Other Countries On Healthcare & Taxes

Snowman999

Member
I don't follow or read up on any other country. I barely follow (it's true) the US.

This is the way it goes in the US -

1. You get a job in the US for either an hourly wage (full time is 40 hours a week), a flat salary (regardless of how many hours you work, you get the same each week). These are the two standards. Depending on how much you make, you pay taxes on your salary. If you're making over a million a year, you're paying close to 50%. I think I was closer to 10%.

2. Most employers offer healthcare at a much cheaper cost than if you were to purchase it on your own. The reason being, the more employees on the same policy the cheaper the price. The cost of the healthcare is removed from the employees check.

How does the above work in other countries?
 

grimtraveller

If only for a moment.....
In the UK it depends on the employer to be honest. Some offer healthcare, some don't. Some offer healthcare only connected with their business, some go a bit further and include the family of the employee. I used to deliver to a company and my contact there told me that he was eternally grateful to the company because when his wife had cancer and couldn't work, they not only gave him the time off he needed, they actually covered her costs even though she wasn't with the company. I think they wanted him to keep it quiet though.

Healthcare is an interesting thing to us in the UK. We have a healthcare system that I think Obama had his eye on when he tried to implement one in the USA. The way it works is that we pay tax and a thing called National insurance. It's a small amount each month but it's taken out of our wages before it ever gets to us. What it means is that whatever may be amiss with you, you're covered. If, for example, your appendix bursts in the middle of the night, as long as someone is around or you're able, a call can be made to an ambulance and they'll come and get you and take you to hospital where you'll be operated on and taken care of and nursed back to some semblance of health. No questions asked. No costs. You've already contributed to the system. It works on the dual principle that even if you're healthy for 89 years and never need the national health service, you just might when you're 90. Meanwhile your money contributed in those 89 years is helping other people with their healthcare. So everyone contributes towards one another's healthcare but when it's your turn for treatment, everyone is contributing towards it.

Now, this doesn't mean that one cannot also have private health insurance. Loads of people do. Having private healthcare insurance means that you may not have to wait as long as you might on the NHS or it may mean that you can have a private room in a hospital rather than be placed in a ward where you might catch a cold from a fellow patient {as happened to me in 2016 when I had a Hemorrhoid op ~ no fun sneezing, believe me !}. But private healthcare is by no means a guarantee of better treatment or a cure. It can be in some cases but its main advantage is convenience and speed. Yes, sometimes it can mean superior treatment but I find that is so dependent on the doctor involved, rather than the cost.

Brits are often moaning about the NHS but when I hear people doing so, I ask them to think about a system where they have to pay for their healthcare or where it really comes down to throw of the dice and when they do, they virtually always say "oh yeah !" We are fortunate here. It's not a flawless system {no system with people can be} and it does have its faults but I can't think of one I'd rather have. It's not free, we contribute towards it but in a way we never notice.
 

DM60

Well-known member
In the UK it depends on the employer to be honest. Some offer healthcare, some don't. Some offer healthcare only connected with their business, some go a bit further and include the family of the employee. I used to deliver to a company and my contact there told me that he was eternally grateful to the company because when his wife had cancer and couldn't work, they not only gave him the time off he needed, they actually covered her costs even though she wasn't with the company. I think they wanted him to keep it quiet though.

Healthcare is an interesting thing to us in the UK. We have a healthcare system that I think Obama had his eye on when he tried to implement one in the USA. The way it works is that we pay tax and a thing called National insurance. It's a small amount each month but it's taken out of our wages before it ever gets to us. What it means is that whatever may be amiss with you, you're covered. If, for example, your appendix bursts in the middle of the night, as long as someone is around or you're able, a call can be made to an ambulance and they'll come and get you and take you to hospital where you'll be operated on and taken care of and nursed back to some semblance of health. No questions asked. No costs. You've already contributed to the system. It works on the dual principle that even if you're healthy for 89 years and never need the national health service, you just might when you're 90. Meanwhile your money contributed in those 89 years is helping other people with their healthcare. So everyone contributes towards one another's healthcare but when it's your turn for treatment, everyone is contributing towards it.

Now, this doesn't mean that one cannot also have private health insurance. Loads of people do. Having private healthcare insurance means that you may not have to wait as long as you might on the NHS or it may mean that you can have a private room in a hospital rather than be placed in a ward where you might catch a cold from a fellow patient {as happened to me in 2016 when I had a Hemorrhoid op ~ no fun sneezing, believe me !}. But private healthcare is by no means a guarantee of better treatment or a cure. It can be in some cases but its main advantage is convenience and speed. Yes, sometimes it can mean superior treatment but I find that is so dependent on the doctor involved, rather than the cost.

Brits are often moaning about the NHS but when I hear people doing so, I ask them to think about a system where they have to pay for their healthcare or where it really comes down to throw of the dice and when they do, they virtually always say "oh yeah !" We are fortunate here. It's not a flawless system {no system with people can be} and it does have its faults but I can't think of one I'd rather have. It's not free, we contribute towards it but in a way we never notice.


This is where Obama went side ways. He didn't, for political reasons, didn't want to say this was a tax. Had he done that and just implemented it that way, we in the US might not be having this conversation.

The one thing that makes healthcare in the US so difficult, many companies, to include European companies, make a ton of money here. As soon as the government regulates it, the gravy train will slow down a bunch.

Another items that hurts the efforts of healthcare reform in the US is tort reform. We have a lot of lawyers in this country and they are all looking for a big paycheck. They will represent a client for free if they don't win. It really is bad and much of our problem here is the way hospitals, doctors and big pharma can be sued.

Healthcare reform in this country needs to take a few steps. We have Medicaid, which is given to the people who don't make a certain amount of money. Medicare is for people who are retired and you qualify for it when you are 65 or have a disability. Between private/company insurance, medicare and medicaid the us is at a 90+%. We are talking about 10% ish, so it is not like that can't be solved.

Back to the tax, then why would it not just be something that a tax would be added, do some reform with pricing, tort, and I am sure a few other areas. Get rid of preexisting health issues and the topic is pretty much done.

When Obama/Dems controlled the government (for two years), he could have done it. He had everything to do it, but he didn't because he knew raising taxes was going to harm the Dems in the 2012 elections (House of Representatives get elected every two years, rotating somewhere around 50/50 so not all are being elected the same year). He had the opportunity and didn't do it. Obama would defend his healthcare push as not a tax. But if you didn't do it you would be fined. I mean really, WTF. Just own it, and to me Obama never owned anything.
 

Supercreep

Lizard People
tl;dr: US politicians and media are untrustworthy.


The problem, as I see it, is that no politician on a national platform is being honest when they talk about "healthcare."

It's health insurance we're talking about. A plurality of Americans want European-style cradle-to-grave taxpayer-subsidized health insurance. We can definitely do that, but politicians aren't being honest about what it will cost and what those increased costs will mean to individuals. We've got one side saying the costs are catastrophic and unbearable, and the other saying they are manageable and that taxes won't be increased for the middle class (who are generally paying most of the income taxes already).

Give us a reliable accounting of the benefits and costs, and let Americans decide what they want.
 

DM60

Well-known member
tl;dr: US politicians and media are untrustworthy.


The problem, as I see it, is that no politician on a national platform is being honest when they talk about "healthcare."

It's health insurance we're talking about. A plurality of Americans want European-style cradle-to-grave taxpayer-subsidized health insurance. We can definitely do that, but politicians aren't being honest about what it will cost and what those increased costs will mean to individuals. We've got one side saying the costs are catastrophic and unbearable, and the other saying they are manageable and that taxes won't be increased for the middle class (who are generally paying most of the income taxes already).

Give us a reliable accounting of the benefits and costs, and let Americans decide what they want.

I think many are on the same side as you. Hell I will go one more, do we believe the government should take that on? If so, then there is way to do it, we all know it can be done.
 

TalismanRich

Well-known member
One issue with US health care is that there is no standardization in pricing. Its like MSRP vs street pricing, except the two are completely unconnected. Go in for an emergency procedure without insurance and you can be certain to receive a bill for the full MSRP version, including $10 aspirins, $20 latex gloves, etc. One the other hand, if you have an insurance company, they get the bill and say "here's your reasonable and customary charge".

When I went in for cancer surgery years ago, there was a sign that said "Ask about our 80% discount". Turns out, if you prepaid your surgery, you got it for 20% of the list price. Instead of a $10,000 bill, you pay $2000 and you're out. My insurance bill paid about 30% total, still a significant discount. Clearly the list price is unreasonable. If you have insurance, you just worry about paying your deductible and copay, and its not a big deal.

Likewise, drug pricing has little to do with actual cost of goods. When my daughter was young, she had a prescription for a drug that was still running about $40 a month. On a trip to San Diego, we went to Tijuana for the day. The exact same pills were OTC, and 3 months supply was about $10.

Having more standardized pricing would go a long way toward making the US healthcare system less of an issue.
 

DM60

Well-known member
One issue with US health care is that there is no standardization in pricing. Its like MSRP vs street pricing, except the two are completely unconnected. Go in for an emergency procedure without insurance and you can be certain to receive a bill for the full MSRP version, including $10 aspirins, $20 latex gloves, etc. One the other hand, if you have an insurance company, they get the bill and say "here's your reasonable and customary charge".

When I went in for cancer surgery years ago, there was a sign that said "Ask about our 80% discount". Turns out, if you prepaid your surgery, you got it for 20% of the list price. Instead of a $10,000 bill, you pay $2000 and you're out. My insurance bill paid about 30% total, still a significant discount. Clearly the list price is unreasonable. If you have insurance, you just worry about paying your deductible and copay, and its not a big deal.

Likewise, drug pricing has little to do with actual cost of goods. When my daughter was young, she had a prescription for a drug that was still running about $40 a month. On a trip to San Diego, we went to Tijuana for the day. The exact same pills were OTC, and 3 months supply was about $10.

Having more standardized pricing would go a long way toward making the US healthcare system less of an issue.

I do think the industry will require regulatory over site, just as any "public" utility.
 

TAE

All you have is now
Regarding UK health care as I understand it for emergency situations it works just fine...for day to day hey doc my ear hurts kind of stuff I understand that it's get in line and wait...and it can be many hours even days...Grim you live there so share your perspective...

On the U.S. system several here hit key points that are true..It is a vicious circle of lawyers and crazy high settlement law suits which effect malpractice rates which then force the doctors and medical facilities to raise their fees for lawsuit protection which makes us go HOLY SHIT! with regard to the drugs and the thievery here in the U.S. it is disgusting as pointed out about buying the same drug in Mexico for a tenth the cost.... Me being 67 and on the Medicare gravy train makes me pretty sad....I have no trouble seeing any doctor or hospital I want to go to...Oh you're on medicare and have a solid supplemental...come on down! I had a rough couple years with some aggressive skin cancers right after turning 65 and watching the medical system milk the medicare system was sobering, frightening as I watched my medical bill soar pass the million dollar mark....Of course medicare only paid maybe $150K supplemental maybe 30K and me under a few thousand...but that's the game the hospitals and doctors play for tax purposes.....they bill a gazillion and write off what they "forgave"...crazy screwed up shit and I see no easy solution in the near future unless we can get rid of the crazy lawsuits which just ain't going to happen in the land of the free
 

60's guy

Member
Me being 67 and on the Medicare gravy train makes me pretty sad....I have no trouble seeing any doctor or hospital I want to go to...Oh you're on medicare and have a solid supplemental...come on down! I had a rough couple years with some aggressive skin cancers right after turning 65 and watching the medical system milk the medicare system was sobering, frightening as I watched my medical bill soar pass the million dollar mark....Of course medicare only paid maybe $150K supplemental maybe 30K and me under a few thousand...but that's the game the hospitals and doctors play for tax purposes.....they bill a gazillion and write off what they "forgave"...crazy screwed up shit and I see no easy solution in the near future unless we can get rid of the crazy lawsuits which just ain't going to happen in the land of the free
I don't see any reason for you to feel sad about being on the Medicare gravy train. Other than the fact that the medical system (doctors and hospitals) try to overcharge for services rendered, they never receive the amount of dollars stated on their billings to CMS.
It amounts to nothing more than an accounting game that they play to perhaps "cook the books". Who can possibly know or understand why the money game is played the way it is. And to what end?

I had cataract surgery performed on one eye shortly after I was enrolled into Medicare. The cost of the surgery was almost $9500. My out of pocket cost was $150.

Your medical bills have to date exceeded $1,000,000 of which Medicare paid $150,000. Supplemental insurance paid $30,000 and you paid "under a few thousand".

I agree with you that the money game that plays out between doctors, hospitals, and Medicare is bizarre.

All things considered, it seems to me that all is well for you.

A few days ago, an acquaintance of mine stated "No one other than Trump and his inner circle knows how he thinks/feels about anything."

I responded:
How is any of what you are positing that "only" Trump's inner circle knows how he thinks and feels about anything, remotely possible? If it is true, then it would also be fair to say that only Obama and his inner circle understood what Obama's true intentions were when he said that he was going to "transform" America. If you go back far enough in time and research Obama's speeches on healthcare, for example, he acknowledged that he was in favor of a government controlled health care system, and he acknowledged that it would take 15 or more years to accomplish the goal of eliminating insurance companies, leaving the government fully in control of everything related to health care.
Eight years as POTUS wasn't nearly enough time to accomplish that goal, but he is still working hard behind the scenes to destroy insurance companies and pharmaceutical companies.
Bernie Sanders is orgasmic knowing that if Biden is elected, Bernie will be in control of the Senate committee that can destroy insurance and pharmaceutical companies in order to implement full control over the health and well being of every American at the discretion of number crunchers in the employee of the government.
To be fair, it's true that every insurance company employs their own number crunchers that do their best to keep their company in the black.
There are many many insurance companies in the U.S.
People still have the ability of choose the insurance company that they feel best meets their needs only because there is a multitude of companies to choose from to meet their needs.
If a "single payer" system of healthcare with the government fully in control ever comes to fruition?.....It wouldn't surprise me that our grandchildren and great grandchildren might remember it that it was our generation that made a bad decision.
You're intelligent. Ask yourself the question..."Other than the single payer system....what else did Obama have in mind when he said that he was going to "transform America"?.
I profer it that the only people who know are Obama and his inner circle, at that time, and now.
 
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grimtraveller

If only for a moment.....
Regarding UK health care as I understand it for emergency situations it works just fine...for day to day hey doc my ear hurts kind of stuff I understand that it's get in line and wait...and it can be many hours even days...
As with many things, it depends. It can depend on where one lives, what kind of surgeries are available in the area and what the actual doctors are like. Some really are better than others.
Where I live for instance, from 2003 to 2016 the surgery we were with were nowhere near as responsive as the surgery we've been with since 2016.

It is true that one can wait a couple of weeks for an appointment and it's often a laughing point here among people that you could be dead by the time the doctor gets to see you. But there are ways around that. Our surgery operates this thing called Patient access where they open their appointments book online at 00.15. At that point, you can book an appointment for some point between 08.30 and 18.30 that day. Some of the appointment times will obviously be taken up but lots aren't so you can choose a convenient time. As an experiment, I've tried to book an appointment via the usual channel and been given one for 3 weeks later then I've gone on Patient access and got it for 9 hours later ! It simply means one has to stay up until 00.15. Other people will get what they want by harassing the surgery. But by and large, even for things that are not emergencies, although one may have to get in line and wait, it works fairly well.

In your particular situation with something like cancer, you wouldn't be facing any kind of bills here. In fact, there's no condition or illness in which a person would ever find themselves in facing bills.
The thing I like about national insurance is that it's a cost/tax that one honestly never notices paying. Well, I never have. Even if one complains about paying too much tax, I've never heard anyone say that we pay too much national insurance !
Healthcare in the UK is not without its problems. It has become somewhat unwieldy. But the principle hasn't. And many government departments have become unwieldy, as have many local authorities/councils.
 

TAE

All you have is now
As with many things, it depends. It can depend on where one lives, what kind of surgeries are available in the area and what the actual doctors are like. Some really are better than others.

Cool thanks for shedding some light.....LOL you guys call what we call the doctor's office "Surgeries"...I only know this because we stumbled upon the UK TV Series Doc Martin a few months back which was a hoot to watch...love that village he set up his "surgery" in.
 

TAE

All you have is now
I don't see any reason for you to feel sad about being on the Medicare gravy train.

Maybe fearful is a better word...as it is going as the rest of boomer era starts on this "gravy train" I just don't believe it will be sustainable...and when we are in out mid 70's to early 80's the care is going to be shit or a lot harder to get decent "affordable" care...
 

grimtraveller

If only for a moment.....
you guys call what we call the doctor's office "Surgeries"
It's a funny thing ~ some people do call it the surgery but for the most part, most people I know just call it "the doctor's."
I've long found it amusing how we assume that a 'doctor' is one of medicine. I wouldn't be surprised if most doctors have nothing to do with medicine.
 

CoolCat

Well-known member
My brother is in Taiwan and its a great system and everyone has coverage per his experiences and his wifes.
She is local and pays nothing, hes been there about 30yrs an pays some small amount monthly <$100.
He has had surgerys and small nothing issues and its always $5 or $35 no matter what it is, out of his pocket.

Im not sure but the Taiwan dude was a Nobel Prize winner or at least a nominee for their Healthcare system design.

He, my brother, grew up in the US so he has a good comparison of offices and waiting rooms etc...he says Taiwan kicks the US ass big time. No one is losing their homes for medical expenses there, as I understand it.

As for ACA, aka ObamaCare....its full of scam insurance companys that dont pay out, it also has great insurance companys the 17% of US uninsured might be lucky to get on with.....I did all the ObamaCare stuff for my son and it took some phone calls to hospitals and doctors to choose one of the Insurance packages and Companys that do pay out and Doctors accept and there is a normal co-pay......but I will say 7 out of 8 companys offered in the list of ACA/ObamaCare are rip off shit companys that are charging the US Govt $500-$600 month and then they dont pay any doctors and leave the patients with $10,000 to Bankruptcy debts from medical bills.

I agree with the OP though, most of the US are covered by Employers Plans or if 65+ Govt Medicare.
Its only 17% I read that dont have insurance, like young people in starter jobs and self employed people.
My kids generation its more common the Employers/CEO's continue to cut worker benefits and that is the future problem for more and more without Medical Insurance and the US only has something setup for 65+ people.

ObamaCare, I spent many hours getting my son something. Its not a good or bad system, it has some good insurance companies who pay out and actually are decent.....but probably 6 of 7 companys listed are crooks that dont pay anything , but charge the US Taxpayer $600 month and the working-stiff $50. But the insurance is garbage! and it takes advantage of the stupid low educated people.
The reality is the Young and Self Employed uninsured is growing and growing...from 10% to last I heard 17%.
In another 10yrs maybe 20% or more will be uninsured and the Govt has nothing in place for them.

Of my kids and nephews, I can say its about 50/50 with those who have Employer Insurance like the Baby Booomers grew up with, and the other 50% who dont have any insurance and have to go it alone (or try ObamaCare aka Affordable Care Govt...which is full of sharks and scammers)
 

Orson

Member
I had cataract surgery performed on one eye shortly after I was enrolled into Medicare. The cost of the surgery was almost $9500. My out of pocket cost was $150.

Your medical bills have to date exceeded $1,000,000 of which Medicare paid $150,000. Supplemental insurance paid $30,000 and you paid "under a few thousand".

Well I think you may have highlighted the problem there and that is the cost of such surgery in your neck of the woods.

Your insurance company would be quids in if they put you on a plane to another country and had the op there.
 
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