• Healthcare: Warren Has No Plan

    November 16, 2019 // 16 Comments »

    Under pressure to fill the blank space about how she would pay for Medicare for All, Elizabeth Warren released a plan built on empty assumptions and fulfilled by unrealistic revenue expectations. It’s bad to the point where it raises questions about whether she is a serious candidate, and that begs the question of what the heck the Democrats are doing less than a year from the election.

    Warren’s revenue plan is 19 pages, describing how she expects to redo the entire healthcare system in America if not the basis for our entire society. Actually the first five and a half pages are introductory, mostly scary stuff about how expensive health care is, and the last page is some cheerleading, which means the actual prescription for acquiring and spending trillions of dollars fits into about a dozen pages. That’s some damn efficient writing, or some pretty thin thinking.

     

    It’s pretty thin thinking.

    Even how much the whole thing might cost, the core underneath everything else, is a fuzzy number. Outside estimates range from $14 to $34 trillion in new Federal spending over a decade; Warren says $20.5 trillion. And yes it is a problem when a program of this size can’t get its actual cost estimate closer than plus/minus multiple trillions.

    Underlying those goofy cost estimates are Mickey Mouse assumptions on savings. Warren’s plan envisions cutting the cost of healthcare dramatically so when the government takes over from private insurance companies it will need less money. While eliminating insurance companies’ profits will have an obvious effect, Warren simply imagines other economies of scale and efficiencies in health care payments ($2.9 trillion) somehow the private sector has failed to realize to its own benefit but a massively expanded Medicare government bureaucracy somehow will.

    Warren also assumes Big Pharma will accept lower profits of some $1.7 trillion based on negotiated drug prices and simply continue to produce the same range of drugs and invest in long term research for new ones. And if they don’t play ball her plan will take away patents on their existing drugs and manufacture them publicly.

    Things will go so well under these assumptions Warren will apparently (the plan is unclear, an example of the kind of detail needed but lacking) do away with payments Medicare users are responsible for today so everything will be free. Currently all but the most basic Medicare coverage requires premiums (for most beneficiaries, previous contributions over a lifetime of work pay about 75 percent of Part B, and the beneficiary pays the remaining 25 percent out of pocket) and many end up buying supplemental private insurance which Warren would outlaw. “High income beneficiaries,” defined as having incomes over $85k, a far cry from Warren’s billionaires, already pay much higher costs. There’s a penalty when an elderly person receives certain capital gains, such as when they sell their home to downsize. Hospitalization coverage under current Medicare has a $1,364 deductible and no cap on co-pay for longer stays. Outpatient coverage leaves one responsible for 20 percent of the actual cost in cash. Medicare prescription coverage has enough gaps in it they are referred to as the “donut hole.” What is already “free” isn’t, and Warren’s plan says little about the shortfalls of existing Medicare even as it promises everything will be OK just over the next hill.

    But Warren’s biggest assumption is the unstated one, that the billionaires she will tax to pay for all this will passively accept their new role in society, buying stuff for the rest of us, and not off shore their money and not order the Congress they own to create loopholes for them. If there is any truth to the idea the wealthy control government via their influence and money (and oh boy is it true) how can anyone assume the rich will allow any of this to come to pass? Amazon paid $0 in taxes last year. Warren’s plan assumes that will jump to 35 percent. She does not explain how she will move them from paying nothing to paying 35 percent. It’s like saying the plan to pay off my mortgage is “earn more of the monies” without anything more complex in mind than that.

    Same for the power of American Medical Association, the cartel which controls healthcare in the United States from med school intake to every detail of practice until a doctor retires. Warren’s plan assumes medical professionals and organizations, all the doctors, nurses, and hospitals, will accept a lower standard of living as their fees will be set by government and payments tied to below-market Medicare rates. Medicine has evolved in a for-profit ecosystem. Remove the profit incentive and it will adapt, adjust, or die off. Many hospitals in rural and underserved areas are already facing insolvency. Other hospitals today lose or make very little money on Medicare patients, and charge insured payers more to make up for it to stay solvent. It’s called cost shifting and Warren’s plan will do away with it. Cost shifting smells bad, but it for better or worse helps fund underfunded Medicare payments. The shortfall may be in the trillions and Warren expects healthcare providers to just, um, deal with it for the greater good.

     

    On the revenue side, after all that cost cutting, Warren still needs $20 trillion in new money, and she says she’ll get it from the rich. That’s a nice argument to throw out to the rube voters she is targeting, people to whom a paid off Visa card is a dream. But a trillion is a really big thing. It is 1000 billions. Warren’s $20 trillion is about the same as the current National Debt, which will still be around as she works this out. The total of all mortgages in America right now is $11 trillion. Warren could pay those off twice for everyone for what her healthcare plan will cost. The Federal government currently spends about $4.4 trillion per year on everything. The current defense budget is $686 billion. Warren’s plan will cost about 30 times the defense budget.

    Meanwhile, Jeff Bezos’ net worth is only $109 billion (see how that works when we’re talking in trillions?) That’s everything he has, not just the 6 percent tax Warren wants him to pay on it yearly. The net worth of the entire Forbes 400 is under $3 trillion. That’s everything they all own, like if we killed them and took it. If we reach down into the top ten percent of Americans, people whose net worth is a couple of million and who Warren claims she won’t need to bother, we get to $35 trillion in total worth. Taxing them won’t help. We’ll have to kill them too and steal their stuff and even then under some estimates it won’t be enough to cover Warren’s healthcare costs. It is not possible to tax even the wealthy enough to pay for free healthcare for everyone, but it sounds good.

     

    Warren thinks we won’t notice her Medicare for All plan is in fact an attempt to redistribute money on a scale never before seen in America. Under the guise of healthcare, she will systematically reduce the wealth of Americans, effectively nationalize the private healthcare industry (America’s largest employer, surpassing manufacturing and retail, the new steel industry), then parcel out what’s not eaten up by the bureaucracy in a mediocre standard of basic health care. She’ll also do something similar, though the plan is not even as detailed, to provide free child care, free college, and disappear some $2.6 trillion in student loans and too bad about the fat cats who expected their money back.

    If you think people who already have some sort of healthcare (69 percent rate their current coverage as excellent or good), or purple voters who saved for college the hard way, will vote for that once they figure out the grift — the Trade Joe suburbanites know they’ll end up paying while Amazon somehow skates free again — you’re a fool. Even one of the economists Warren cited in her plan has since done interviews reminding everyone he was talking only theoretically and acknowledges the practical problems.

    The hollowness of this plan is a body blow to a candidate who presents herself as a policy wonk. How could she have gotten something so central to her message so wrong? Warren is flirting with the Beto phase of her candidacy, where she says yes to everything (tax churches! impound guns! no borders amigo!) to bully up some support. As Joe Biden fades in front of an electorate that sees him as so negligible a choice, all hair plugs and botox, Warren will likely be pushed aside by someone, maybe Michael Bloomberg, and end up an “issues” candidate like Sanders ver. 2015 or Jill Stein or Andrew Yang, running to influence the discussion, not to win (Warren’s wealth tax may not even be Constitutional.) She’ll join the others in barking like hyenas that the moon is too damn bright and somebody needs to fix it.

    For the rest of us this means after putting up with three years of hashtags, pussy hats, trans-mania, and having every form of culture soaked through with mob-enforced diversity, when it comes down to winning an election in 2020 no one has a real plan to address healthcare. Most have chained themselves to prettied up versions of the weak tea of Obamacare. Sanders is Warren except he admits he’ll raise taxes across a deeper swath of society. They all had years to come up with something and this is what we get. To say the system for producing a viable candidate is broken is to still believe there is a system.

     

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    Looking for Trouble (and Answers) in Berlin

    September 16, 2019 // 11 Comments »


     

    I went looking for trouble in Berlin.

    Traveling in Germany as an American I was left with one thought: why can’t we live this way? Of course modern Germans have their problems, but it seems wherever you go it is clean, safe, organized. They pay taxes, sure, but receive nearly free healthcare, college, and federally-mandated vacation time. The trains run on time. They have trains everywhere.
     

    But there had to be more to it. So I went looking for trouble, asking Berliners where I shouldn’t go, where the off-limits parts of town are, you know, the places I wouldn’t be safe. It turned out to be a difficult question. OK, there were some areas where I might be pickpocketed at night, and a few parks where if I went in search of someone to sell me drugs I might find him. Prostitution is legal and sin is orderly. The closest I saw to a fight was four drunk non-German tourists hassling passers by. I went to an immigrant area which was statistically Berlin’s highest crime zone, and saw lots of graffiti and received some close looks but nothing more threatening than that. I couldn’t find a really bad part of town, and I tried.

    A similar quest in nearly any major American city would be a lot easier. We run our lives, never mind plan a tourist’s itinerary, around the bad parts of town. I live in New York City, where we play a kind of parlor game about which areas are not as bad as they used to be. In Alphabet City where they filmed Taxi Driver in the 1970s the former crack houses now rent out tiny apartments for over $3,000 a month. There is a moderate push-pull between the border of the Upper East Side and Harlem as gentrification drives up housing prices.

    The police presence around the areas in Harlem where tourists venture — the legendary Apollo Theater, the soul food restaurants — is effective even as the area still retains its snap. I was savagely beaten not far away, near the White Castle which serves as a kind of Checkpoint Charlie between zones. I wandering into five black teenagers pounding the life out of a much smaller Hispanic kid and yelled for them to stop or I’d call the cops. They quit, but circled around the block and attacked me, all at 4pm in the afternoon, you know, just after school.

    So at age 60 I threw my first punch in anger since maybe 8th grade. After the cops came and the attackers scattered (and nobody nearby saw nothing) I was told I was likely part of an initiation, as no one made any attempt to rob me or the Hispanic kid. The cops said almost certainly a gang member was taping it all, so I should check online. It made me remember how the insurgents in Iraq would also have a video guy nearby when they set off an IED.
     

    Pray for the tourist who alights at Hunts Point in the Bronx. The neighborhood has the highest reported crime rate in New York City, including the most violent crime. And given the poor relations between residents and the police, you can be assured reported crimes represent only some sliver of what really happens. Over 50 percent of the area lives in high or extreme poverty. Unemployment is among the highest in the state. It’s all just eight subway stops from Jeffrey Epstein’s old mansion.

    Hunts Point is split between blacks and people from Puerto Rico and the Dominican Republic, but race is less the criteria for victims than familiarity. Very, very few people on those streets don’t already live there, and as a stranger of any hue you are unwelcome except as prey. Daytime, in and out of a roast chicken joint, okay, but stay off the side streets, keep your eyes down, avoid displays of gang colors (and you better know what they are) and, well, just don’t go there.

    A good friend spent a couple of years in a Hunts Point high school under Teach for America, our national service program designed to destroy the souls of liberal arts graduates, and was told her most dangerous days would be her first, until the beast that is the neighborhood adjusted to her presence. Luckily she he was quickly subsumed as a neutral element, and by the end of her tenure probie gang members in her classes would even graciously suggest she not hang around after school certain days when trouble was expected.
     

    New York is also awash in hate crime, centered in parts of Queens and Brooklyn formerly considered “safe.” Hate crimes reported this year show an 83 percent rise over the corresponding period last year, what the governor calls a “growing cancer.” In one recent incident, Heil Hitler, a swastika, and the words “gas chamber” were spray painted on a predominantly Jewish club which counts many Holocaust survivors among its members. The hate crime wave is under-reported, however, in that the majority of the incidents are anti-Semitic, and the perpetrators often black, as once-separated neighborhoods grow together, all counter-narrative to the national white supremacy meme.
     

    On the S-Bahn train trip back into Berlin center from another not-so-bad bad neighborhood I was preoccupied with the people around me. None of them were really poor, or even could become poor. Under Germany’s social system, there is only what they call “relative poverty,” with the lowest levels of households receiving about 60 percent of the average German income. So everybody eats.

    And everybody gets medical care; the healthcare system in Germany is funded by statutory contributions ensuring healthcare for all. You can also choose private insurance. The system can be complicated, but basically takes about 7 percent out of everyone’s paycheck, matched by their employer. Absent yearly copays of maybe $50, that’s it. If you make below a minimum wage, you pay nothing and still get the same healthcare as others. The system also covers long-term nursing care.

    College is free. At work, there are maternity benefits, a cash child allowance, and laws ensuring expectant mothers stay home for six weeks before birth and eight weeks after. Child mortality rates are almost twice as good as in the U.S. overall, and staggering compared to forgotten places like Hunts Point. The United States is the only advanced industrial nation that doesn’t have national laws guaranteeing paid maternity leave.

    For every German there is a national pension plan, work-related accident insurance, and welfare for extreme situations. No one lives homeless except by choice. The U.S. is also the only advanced economy not guaranteeing workers any vacation, paid or unpaid, and the only highly developed country (other than South Korea) that doesn’t guarantee paid sick days. In contrast, European Union nations guarantee workers at least four weeks paid vacation. Among the countries in the Organization for Economic Cooperation and Development, the U.S. has the lowest minimum wage as a percentage of the median wage.

    In Germany there are plenty of rights. Free speech and freedom of religion all you want, elections at all levels. Even with restrictions Germany has one of the highest global rates of gun ownership. And none of that gets mixed up in questions of whether to provide everyone healthcare, because it has nothing to do with providing everyone healthcare, or a college education, or maternity leave.
     

    I’m sure there are downsides beyond what a short term visitor can see. But look around Germany: whatever the tax rates, it works for a very broad range of people. Not perfectly, but it works and it’s better than what we have in what we unironically and constantly otherwise remind ourselves is the Greatest Country in the World. You can’t get past that. I don’t know how to twist every detail to make it work in America, and I’m not sure Bernie or Elizabeth or whomever we could elect can try hard enough (Trump and Biden are campaigning on not trying), but there it is, in Germany. And in the UK, Japan, China, Canada, etc. To an American, it all sounds too good to be true.

    I write with a certain desperation, not wonderment. I’m not an undergrad who just took his first trip overseas, amazed at the great big world. I lived abroad for 24 years, used national health care in three nations, and traveled to many others. I’ve been a Democrat, voted Republican and third party, been called a fascist and a liberal, had long hair and short, lived in my car and paid off a mortgage.

     

    In Germany I had some sense of what life would be like freed from the burdens which define American life: no worries about healthcare, or old age care. Money enough to really live on if I lose my job or become disabled. No decades-long burdens to get my education, followed by more to help pay the rising costs of my kids’. No worries about outliving my savings, or having a carefully crafted retirement plan blown to shreds by a recession, or being struck down illness my insurance won’t pay for. To never have to wonder how to pay for their spouse’s life-saving medications or watch them whither. What would life be like absolved of those fears?

     

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    Trump, Privatization, and the Passion of Veterans Affairs Secretary David Shulkin

    April 15, 2018 // 28 Comments »

    As some seek to further privatize veterans health care, with hundreds of billions of dollars at stake, sacrifices will have to be made. Let’s hope few fall on the veterans themselves.


    Former Veterans Affairs Secretary Dr. David Shulkin once held the title of least controversial Cabinet secretary in the Trump Administration. He was confirmed in the Senate by a vote of 100-0, and for most of his time in office enjoyed broad bipartisan support as he sought to reform veterans’ health care.

    That all changed for the lone Obama Cabinet holdover when Donald Trump sacrificed Shulkin on March 28 in favor of White House physician Rear Admiral Dr. Ronny Jackson. Though pushed out ostensibly over a damning ethics report, Shulkin’s story is really one of whether or not further privatizing health care for veterans is the right way to fix a damaged institution. Shulkin being pushed out is a big story that has been both understated and oversimplified in the press as mostly just another episode of the Trump chaos soap opera.

    Shulkin himself pulls no punches. “I believe differences in philosophy deserve robust debate, and solutions should be determined based on the merits of the arguments. The advocates within the administration for privatizing VA health services, however, reject this approach,” wrote Shulkin after his dismissal. “They saw me as an obstacle to privatization who had to be removed. That is because I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans.”

    Despite the quick-fix appeal of privatization in the face of a VA clearly not meeting fully the needs of its population (Shulkin took over the VA in the wake of a report citing a “corrosive culture that has led to poor management, a history of retaliation toward employees, cumbersome and outdated technology, and a shortage of doctors, nurses and physical space to treat its patients”), is a system morphing toward “Medicare for veterans” the answer?

    In its simplest form, privatization means that instead of seeking care at a VA facility at little-to-no charge, veterans would be free to visit any health care provider in the private sector, with Uncle Sam picking up most of the tab. The VA would shift from directly providing care in its own facilities to become the insurance company of dreams. In many cases long waits to access a VA facility would diminish, veterans in rural areas would most likely have less of a travel burden, and patients could better match their needs to a provider. The latter could be especially important to LGBTQ veterans. It’s hard to argue against choice.


    The issue is money. According to one report, moving vets to private providers would double spending in the immediate term. By 2034, the cost of VA health care could be as high as $450 billion, compared to a baseline of less than $100 billion. And even those numbers may be too low; as Vietnam-era vets require more expensive end-of-life care, and as waves of veterans from the past 17 years of the War on Terror enter the system, costs will rise. The challenge is clear; between 2002 and 2013, the number of annual VA outpatient visits nearly doubled to 86.4 million. Hospital admissions — the biggest driver of costs — rose 23%.

    Under any calculus veterans health care is big money and proponents of privatization want to pull as much of it as possible into the commercial sector. But where would the money come from? Major veterans’ organizations opposing additional privatization worry disability benefits and other core VA programs such as education would be cut back. Others speculate a privatized VA system would quickly go the way of civilian insurance, with limited networks, increased co-pays, and complex referral systems, all as a way of passing increasing costs on to the patient. As for many under Obamacare, vets would be caught in the gap between being able to have insurance, and being able to afford health care. Choice can come at a price.


    The specialized needs of many veterans are part of the reason for the specialized veterans’ health care system. Despite much justified criticism, the VA serves the needs of many of its patients well. In the critical area of psychology, VA performance was rated superior to the private sector by more than 30%. Compared with individuals in private plans, veterans with schizophrenia or major depression were more than twice as likely to receive appropriate initial medication treatment. RAND concluded separately “the quality of care provided by the VA health system generally was as good as or better than other health systems on most quality measures.”

    The VA also has expertise in prosthetics, burns, polytrauma, and spinal injuries rare in civilian life. The VA has a lifetime relationship with its patients, leading to broader implementation of preventive care and better integration of records. These advantages could be lost as more choice under a largely privatized system could result in significantly less choice at the VA in areas where it matters most.

    The risk is throwing out the baby with the bathwater, as increased privatization will inevitably mean shuttering some VA facilities. The solution lies in a system which pairs the best of privatization with a reformed government-run veterans health care system. Paring off some services into the private sector while retaining those unique to the VA, all to the satisfaction of Congress, demands an administrator with extraordinary bureaucratic skills. The Trump administration was very likely wrong when it decided Shulkin was not that man.

    Though painted as a solid opponent of privatization, as he was fired Shulkin was already pushing the VA to further privatize its audiology and optometry programs. He oversaw change that led to 36% of VA medical appointments being made in the private sector. Shulkin’s Veterans Choice Program (VCP) allowed access to private doctors where the VA couldn’t provide specialized care, when wait times exceeded standards, or when travel to a VA facility represented a hardship. Shulkin was advocating for the program’s expansion when both his funding and his tenure ran out.

    The VCP program was consistently underfunded, in part due to the unpredictability of month-to-month expenses that will plague any privatized system. However, some of the underfunding was political; one holdout was Senator Jerry Moran. Moran wanted the program tapered off in lieu of his own bill calling for the greater leaps into privatization Shulkin remained skeptical of.

    As Department of Veterans Affairs Secretary, Dr. David Shulkin was an experienced medical administrator who had specialized in health care management at some of the nation’s largest hospitals. The new secretary nominee, Dr. Ronny Jackson, is a fine Navy doctor who has served two presidents, but comes to the job with no experience with an organization the size and complexity of the VA, already the government’s second-largest agency.


    Questions will be asked at what will no doubt be contentious confirmation hearings about whether Jackson can rise to the challenge, or if privatization advocates will take advantage of him to rush ahead with their own preferred changes, to their own financial gain.

    Hanging in the balance? Nine million veterans who rely on the VA for life-sustaining care in return for the sacrifices they have made.




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    Moving Forward to 2018? The Danger of Undead Hillary

    May 10, 2017 // 23 Comments »




    I’m wondering how successful the Democratic meme of “Trump voters, now you’ll get what you deserve” will be.

    Media regularly now run stories “telling” Trump voters how bad their decision was. Many outlets unlikely to be read by Trump voters produce elaborate charts and expert commentary about how whatever Trump is doing with taxes or the economy will negatively affect voters in Red states the most. The implication is hah, hah, suckers, you voted for more jobs and you’ll get nothing! Tag-on articles also include dubious surveys showing vast numbers of Trump voters agree with statements like “Even though Trump policies will definitely kill my mother in front of my eyes, I’d still vote for him.” That’s a two-fer: you were dumb to vote for him once, Cletus, and you still won’t admit how freaking dumb you are.

    The highbrow version of those nasty little stories is the literal glee of too many progressives over how poorly Republican health care plans will work out. Following their defeat in the House over so-called “Trumpcare,” Democrats as one pivoted to saying their loss was their gain, as Americans will suffer and maybe even die as a result of the new rules, and finally realize how wrong they were to vote Republican.

    So a serious question: do party leaders really think this will translate into votes for Democratic candidates in a few years? That badgering people to admit they were wrong is a good tactic (we all know how much anyone likes to admit they were wrong)? That mocking voters for their 2016 choice will bring them to your side in 2018? That hoping enough suffer under even worse health care policy to vote for the party that stood by chortling and watched it happen?


    Alongside this very odd strategy of gain through others’ pain is the issue of Undead Hillary. The two are connected.

    The standard for a losing candidate is to quietly go away. Mike Dukakis (Remember him? No? That’s my point) is the perfect example. For those losers who don’t want to simply write a memoir and fade away playing golf, they can also respectfully reemerge after some time has passed as an elder statesman (Walter Mondale) or as a specific issue spokesperson quietly tolerated at the sidelines of the moving-on-now party (Al Gore and climate change.)

    The problem for Democrats is that Hillary Clinton is not yet convinced, nor are many of her supporters, that she really lost the election. They act in some ways as if the campaign is still ongoing.

    By basically continuing to run a version of the same full-on negative strategy they did in 2016 (Trump is dangerous, evil, stupid, a threat, Putin c*ck holster), there seems to be this poorly-formed notion that somehow Trump will disappear (Emoluments Clause, impeachment for something, whatever) and that it will then be Clinton, not Pence, waking up the next morning in the White House.



    In other words, until the Democrats can stand up as a party and say “We lost. There were a variety of factors but at least some sizable part of the electorate wanted what Trump offered and did not want what we offered” they will continue to push Undead Hillary forward as if she and her negative campaign still represent a hope back into power.

    Until then, no alternatives. No new ideas. No positivity. Indeed, a near-ghoulish sense of “Well, America, you didn’t chose our Clinton so enjoy life in hell as a penalty” pervades. It seems a very unconvincing way forward for a party that currently controls no part of government.




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    Won’t Paying for Bernie’s Healthcare Make Us Pay Higher Taxes Like in Europe?

    April 22, 2016 // 8 Comments »



    Won’t paying for Bernie’s healthcare make us pay higher taxes like in Europe?

    Not likely. Here’s what Hillary doesn’t want to tell you.


    Free or very low-cost universal health care is available to citizens of all the countries marked in green, below, as well as China, North Korea, Thailand and Vietnam, left off for some reason:


    You’ll see the U.S. stands alone. Somehow our nation, alone among industrialized nations and some not so industrialized, has yet to figure out how to find a why to provide affordable healthcare for all of its citizens.

    One of the arguments posited is that the U.S. is too big for some poncy European system to work, but of course China and Russia are bigger. Another is that quality of care suffers, but people in Japan have some of the longest life spans in the world, and things are pretty good across Europe.

    But the argument that seems to stick best in America is that such “utopian” healthcare schemes are simply too expensive, that taxes over there are so much higher than in America.

    So keeping in mind that most of the places that offer free or very low-cost universal health care also offer free or very low-cost college (how’s it feel that a degree at Podunk State U costs more than Oxford University — about $12,000 a year for UK and EU students?),

    And, most of those other countries have dollar-adjusted higher minimum wages. And they save extraordinary amounts of money that in the U.S. end up being spent on social welfare and public health for people who are unhealthy because they can’t afford to see a doctor.



    But let’s look at some tax figures:

    Oops. The average U.S. income tax rate is actually higher than some of those places.


    And of course in the U.S., in addition to federal income tax, we also pay state and sometimes city tax. And Social Security/Medicare tax of 7.65% And property tax, sales tax and taxes/surcharges on cell phones, airports, hotels, restaurant meals and on and on. And of course other countries also have other taxes; the point is Americans are already paying a lot of taxes and getting damn little in return.

    And on top of that, we also pay (those who can afford it…) for health insurance. For 2012, the annual premiums for employer-sponsored family health coverage averaged $15,745, up 4% from 2010, with workers on average paying $4,316 toward the cost of their coverage. And of course those premiums paid do not include deductibles and co-pays.

    And prescription medicine costs. Americans pay more for drugs than anyone in the world. Drug prices in the United States are often up to 10 times more expensive than in almost all other developed countries.


    And that is how Bernie Sanders comes to the conclusion that even if taxes rise, the single-payer health care system he proposes would save an average American family of four almost $6,000 per year.

    Think about it. Doctor’s orders!




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