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They are in countries that also have high taxation. The US chooses to remain one of the lowest taxed countries in the developed world. The gap could be used to fund private insurance costs, would you rather have that as an option or be mandatory remit to the state?


That is not exactly true. If you factor in state, county and property taxes, the taxes in the US are similar or sometimes even higher than other western European countries (It depends on the income and living situation, you could maybe approximate the average by looking at the state budget per capita (https://en.m.wikipedia.org/wiki/List_of_countries_by_governm...), but calculating it is far more complicated).

If you factor in insurance, Americans pay more as their percentage of income. In the US there is more private and public bureaucracy in the healthcare system, higher wages for doctors (because they often have to repay their student debt and prices are on average higher in the US) and overall higher prices for equipment and drugs (often due to (often lobbied) laws that favor some US businesses). In Europe health care is treated more as a public service (although there is also for profit health care there). The high profits for US companies in the medical sector have to come from somewhere and they often come from the pacients and the taxpayer, because the US also subsidizes their health care system by taxes. In fact the US government spends more per capita than other governments in the world on health care. https://en.m.wikipedia.org/wiki/List_of_countries_by_total_h...

Besides that the taxes in the US are more inefficiently spend than in many western European countries. I could write a long essay about that, but this is just a comment to a hn comment and I already spent to much time on writing it.


I would rather the state be able to collectively bargain on behalf of 330+ million individuals, personally. It would dramatically reduce costs. I never understand this argument because the average American pays more in insurance premiums, deductibles, and out-of-pocket expenses than what the tax would be. Unless you're a (temporarily embarrassed) millionaire I don't get it. As a nation we spend 2x as much per capita on healthcare costs than any other developed nation, and for some of the worst outcomes! Cuba, a tiny island nation-state suffering from 60 years of embargo has lower child mortality rates (under 5 years, infants, and neonatal) compared to the US. How can that be justified?

Life, liberty, and the pursuit of happiness—so long as you have a premium healthcare plan brought to you by Blue Aetna Cigna Humana Kaiser(tm)!

https://www.propublica.org/article/cigna-pxdx-medical-health...


You're actually asking, would you rather be forced to have all your health needs taken care of, or have the freedom to choose inadequate healthcare in order to save money?


So long as insurance providers are obligated to cover individuals that can’t afford the premiums, then sure, why not. But if you’re going to do that, you might as well cut out the rent seeking, handle it at a government level, and make it cheaper overall.


I dunno. I'll take my high tax rate and universal healthcare any day.


My taxes as a US citizen were higher than here in Germany. And I still have to pay taxes to the US even though I don't live there. One of two countries that enforces this. YMMV.


Money really doesn't seem to be a problem for the US government at all. I really don't think it is the taxation, but how they decide to spend all the money they have.




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