For comparison purposes, it's useful to think of things like retirement contributions and healthcare premiums as taxes, even if they're not formally taxes. There is an article comparing this across countries that argues that if you take this view, US taxes are actually pretty high, because our health insurance is so expensive. https://www.peoplespolicyproject.org/2019/04/08/us-workers-a...

For national financial comparisons - sure.

The real difference, of course, is that taxes will ensure you're covered even if you're low income.

You can also make the taxes progressive, so wealthier pay more. I'm also not sure if this looks at total costs or only premiums. People don't go bankrupt or have surprise bills [1] for medical reasons in other countries the way they do here.

[1]: https://www.marketwatch.com/story/1-in-5-americans-get-hit-w...

While that may be true, its also true that people from all over the world come and pay airfare, stay, and tens of thousands of dollars to get procedures done here.

For example, Canadians going to https://surgerycenterok.com/

Here is another fact. The above has had transparency in prices since it was founded in 1990

Guess what also has not changed: the price that they charge for every single procedure since they were founded. In fact they technically charge less now because some procedures include additional services that were originally not part of the package.

So why is it that 1 clinic does not need to change pricing in 30 years, while everything else is increasing at 5-10% per year?

Hint: you dont have to throw away the baby with the bathwater. Its possible to have a system that is not going to bankrupt you and also at the same time not make you wait for 3 years for something you need today

In the US, you're already covered if you're low income, through Medicaid and ACA subsidies, that's part of where the current taxes go. It's certainly debatable if the existing programs are optimally structured.

> In the US, you're already covered if you're low income, through Medicaid and ACA subsidies, that's part of where the current taxes go

Talking to low income folks, it's not the same as in other countries. They still have financial stress because of medical concerns.

Medicaid experience differs greatly depending on the state you're in. And how it compares with people who have the means to buy insurance also varies quite a bit.

In general, Medicaid is one of the more generous health insurance plans available in the US. The maximum nominal deductible is $3, and the maximum nominal copay for managed care is $4. For drugs, it’s around the same: $4 for preferred drugs and $8 for non-preferred drugs.

There’s certainly variation in who can qualify, per State; some States are more generous than others. It’s debatable whether it makes sense to even consider the US as a whole, since it’s really a heterogenous collection of 50 self-governing sub-cultures. The Canadian healthcare system for eg is also provincial, with the Federal government providing minority financial support. It’s actually more Province-driven than Medicaid is State-driven, today.

Do you get the same level of cover when you’re low income?

Ironically, you get some of the best coverage when you're low income, since Medicaid is so generous.

While it's true that the UK has recently made itself a lot poorer, these kind of direct comparisons don't really capture the differences in living costs between countries since most expenses also scale with median earnings (rent, services, domestically produced goods.)

Consumer goods made abroad are incredibly cheap in the US in comparison to the UK, but as a Brit living in the US I definitely relate to this observation I recently saw go by:

> As a friend of mine from abroad who lives here put you “you don’t really get that there’s a really high standard of living and nothing works“

- https://twitter.com/__seab/status/1298342388537139200

I think you're mixing up full time salaries and all salaries. For full time in the UK in 2019 it was just over £30k meaning a take-home of £2018 per month, $2662 at your exchange rate.

Still lower, we're a poorer country, but it is quite a difference.

If you make too much below the median salary in the US, you probably still can't afford health insurance.

Also consider that everything isn't covered when your employer pays for your health insurance. Americans still have a lot of out-of-pocket costs.

And remember that there are a lot of people who are unemployed or underemployed, or work under arrangements that don't provide them health insurance at all. They also probably make a bit less than the median salary. So sure, maybe 50+% of the US could afford their own health insurance, but is it ok there's some percentage, regardless of how small, that can't afford it and has to do without? I say no.

If you make too much below the median salary in the US, you either qualify for Medicaid (at best) or direct ACA subsidies (at worst).

Sure, but there are several bands of income levels where you're basically screwed. The ACA subsidies have some phasing in/out based on income levels, but they're far from perfect, and depend on often-unreliable definitions of the "poverty line".

> Also consider that everything isn't covered when your employer pays for your health insurance. Americans still have a lot of out-of-pocket costs.

I have a doctor I see every 4 months. I mentioned to her that I thought my copay probably was about what she was actually making off my visit and she said, 'if that'.

She also said insurance companies are now doing things like not approving full scripts for insulin. And demanding that she prove a 50 year Type I diabetes patient still needs insulin.