No, this is an excellent case of universal healthcare. In countries with it, this situation - an emergency illness leading to a pile of debt, doesn't happen. There's a huge difference between "you didn't pay your taxes" and "you got stick and are now stuck with a bill you can never hope to pay off".

It's pretty sad to think someone could be in a situation where they are sick and simply won't go to the doctor to get help -- because they can't afford it. The last thing someone should have to worry about when trying to recover from cancer or some other illness/injury is how is this bill going to get paid. I'm in law enforcement, imagine how many less calls there would be if the person calling the police had to pay for the service (directly, full cost). Healthcare should be in the same bucket as other public services, regardless of the income generated by that person.

People who make arguments for American systems benefit from American ignorance of the fact that ills that occur in America don't happen anywhere else.

Except you don't unexpectedly get hit with a tax bill. The tax system is also the place best suited for progressive income withholding.

From the article:

> Patients also have trouble because like many U.S. hospitals, UVA bills people lacking coverage at rates far higher than what insurance companies pay on behalf of their members. Such bills often have little connection to the cost of care, experts say. Insurers obtain huge discounts off hospital sticker prices — 70 percent on average in UVA’s case, according to documents it files with Medicare.

This is just insane. Price discrimination by health care providers should be illegal.

People get hit with unexpected tax bills all the time. Any scheme of property taxes will generate taxes on illiquid assets. So will municipal user fees (sewer, water). So will I come taxes for people likes tipped employees.

No one ever went bankrupt from income tax. Property taxes don't suddenly jump an order of magnitude. An unexpected user fee is almost always a rare event like a broken water pipe or a bad meter and can often be negotiated with the utility.

People have absolutely gone bankrupt from income tax. Let's say you receive a large amount of income in the form of an asset which is suddenly devalued before you sell it. You owe income tax on the original value you received. But the stock is now worthless, so you have nothing you can sell to pay your income tax.

This used to happen with ISOs during the dot-com bust. It can still happen with other volatile instruments, like cryptocurrency.

You're right, but that's pretty exceptional and I feel like something you really ought to know is a potential scenario. (I was aware of it at least as someone with stock options throughout 1999-2013.) This is different in kind than a medical expense which can happen to anyone randomly and bankrupt even those who thought they were insured against it.

I think I have very good medical insurance through my employer and I'm still terrified an unforeseen medical expense will somehow bankrupt me.

People don’t declare bankruptcy for tax debt largely because federal taxes aren’t dischargeable in bankruptcy. But tons of people lose, for example, their homes due to tax related financial problems.

This seems a bit of a false equivalency: If you get an "unexpected tax bill" due to a change in your liquid assets for a sum that exceeds several times your gross worth like some of these medical bills, then you are doing some really shady tax reporting..

I think it goes like this. I get a huge medical bill - say, $50,000. What can I do to pay it? What assets do I have? Well, I've got $1,000 in the checking account. That isn't going to cut it. Ah, but I've got $60,000 in my IRA, and the rules say I can tap it in this situation (IIRC). Well, goodbye retirement, but at least I can pay off my medical bill now.

Unfortunately, that $50,000 I took from the IRA counts as income, so my income this year is $50,000 higher than my withholding. Behold, a rather large unexpected tax bill. Nothing shady required.

If my memory is wrong, if you can't take it out of an IRA for emergency medical expenses, then replace "IRA" with "stock I bought two decades ago for much less than it's currently worth". Same result.

There is a different though - when you are in poor health does your government decide you suddenly owe them 230k for surgery while you're unable to collect your income?

I mean, I’m not sure how you do it over there, but here in dystopian euro-socialist Ireland (in real life, we’ve had mostly center-right coalitions for the last century, but we do have a health-care system and so on), no, the government very much won’t take your house for inability to pay property tax. There would be a revolution.

Property tax is also much lower here than nearly anywhere in the US, of course; typically 0.18% of the 2013 value for homes (so about 0.1% of current value in practice). Typically, if you can’t pay, they’ll collect when you sell or die. Income tax is much higher than anywhere in the US for mid to high income people, of course, but it’s harder to be hit with unexpected income tax.

The Irish healthcare system is far from perfect, by the way. Public hospital care is free for everyone(except for a capped per-night charge at 750 euro per year unless you’re low income) and primary care is free for low income people, the elderly, and young children, but there’s still a gap where lowish-income people can struggle with it, and public waiting lists for elective procedures can be long. But no-one’s going bankrupt over it, so there’s that.

What a specious argument. In countries with universal healthcare if you have to go to hospital you either don't get a bill at all or just get a nominal one, and your income tax exposure doesn't change.

Income tax is a different story though - and remember a massive percentage of people don't any any property and therefore have never paid a cent of property tax (me!)

If you have a very low paying job (or no job) and therefore pay extremely low income taxes, you still get fantastic healthcare!

If you’ve ever paid rent, you’ve implicitly paid property taxes. The sustainable, market rate for rent factors in all costs of the owner.

My understanding is that setting rent is more related to what people are able to pay than the underlying cost structure of owning a building.