Can the USA Afford Universal Healthcare?

[Arwon]

Shoot for the skies people.

 

[hobbsyoyo]

Shoot for the skies people.

We can dream I guess

 

[Arwon]

Not to bash your very creative political system more than necessary, but these sorts of labour and tax law regulatory measures are simple, mechanical and pretty centrist public policy propositions. They're pretty simple support measures solely about helping a legislative change have its intended effect, ensuring stated tax rates actually collect roughly the intended amount of tax, and walling off pernicious effects of larger policy changes.

That they're "one can dream" stuff is genuinely failed state areas.

 

[hobbsyoyo]

Not to bash your very creative political system more than necessary, but these sorts of labour and tax law regulatory measures are simple, mechanical and pretty centrist public policy propositions. They're solely about helping a legislative change have its intended effect.

I mean I agree except in the US it would not be received as a centrist idea and will be attacked by a lot of dumb people who think they are one lucky break from becoming billionaires themselves or are otherwise completely disconnected from reality. "Keep your government hands off my Medicare" is a meme because it is so typical of the thinking of certain demographics.

 

[Arwon]

It's like you guys are with everything the way we are with climate change and refugees

 

[civvver]

I mean it's presently part of the total remuneration package. Just do the sound public policy thing, legislate that the same total remuneration has to persist but be transferred to actual salary/wages, fund an enforcement body, and jail the recalcitrant capitalists for theft.



That's why you also tax businesses for those sorts of fringe benefits at the value of what's provided. It's remuneration, and whether it's a parking spot, a free car or access to legal services, companies shouldn't be using non cash benefits to reduce salaries for the sole purpose of reducing their tax burden like that.

On the healthcare side you can kind of do this because law a few years back required companies to list what they spend on healthcare on your w2. So it is reported. The first step towards taxation is auditing! The difficult part is to see everyone's individual pay go up by the same amount. Because your pay depends on many factors, it could be hidden. Say a company spends 10k on your health care annually and this law goes into effect, but you also get a promotion at the same time and a performance increase of 5k. The company could give you a 10k raise and hide it, tell the government that they satisfied transferring all the health care benefits to the employee but really they stiffed them out of a promotional raise. And that's pretty hard to prove otherwise without the employee being heads up and bringing a lawsuit or something or some expensive auditing. That's why it seems better to just tax the companies directly into a medicare fund and make it essentially a wash. Government just estimates what companies spend on health care across the board, adds some tax close to it, they all drop health care coverage as a benefit. I could be totally off base here, I'm not an accountant or HR pro, but that's my opinion.

Also taxing benefits has minuses too because now employees might have to pay for something they may or may not want. Some benefits are taxed as personal income as well, like company cars typically are. Company lunches aren't. I know either CA or the feds wanted to get facebook for providing free lunches to employees. The downside is what if the employees don't want to pay the tax and now want to opt out of the lunches? Can they do that? It all gets tricky. If it's just a thrown in benefit you say sweet, why not, but if suddenly you're on the hook for taxes you may want to decline it and then the benefits might actually become detriments.

The whole reason we got into this mess in the first place was due to tax avoidance/caps on salaries. It's the same reason companies give CEOs stock options over salaries now too. You add more specific taxes like that, companies will find a way to change the compensation plan.

 

[Estebonrober]

That will never happen. It's the same flawed logic that when trump's corporate tax cuts went through business would give that money back to employees as wage increases. We got a couple PR stunts with companies like walmart offering small bonuses, but they were going to have to do that anyway due to the low unemployment. Majority of businesses just pocketed the money or returned it to shareholders and ceos.

That's why the only means of funding I'll support is if the business have to take what they are spending now and ship it to the government as taxes to pay for the universal health coverage. If it's a personal tax or anything and suddenly companies don't have to provide insurance or as much funding for health care they'll just pocket that cost as profits.



That's what everyone wants but there are a ton of steps to get there. It would have to be regulated or companies simply won't do it cus there isn't enough competition for employees.

Well I can tell you this, if my employer pocketed that money and suddenly I'm being hit with 13k in taxes a year and not getting compensated for that I'm not the only one that will be in the streets barking mad.

 

[rah]

Our company offers you a considerable rebate if you decline the health insurance (or if you have coverage through a different source)

 

[hobbsyoyo]

Our company offers you a considerable rebate if you decline the health insurance (or if you have coverage through a different source)

Sounds like you have a great company. Most don't do this. They either force you to buy healthcare you don't want or need or give you nothing when you decline.

 

[civvver]

Our company offers you a considerable rebate if you decline the health insurance (or if you have coverage through a different source)

We used to get $100 a month. Which you can't buy your own healthcare for that. But anyways, my companies health care is pretty good, but it's self funded, all the same, you just choose the amount of people to cover in your family and HSA plan vs non-HSA plan. They're exactly the same except HSA they put money in your account, it has a high deductible and low premiums, and non-HSA is reversed, low deductible, high premiums. But all the coverages and copays are all the same percentage based.

My point wasn't that it's bad, just that it generally lacks choice, which has always been one of the big knocks against government run stuff. People think the government will tell them what's covered and what's not and which drs they can see but we mostly have that now so there's no difference to me. If it makes it cheaper, I'm all for it. If it's not cheaper, I'm against. Quality of care vs price is like a sliding scale argument I guess. I'd sacrifice some quality and convenience in some areas if the price is right.