Who Really Does it
Better?
The Big Lie from the Right is that Brits pay through the nose for lower quality healthcare in the form of “higher taxes.” (always a generality never a factual, analysis) A close second is the "Oh Yeah", then why does everyone buy private insurance?" I'll refute the second first. They don't. Only About a tenth of Britons have private insurance, and it's really more like a supplement. So there.
The United Kingdom provides public healthcare to all permanent
residents, about 58 million people. Healthcare coverage is free at the point of
need and is paid for by general taxation. About 18% of a citizen's income tax
goes towards healthcare, which is about 4.5% of the average citizen's income.
For simplicity’s sake I will convert pounds to dollars for comparison:
The personal exemption in the UK is $17,770. In the US it is
$4,050 (2020) Even with proposed significant increases in exemption, the UK
exemption will be at least $5,000 higher.
A couple in the UK who earns $37,500 before taxes will, with
the 2 personal exemptions, be just under the 20% tax bracket. In other words, no
income tax. With a taxable income between $25,140 and $70,400,
the tax rate is 20%. Between $74,000 and $210,000 the rate is 40%. Above
$210,000 to infinity the rate is 45%.
So why do all this math? Bear
with me a bit longer.
In the US, under
the current “Trump” tax reduction, which is to be constant for higher brackets
but will decrease for lower earners, a couple with combined taxable
incomes of (rounding off) $20,000 to $80,000 will be taxed at 12%. However,
using 2020 numbers: The UK couple will exclude $35,000 under their current
personal exempt income provisions, while the US couple would exclude no
personal exemptions, other than the standard deductions after taxes are
computed. Although it isn’t a strictly “apples to apples” analysis, this can be
viewed as the UK couple exempting over $37,000 before calculating taxes, while
the US couple gets their lower personal exemption after taxes.
A US couple with $80,000 combined taxable income can expect
to pay $9,200 (plus 10% 0f any over $80,000)
A UK couple earning the same equivalent) top of the 20%
bracket would pay $16,000, but to get to that (£57,000) level they will have excluded another
untaxed $37,500 in personal allowances, making their actual taxable amount
significantly lower than their income
Even
ignoring that significant consideration, let’s move on to how much of that goes
to the NHS (National Health Service). To
do a realistic comparison we have to try to compare the gross incomes. Let’s
take the couples we compared earlier: The UK couple actually paid $16,000 on a
combined (taxable plus excluded) $117,000 in gross income. At the 4.5% rate of
UK income which goes to NHS they spend even with two kids, (as a portion of income) a combined $5265 per year for health care. That’s it, other than
drug copays in some cases.
On the other
hand, the US couple (family of four) can expect (national historical average)
to spend somewhere over $24,000 annually for medical expenses. As an example, the
average total costs just for Massachusetts family health insurance premiums roughly
tripled from 2000 to 2019, hitting $21,424 and surpassing the national cost for
a new compact car! This includes employee contributions to employer provided
health insurance where it exists.
By contrast, the employer in the UK isn’t required to spend on NHS but may contribute to private health insurance and life insurance. These perks vary by employer. 11% of UK citizens buy additional private health insurance. This is generally not coverage of routine illnesses since all emergent issues are seen right away by NHS, but elective things, such as hip replacements, are sometimes subject to waiting periods of as much as 6 months (I waited 4 months in the US with Medicare and a premium health insurance supplement!) A common misconception in the U.S. is that countries with universal health care have much longer wait times. However, data from nations with universal coverage, and historical data from coverage expansion in the United States, shows that patients in other nations have similar or even shorter wait times.
Should a UK family of four with 2
adults in their 40s and 2 kids in their teens decide to purchase private family
insurance it will cost them perhaps as little as a paltry $1543 PER YEAR
(and some employers may subsidize part or all of that)
Summarizing
shows that the UK does more with less, even before factoring in grossly
exorbitant US drug prices. The other huge lie is the statement that Medicare
for all is unaffordable. Such statements are invariably accompanied by figures
such as, “Medicare spends $10,000 annually per person, and we can’t afford it.”
They then usually extrapolate that figure to the entire population. The big lie here, of course, is that for most
of the population, including all adults under 65, the actual annual spending is
far lower and, for children, even much lower. In fact, for the entire group
ages 1 to 64, the annual national average is under $4,000! Ask yourself this: “If Medicare is so hard
pressed, why can Medicare Advantage plans make money and take just my measly
monthly Medicare Social Security deduction? The simple answer is “They can’t!”
But, Waldo, they don’t have to, because Medicare supplements your input by a lot,
and they do it every month whether or not you use any medical care.
In Sumter
County Florida, where I live, the Medicare additional money for me (and the
rest of the Medicare recipients in the county) is $907 monthly, believe it or
not, if I was suffering with any of several chronic illnesses it would be significantly more.
So, Medicare is sending my Medicare Advantage provider over $12,000 annually.
Free Market capitalists, like John Stossel, absolutely love situations such as
this. Insurance companies love it and Big Pharma absolutely adore it
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