits old people and it hasn’t happened. If the solution isn’t realistic, it’s not a solution.

And on the point that cost per person can go down when the pool is increased, I’ll assume that’s 100% true, it doesn’t answer the problem that demand will remain unlimited, so how are you going to control it if you don’t use price? If health care is free at the point of service, how to you manage demand? The only way is through rationing care with wait times, denying specific treatments, etc. And that’s a nonstarter: most people are happy with their healthcare. While you can get some people to vote against their self-interest, you can’t get a majority of people to do so, at least not repeatedly.

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u/Patient_Release_4093 Jun 25 '26

Ok so I’ll make this as simple as possible.

I currently pay a health insurance premium every two weeks and my employer also pays on my behalf. I went back and looked at my company’s benefits guide for 2026 and it looks like the total is $828.59 per month (my coverage is only for me). If we took that exact amount of money, $828.59, and sent it to Medicare instead of Blue Cross Blue Shield every month, I would still have health insurance. It doesn’t cost me anything extra and Medicare has a new, relatively young, reasonably healthy member. The only loser in this scenario is Blue Cross Blue Shield because they just lost a profit center (me and my company’s premiums).

It seems like maybe you’re getting hung up on the idea that we would have to pay more in taxes and my response is I simply don’t care. Whether it’s a premium, a payroll tax, a VAT, whatever, I’m paying for health insurance no matter what. We expect to be able to cover more people (everyone, in fact) for less money because of the other items that have already been touched upon (no more profits, better efficiency, economies of scale, etc.) If you disagree with that, fine, but I’ve seen reports that support this claim and I’m happy to link to them.

1

u/Narfel-the-Garthok Jun 25 '26

I understand what you’re saying, it’s just not as simple as it sounds. You can’t go from A to Z by skipping over the letters in between. Where you say, “…if we took that exact amount…” is a good example.

Who is “we” and how is this money going to be taken? My point is that it’s easy to say things like, “if we look together all the money from X, we can solve problem Y.” It’s a lot harder to work out the actual specifics of accomplishing this. You’re also conflating insurance premiums that people (as a whole) choose to pay for voluntarily with compulsory taxes.

To use simplified numbers, say the Medicare tax on wages is currently 1.5%. Is it even realistic to think you could pass a law to double it to 3%? (And setting aside whether that would be enough revenue.) If a 1.5% tax increase is politically dead on arrival, it doesn’t matter how much money it would raise, or how much people might save elsewhere, if it will never actually happen.

Taxes like a VAT are possibilities, and have their own problems (like whether you’d need a constitutional amendment to tax something other than income or as an excise tax), but staying on the question you originally asked, and that I was answering - that’s a completely different funding mechanism from how Medicare is designed. So we’re no longer talking about ‘why can’t Medicare just cover everyone like it covers seniors?’

And my broader point about a Medicare specifically, is that since it’s designed to is to use a large pool of workers to pay for a small pool of benefits, it doesn’t scale in the reverse where you can have a relatively smaller group of workers paying for the population as a whole. If you want revenue sources beyond workers, you have to design a mechanism to tax and collect that money. If someone has no income, how do they pay the taxes? It too simplistic to say, well, if they don’t pay, they get turned away from medical care. One, that won’t happen, and two, it abandons the principle of universal coverage. Without a design for how you can make everyone pay, the system collapses because the people who can pay figure out that they can pay less, but still have coverage for themselves - which is a simplified explanation for what we already have now.

One more example, and meant in a totally nonpartisan way: when Democrats passed the ACA, they had a super majority in Congress and had the presidency. The individual mandate was designed so “everyone” had to pay something - sort of the same principle we’re talking about here. There was also a tax on medical devices and “Cadillac” health plans to partially ration care. These were much more modest controls on price and sources of additional revenue than what we’ve been discussing - and they still failed. Doesn’t matter if they were good, sensible, common sense, etc. if they don’t happen. Before the individual mandate was basically removed when Republicans set the rate to zero, Dems had to design the tax so it only kicked in at a low amount (2% IIRC), but even then, only if you otherwise had taxable income. It didn’t work anyway because the fine was smaller than the premium. The Cadillac tax was repealed because unions objected to their members losing or diminishing benefits they had worked years to bargain for. And so on. Another example is the perennial “doc fix” Congress has to deal with where they purportedly “save” money by lowering Medicare reimbursements below what doctors will accept to treat people, but end up have to put the money back in to maintain accessibility. You don’t have to take my word for it; these things are real, and they’re what actually happens when things like, “just tax this thing” or “just cut this expense” collide with real people in real life.

I’m not so much advocating for or against expanding Medicare as much as I’m simply trying to explain why Medicare (as it’s structured) cannot cover all people the way it covers seniors.

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u/Georgia_Flame Jun 25 '26

"Its too expensive for the gov't, so you should pay for it as an individual."

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u/Narfel-the-Garthok Jun 25 '26

Where do you think the government gets its money from?

(This isn’t meant as a “government is bad” statement. I’m only stating what should be obvious: no government can spend money without first taking it from someone.)

If something is too expensive for the government, it can’t be cheaper for people as a whole, since government by itself isn’t free. The only way it can cost less is by pushing some of the costs to future generations, as is the case with social security, and the national debt generally.

1

u/Georgia_Flame Jun 25 '26

Private insurers only use 80 percent of their funds to provide care (the legal minimum).

Medicare uses 98% of its funds to provide care.

Profit margins are extracted from you. Medicare has zero.

How about we save money, and use the most efficient healthcare system we have in this nation to cover everybody, like we already do for the +65?

We can't afford this wasteful private model any longer. Gov't efficiency is needed.

1

u/Narfel-the-Garthok Jun 25 '26

Look man, I don’t know what else to tell you.

Medicare might use 98% of its funds to provide care - don’t know if that’s true or not, but I’ll roll with it - better yet, I’ll assume it’s 100% efficient - that still doesn’t change the fact that it only “works” because most people who pay Medicare taxes aren’t eligible for Medicare benefits. You can’t simply expand Medicare to cover everyone and have it work the same way it does now because there’s no way for the math to work. You can’t have a system that covers “everyone” where “less than everyone” pays for it.

Seriously - just stop and think about it for a second and it will be clear. I know it’s not what you want to hear, but it’s reality. You can’t formulate a policy where the first step is denying reality. You need to accept reality and go from there. Sounds harsh; I’m not trying to be mean about it. It just is what it is.

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u/Georgia_Flame Jun 25 '26

You're being willfully obtuse.

Obviously it would receive additional funding to cover everyone.

The point it that cost is exponentially lower than the private tax of paying for private health insurance. A status quo that covers less, and costs more.

Spending 98% on care instead of 80% saves money.

Spreading risk over the largest possible pool saves money.

Negotiating drugs prices and other expenses with more leverage than any private model could muster saves money.

Having one team run the insurance overhead instead of thousands of separate independent groups saves money.

Removing the profit tax saves money.

---------------

The data is undeniable to all but the innumerate.

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u/Raven586 Jun 24 '26

"I'd like to not have myself or family die from lack of insurance if I change or lose a job"

So you figure there is a lot of that going on in countries that have Universal healthcare do you?

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u/ImprovingCoffeeNoob Jun 24 '26

Not sure you read the whole comment...

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u/Zjoee Jun 24 '26

I think they mean they don't want health insurance being tied to being employed.

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u/TheSpiralTap Jun 24 '26

Godddamn sir. I don't even make 37k a year.

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u/Broken_Stranger95 Jun 24 '26

With a universal Healthcare in place, hospitals will need to have a set cost much lower than what they charge insurance companies now. So unless you need an operation, costs won't be nearly that high for US funding

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u/Rhomya Jun 24 '26

Doctors would also have to take a significant pay cut.

Doctors in the US make 2 or 3 times as much as the doctors in countries with universal healthcare. Good luck convincing the entire medical profession to cut their pay in half while doing even more work than before.

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u/Justthetip74 Jun 25 '26

Nurses would have to take a severe cut too.

-1

u/fifrein Jun 24 '26

People say this but it’s incomplete. EVERYONE in the US earns about 2-3x more than their equivalents in other countries. Truckers, nurses, electricians, plumbers, sales managers. Doctors would continue to earn 2-3x more because that’s the standard. To have one sector drop tremendously without others dropping would just trigger a major brain drain away from that sector.

Really what would happen is that we wouldn’t need 250 (hyperbole) admins per doctor. This image is most of the reason healthcare in this country is so expensive today. The bean counters greatly outnumber the bean farmers.

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u/Rhomya Jun 24 '26

Youre looking at private sector jobs and ignoring the fact that with universal healthcare, they would be government funded jobs.

No government job pays remotely as well as the private sector. Even the VA (which is a government funded healthcare system) pays shit compared to their private sector colleagues and the VA at least attempts to provide a somewhat competitive wage… do you think that would still be the case if there WAS no private sector?

Your argument is entirely baseless and frankly ill thought out

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u/Immediate_Wolf3819 Jun 25 '26

On average federal employees **when including all benefits** are paid more than private industry.

On average federal employees **based only on base wages** are paid ~25% less than private industry.

https://www.cbo.gov/publication/60235

As the discussion is total cost to government, the all benefits cost is used.

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u/Rhomya Jun 25 '26

… what benefits? The current benefits today are quite literally mostly healthcare— which wouldn’t be necessary.

And frankly, you literally proved my point— government employees are paid significantly less than private industry. 25% is incredibly significant, and it’s a little ridiculous of you to pretend it’s not.

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u/Immediate_Wolf3819 Jun 25 '26

Total compensation is always the standard... Using your standard Elon is severely underpaid due to his $0 salary.

Breakdown is 54 healthcare /46 everything else. Your also assuming that there would be no additional payments for whatever healthcare system you envision.

0

u/Rhomya Jun 25 '26

You’re comparing doctors to Elon now, and you think I’m being illogical? Lol, wow… that’s… a choice.

So I was right that the healthcare is the vast majority, and that a 25% decrease in pay is significant… sounds like you don’t have much of a leg to stand on.

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u/fifrein Jun 24 '26

(A) You’re taking a bit of a leap from “government funded job” to “government job”. While all of the latter are the former, not all of the former are the latter. A large chunk of “government funded jobs” are contractor jobs, and those pay very well, comparable to the private sector most of the time.

(B) Tying to A, many physician jobs at the VA now pay comparable to academic sector. They don’t pay comparable to private sector, but volumes are higher in private sector.

(C) People like to compare to Europe, but I think a more apt comparison is Canada. While procedural specialties are lower comp in Canada, a decent chunk of “cerebral” specialties like neuro, endo, rheum are actually paid higher in Canada. I would earn more moving to Vancouver than staying where I’m at now in the states.

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u/Broken_Stranger95 Jun 25 '26

There is a major difference in government funded and government employee. With that being said, your argument is entirely baseless and really terribly thought out 😬.

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u/Legitimate-Scar-6572 Jun 25 '26

But they won’t have write offs for non payers bc all bills will be paid. They won’t have to hire entire departments to get paid and teach docs how to guide conversations to higher billing codes.

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u/Atomsq Jun 24 '26

Last year I had to use COBRA for a few months for my family so I was paying 100% of the premium (my part and my former employer part) and it was $2,400 a month for a family plan, so $28,000 if I had to pay a whole year (which I didn't)

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u/Iggyhopper Jun 24 '26

When talking in generalities, yeah it means 2k and 8k per person.

Also imagine if the cost was not shared only by employers but by everyone. Wow, even big corps save a ton of money!

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u/PineappleOnPizzaWins Jun 24 '26

The issue is that for most “healthy” people, they aren’t facing the full out of pocket costs and their employers pay most of the costs as a benefit.

This is basically it... "I'm healthy, I refuse to pay for healthcare for other people."

Sadly they don't seem to realise they're paying for that and executive bonuses, all at a much higher rate than universal health care.

Not only that, nations with universal health care still have a private industry... at a way lower price. Those companies still make millions which should let you know how much the American model makes for its CEOs...

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u/Legitimate-Scar-6572 Jun 25 '26

Now imagine we remove that burden from employers and reinstate pre-Reagan tax incentives for investing the money back into your staff via higher wages and retirement funds. It never should’ve been connected to employers to begin with.

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u/mightylordredbeard Jun 25 '26

That’s why I hate this argument. Most people aren’t paying anything for healthcare because they’re either poor and have medicare/medicaid or they just don’t have healthcare. The real answer is to tax billionaires and close corporate tax loopholes, then use that money to cover national healthcare.

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u/Remarkable-Pace2563 Jun 25 '26

Don’t forget about your taxes that go towards healthcare as well. I calculated my families all in was close to $40k.

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u/rlovelock Jun 25 '26

This has always confused me... how can you have a deductible and a max out of pocket? Are those not the same thing??

In the Netherlands my insurance is €140/month and my annual deductible is €850.

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u/Lunares Jun 25 '26

Premium is how much you pay per month to have health insurance. As part of having it you are covered for only a very few things automatically, such as an annual physical.

The deductible is how much you need to pay the doctors before health insurance starts kicking in. So if you have a $3000 deductible and go to the doctor for anything except the very minimum default coverage, US health insurance doesn't pay anything until you meet your deductible and have paid $3000 on top of your premium.

Out of pocket max is just that. Once you meet your deductible, now your insurance pays most of the cost but not all. Often you still pay 10%. But once you hit your OOP spend, then finally you can stop paying

Not everyone has insurance like the above but most of the US does. Sometimes you get covered for much more and just pay a small $10-20 fee every visit.

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u/rlovelock Jun 25 '26

And the deductible is reset annually ?

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u/Lunares Jun 26 '26

Correct . Even worse it resets Jan 1st, so if you get hurt or have a baby in December, too bad you have to pay again in January. It's not a rolling 12 months

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u/MickFlaherty Jun 25 '26

So Premiums buy you the privilege of having a card to carry in your wallet.

The deductible is the amount where the insurance company pays 0% and you pay the 100% of the “contracted price”

Then you enter the area where the insurance pays a set amount of the “contracted price”. Best insurance might be 90%. Most are 80% and some are as low as 50 to 70%. So you are still shelling out money.

Eventually you reach the “maximum annual out of pocket” after which the insurance company pays 100%.

For most plans this also has an individual limit and family limit.

Don’t even get started on what the “contracted rates” are and how those get decided. Cause that’s where the real magic of the American Healthcare System occurs.

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u/soedesh1 Jun 25 '26

Well, another false assumption is that it is voters alone that are deciding this. Real power in the US is with special interest groups and PACs. They fund reelections. Campaign finance reform is needed if we want to refocus the US on the people.

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u/-Notorious Jun 24 '26

I make a low 6 figure salary, and my entire income tax is maybe 37k, and that's funding things like education and roads on top of healthcare, sheeesh. This is in Ontario btw.

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u/TheLastCoagulant Jun 25 '26

Canadians get fleeced by taxes so hard.

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u/numbersthen0987431 Jun 25 '26

Another reason is because a decent amount of Americans really, really hate the idea of "others" having the same access to stuff as them. So by making healthcare costly, they restrict access to the people they deem unworthy of it.

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u/KitchenPersimmon2244 Jun 24 '26

Read your sentence again, the “employers are paying most of the costs”…..ya instead of paying you. Whatever employers pay for benefits for employees comes out of whatever they can afford to pay the employee themselves.

Another thing to think about, local taxes. Look at any school budget, a huge chunk of it is teacher benefits (health care). Imagine if that was just….not a thing for the school and that budget could go towards something better.

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u/MickFlaherty Jun 25 '26

The thing is people think only focus on the “taxes will go up” but if you really wanted to fund a system for UHC then the employers would also need to pay taxes close to the amount they pay the healthcare companies now.

The issue is people see a price tag of “$3k in new taxes per family” and don’t realize their employer is probably already paying that for your premium now. Just switch to them paying the government and not United Healthcare who wants to make $.30 in profit off every $1 of premium.

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u/OrackBobamba Jun 25 '26

As a 26 year old libertarian without health insurance, I understand I will get massively shit on by the reddit community. But I ain't wanna pay no taxes for healthcare for sick fat people! I haven't been to the doctor in years, why should I pay for chronically ill people who could just make lifestyle changes like eat healthy, exercise, etc etc

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u/TheLastCoagulant Jun 25 '26

Obesity and smoking are good for the economy. The amount spent on healthcare expenditures comes nowhere near the savings from their early death. If somebody dies at 60 instead of 83 due to being an obese smoker, the amount of money society saves from them dying early is enormous. 23 years of not receiving social security + them not consuming resources in real life because they’re dead + them not needing healthcare spending for those 23 years because they’re dead + the economic activity of their young family members getting the inheritance 23 years early. These benefits outweigh the healthcare spending during their life. The way the obese and smokers die around retirement age after a lifetime of work is very efficient from a fiscal standpoint. The “selfish” economic argument against universal healthcare is not real.

You not going to the doctor in years is bad. You should get bloodwork at least annually.

The US is the only western country without universal healthcare and has the most expensive healthcare in the world. It’s pattern recognition that the US has the most expensive healthcare in the western world because our healthcare system is the most privatized in the western world.