Nordic Welfare State being cut down to size

[Spartana]

So I guess the question is how would Americans feel about having a substantial raise in taxes to fund a system like this? From the link spartana provided there also is an amount you pay each year when you access care. So it sounds like we are talking close to a 50% tax rate! give or take. So emergency care is assumed to be covered. Then people that want it pay for private insurance. This is a very different system than what we are used to.

Of course, with the ACA I would be very surprised if our taxes don't rise. Expanded medicaid and subsidies have to come from somewhere. It is just a big shift in thinking. I have a hard time believing Americans would swallow a 40 or 50 % tax rate. What do you think?

Not too long ago I looked up the tax rates of various countries, including Sweden. If I remember correctly Sweden had a personal income tax rate starting at 30% (USA's bottom is 0%) for lower earner and going up to 68% (USA's is around 38%) for higher earners. Can't remember what their corporate rate was but there are other taxes like local taxes, VAT (sales tax), etc... that were pretty high. I think VAT was around 25%. Some other countries I looked at that had universal health care had lower tax rates because they had less social services overall than Sweden. Some countries also had a separate healthcare tax besides personal income tax that was at a set rate - kind of like our Medicare and Social Security tax is. I'll try to find the link as it was pretty interesting.

As for how much I think we should all pay towards universal healthcare? Hmmm.... not sure. I kind of like the idea of expanding Medicare to allow all people to buy insurance at a more affordable contracted fixed rate. I also like the idea of a separate flat tax rate based on gross income that everyone pays (again like we do for Medicare and SS) and not just the wealthy. Also a matching % flat rate corporate tax that businesses pays/employee instead of providing health insurance for them (although they still can provide private health insurance to their employees as a benefit if they want). Lower income/asset people could have government aid to pay for health insurance. Probably wouldn't be enough moolah from those taxes to pay for it all though so may have to have some personal income tax increases as well. 10% on top of what we already pay? Too much? Not enough?

From: http://www.taxrates.cc/html/sweden-tax-rates.html
Individuals pay both national income tax and municipal income tax. In 2010, individual income tax rates in Sweden change between 54% and 61%, 57.77% being the average tax rate, Corporate tax rate is 26.3% and VAT is 25%, Dividend and interest income are taxed at a flat rate of 30%. Capital income is taxed separately from income from employment at a rate of 30%. Social security contributions – Contributions by the self employed amount to 29.71% (for 2010), plus a pension insurance fee of 7%, Social security contributions – The general aggregate contribution by an employer on behalf of an employee is 31.42% (for 2010).

[gimmethesimplelife]

So I guess the question is how would Americans feel about having a substantial raise in taxes to fund a system like this? From the link spartana provided there also is an amount you pay each year when you access care. So it sounds like we are talking close to a 50% tax rate! give or take. So emergency care is assumed to be covered. Then people that want it pay for private insurance. This is a very different system than what we are used to.

Of course, with the ACA I would be very surprised if our taxes don't rise. Expanded medicaid and subsidies have to come from somewhere. It is just a big shift in thinking. I have a hard time believing Americans would swallow a 40 or 50 % tax rate. What do you think?

Your post has really made me think. I myself would be willing to pay 50% more in taxes easily - but the kicker with me is on my income my taxes are quite low so 50% more to me is not that big a deal. It would mean fewer books and/or fewer secondhand clothes. Not all that big a sacrifice. However, OTOH, those who have somehow managed to maintain what would be considered a middle class income - for those people a 50% hike would be a much bigger deal and I'm afraid to say would have economic consequences - less consumer spending which comprises around 2/3 of the economy in the US. Less consumer spending means more layoffs and fewer jobs, up and down the income spectrum. So the answer - I don't know.

Advice I can give is this - if at all possible, have some liquid money saved in case you get sick for transportation costs and health care costs in another country with reasonable medical costs. I read this advice online on another forum and I couldn't agree more with this. I am even starting to think of having this readily available cash to run to another country for reasonably priced health care as a cost of holding US citizenship.....I also think a by product of higher co pays and deductibles under ObamaCare plans is going to be more medical tourism, and if anyone considers the above advice out there at all - I'm thinking in another five to ten years it will be standard everyday advice given to all. Pretty sad is my opinion. Rob

[Spartana]

I also think a by product of higher co pays and deductibles under ObamaCare plans is going to be more medical tourism, and if anyone considers the above advice out there at all - I'm thinking in another five to ten years it will be standard everyday advice given to all. Pretty sad is my opinion. Rob

Medical tourism is actually a booming industry. Even some employers are (voluntarily) offering to send their employees overseas to have surgeries because the cost is so much lower - even including the airfare and "medical" recovery hotel stays. The employers even offer a big bonus to the employees who choose this. India seems like a common choice and is the lowest cost.

Here's one cool site amongst many many more :
http://www.business-in-asia.com/asia...l_tourism.html
http://news.health.com/2009/04/08/traveling-treatment/

The problem of course is that while it's cheaper, you are paying the full amount. So it might end up being much much more expensive overall than just buying insurance here. Especially if you can increase your income by just a few thousand dollars a year and get the ACA subsidies.

[try2bfrugal]

Of course, with the ACA I would be very surprised if our taxes don't rise. Expanded medicaid and subsidies have to come from somewhere.

The program is already fully funded, according to the nonpartisan Congressional Budget Office. It is expected to lower the deficit by $100 billion over the next decade, not add to it, and there are no plans to raise taxes on the middle class to pay for it -

"MIT economist Jonathan Gruber, who helped develop the law, says about half the costs are offset by projected savings in Medicare payments to insurers and hospitals. Another quarter is offset by added taxes on medical-device makers and drug companies.


"The other source of revenue is a tax increase on the wealthiest Americans," he says. "Those families with incomes above $250,000 a year will now have to pay more in Medicare payroll taxes."
Those provisions actually make the bill a net positive for the federal budget, according to the nonpartisan Congressional Budget Office. By the CBO's accounting, Obamacare will produce a surplus. Gruber says the law will "actually lower the deficit by about $100 billion over the next decade and by $1 trillion in the decade after."

From National Public Radio -

http://www.npr.org/blogs/health/2013...ance-subsidies

[flowerseverywhere]

Gimme. - I didn't mean 50% more! I meant 50% of your total income at least- per the link spartana provided you would pay 30% of your income in taxes, plus higher taxes across the board. That is more than a few extra books. The average tax per her link is over 57%

trytobe - I would love to believe them but I just don't. The math does not make sense to me. More people accessing care, gbmt paying more and it all a wash? Not buying it. Only about 2% of earners make more than 250,000

http://www.politifact.com/florida/st...s-250000-year/

i can't believe that will pay for all of this, and I am for affordable care for all

[try2bfrugal]

trytobe - I would love to believe them but I just don't. The math does not make sense to me. More people accessing care, gbmt paying more and it all a wash? Not buying it. Only about 2% of earners make more than 250,000

I am unclear why you think the program is only funded by increased taxes on the wealthy. Do you have a reference for that assumption?

The largest source of funding is Medicare payment cuts. You can see how the ACA is funded from these charts based on an analysis by the Congressional Budget Office:

http://www.washingtonpost.com/blogs/...in-two-charts/

The Congressional Budget Office is not affiliated with either political party:

https://www.cbo.gov/about/overview

"Since its founding in 1974, the Congressional Budget Office (CBO) has produced independent analyses of budgetary and economic issues to support the Congressional budget process. The agency is strictly nonpartisan and conducts objective, impartial analysis, which is evident in each of the dozens of reports and hundreds of cost estimates that its economists and policy analysts produce each year."

Here is a chart that shows where the Medicare payment cuts come from:

http://www.washingtonpost.com/blogs/...ion-heres-how/

If Congress overturned the ACA, spending for Medicare would increase by an estimated $716 billion over the 2013–2022 period, and of course we wouldn't have any of the benefits of the ACA, such as Medicaid expansion for very low income households and insurance subsidies for lower and middle income households.

[flowerseverywhere]

Try2b. Your article states the medicare advantage plans were projected to save money. They didn't. Imagine that

This very interesting but lengthy article explains some of the problems with this approach. It is well annotated.



http://www.nationalcenter.org/NPA640.html

and another.

http://www.urban.org/UploadedPDF/412...ca-seniors.pdf


both articles are written by MD and PhD types, not columnists.

also I am not saying to turn over the ACA. I am only saying it does not make sense to me, no matter how it is repeated and phrased, how they say it will be paid for with no new taxes. Maybe in two years you will be pointing out what a dummy I was.

[Spartana]

Gimme. - I didn't mean 50% more! I meant 50% of your total income at least- per the link spartana provided you would pay 30% of your income in taxes, plus higher taxes across the board. That is more than a few extra books. The average tax per her link is over 57%

trytobe - I would love to believe them but I just don't. The math does not make sense to me. More people accessing care, gbmt paying more and it all a wash? Not buying it. Only about 2% of earners make more than 250,000

From this article: http://www.politifact.com/florida/st...s-250000-year/

i can't believe that will pay for all of this, and I am for affordable care for all

To be fair to the Swedes, those high taxes go to pay for a lot more social welfare services than just medical care. Things like a fully paid year off work for either/both parents when they have kids, fully funded childcare once they go back to work, higher level education, unending unemployment benefits, etc... They also heavily subsidize their industries - like Volvo and Saab (didn't Saab die off during the recession? Didn't Volvo go to Ford or some other auto maker?). So I'm not sure exactly how much of their taxes actually are used to fund their medical system. Now that Sweden (and a lot of European countries who offer many social welfare benefits) have a greater influx of immigrants (and who often have large families and lots of kids) they have been struggling with funding their social welfare programs even at those high tax rates.

http://blog.gmfus.org/2013/12/18/swe...stem-up-close/

In Sweden, new parents get 480 days of parental leave and a child allowance from the state. There is free day-care offered from age 1, and a free primary and secondary school system that promotes democratic values. School lunches are free for all students. University and post-graduate studies are free. Healthcare and dental coverage is high quality and universal, and patients choose their doctors. A public pension system reserves a portion of your income for retirement. There is an efficient public transportation system of metros, streetcars, buses, and commuter trains

[iris lilies]

... Now that Sweden (and a lot of European countries who offer many social welfare benefits) have a greater influx of immigrants (and who often have large families and lots of kids) they have been struggling with funding their social welfare programs even at those high tax rates.

E

Exactly. I am interested in where things are going since that Nordic mono-culture has been changed to be more diverse. I always roll my eyes when the Scandinavians are compared to the U.S. because culture and attendant values matter especially in health issues.

When we take our state of, say, Idaho or New Hampshire and compare social issues to a Scandinavian country there are many parallels, it is often a match up. Not so much with Mississippi, Alabama, and that cultural mixing bowl California.

[try2bfrugal]

Try2b. Your article states the medicare advantage plans were projected to save money. They didn't. Imagine that

This very interesting but lengthy article explains some of the problems with this approach. It is well annotated.



http://www.nationalcenter.org/NPA640.html

and another.

http://www.urban.org/UploadedPDF/412...ca-seniors.pdf


both articles are written by MD and PhD types, not columnists.

also I am not saying to turn over the ACA. I am only saying it does not make sense to me, no matter how it is repeated and phrased, how they say it will be paid for with no new taxes. Maybe in two years you will be pointing out what a dummy I was.

Your post that I replied to was that the ACA was unsustainable because it was funded solely by taxes on the wealthy. That assertion was, and remains untrue, and you have not provided any resources to prove that point.

The first article is written by a partisan conservative think tank. Surprise! They are against the ACA.

http://en.wikipedia.org/wiki/Nationa...olicy_Research

The second article is a balanced article of the pros and cons to Medicare changes that concludes that most policy analysts think positively of the potential of new delivery and payment approaches to improve care. Maybe I missed it, but I didn't see where this article pointed to future tax increases to lower and middle class families to support the ACA? Can you tell me what part of the article supports that idea? Funding for Medicare and high U.S. health care costs are issues for the U.S., ACA or not. Without the ACA the CBO says Medicare costs would increase by an additional $711 billion over the next ten years, so if anything the ACA appear to reduce, not increase Medicare costs.