I agree that health care is very expensive, but you may be overestimating a bit... I looked up some plans on California's exchange for a hypothetical family of 5, and all except for the "platinum" tier were between $1200/mo and $1600/mo -- so 6% to 9% in this particular example.

With a lower income, the percentage would increase -- but only up to a point since a family of 5 starts qualifying for ACA subsidies if their income is less than $120K.

The subsidies make a big difference -- 84% of people who purchase insurance through the exchanges receive a subsidy and the average monthly cost of a plan after taking subsidies into account is $145 (vs $595 without) [1].

[1] https://www.healthinsurance.org/obamacare/will-you-receive-a...

Why would you choose family of 5 as your point of reference? That’s very uncommon in tech-California.

Your math is bad, and you're using a nonstandard set of numbers.

Generally in CA, and most of the US, you would receive health insurance through your employer, and the bulk of your medical insurance premiums are non-taxable subsidies by the employer.

The insurance figure came from https://blueshieldcaplans.com/?marketcode=15WS10900

Like I said, your math is bad. You're using numbers from individual plans, not employer-sponsored plans. As individual plans are entirely separate pools from the employer-sponsored plan pools, the numbers aren't even remotely similar.

In all other first world countries it doesn't matter if you are self employed or work for a big company. Your healthcare is the same.

Is the health insurance cost a percentage of your income? I thought it is a fixed amount based on what the insurance is covering.

It's harder on the poor. The percentage figures will vary based on your income level. Luckily the OP chose an income level in the top 2% of all Americans which made it a somewhat reasonable level.

This was also an individual plan bought on a healthcare exchange. Large employers have a stronger negotiating position and can get somewhat better rates, but in the end you're still basically paying a tax and it is disingenuous to compare tax rates with countries that provide socialized healthcare with their taxes and not include the cost of healthcare coverage in the States.

It is not fair to compare taxes between countries with and without healthcare, but it is almost impossible to compare otherwise. For example USA has huge prices and excellent services compared to almost any other country, in my country (Romania, Europe) the socialized healthcare is so bad many people have a private insurance, I have 2 private insurances through my employer and I still pay out of the pocket about half of everything I get (100% of dental care is out of the pocket, most consultations are covered by the private plan, most treatments are out of the pocket).

Little bit of both. It's a fixed rate, but a lot of employers use a "tier" system where the rate depends on your income.