U.S. health system is already predominantly taxpayer funded

[eridani]

http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302997

Americans pay the world’s highest health-related taxes. Yet many perceive that US health care financing system is predominantly private, in contrast to the universal tax-funded health care systems in nations such as Canada, France, or the United Kingdom. By 2024, government expenditures in the United States are expected to account for more than two thirds of national health spending. This is nearly the same proportion as in Canada, where official figures put government’s share at 70.7% (although this figure excludes modest tax subsidies for supplemental private coverage).

Public funds help the vast majority of Americans pay for care, but these funds flow through many different spigots. The funding streams for the poor, the elderly, veterans, family planning, and public sector workers are visible and hotly debated. Meanwhile, the hundreds of billions in tax subsidies that disproportionately benefit wealthier Americans have drawn far less public attention.

Although taxpayers fund the vast majority of health spending, overall priorities for this funding are rarely discussed.

Appreciation of the magnitude of government funding might encourage more explicit, appropriate, and equitable targeting of these expenditures as components of a total health budget.

Comment by Don McCanne of PNHP: We often hear that we cannot afford the taxes to pay for a single payer national health program - an improved Medicare for all. ed;Yet we are already paying most of the taxes that would be required-- it’s just that they are relatively obscure and thus not recognized by most taxpayers.

By 2024, government expenditures will pay for more than two-thirds of national health spending (up from 64.3% in 2013). “Government health expenditures in the United States account for a larger share of gross domestic product (11.2% in 2013) than do total health expenditures in any other nation,” according to this study. Our government health expenditures alone are more than both government and private health expenditures in any other nation. We are paying for a national health program, but we are not getting it.

Most people are aware of the insurance premiums and out of pocket expenses that they and their employers pay for health care, so they tend to think that most health care spending is private. They are aware of the payroll deduction for Medicare, but they do not tend to consciously connect other taxes, especially income taxes, with expenditures for Part B and Part D Medicare, Medicaid, CHIP, the VA system and other government health programs. Also, totally out of mind is the portion of personal and corporate income taxes that help pay for government health programs - taxes that are built into the pricing of consumer goods and services (not to mention that the cost of employee health benefit programs is also built into consumer prices). (This may be double counting for the tax tally, but higher health spending in the U.S. do pass on opaque employer plan health costs to the consumer.) And one of the largest silent taxes is the tax expenditure (tax subsidies) on the federal, state and local level that help pay for private, employer-sponsored health plans. Also, we are paying, through taxes, for most of the health benefits offered to federal, state and local government employees.

The roughly $300 billion we pay for tax expenditures for employer-sponsored health plans (will be over $500 billion by 2024) is a prime example of how dysfunctional our health care financing is. The subsidies are credited in direct proportion to income - the higher a person’s income, the greater the subsidy. That is really unfair to lower-income individuals and families who may be paying the same insurance premium, directly or indirectly through forgone wage increases, as the higher-income employees do, but at a greater dollar amount than those with higher incomes after the subsidy is applied, and at a much greater percentage of income. This is a highly regressive tax policy.

The point is, we are already spending our taxes on the health care system, and we can do it much more equitably through a well-designed single payer program. Not only would we increase transparency, we would also reduce inefficient spending by eliminating the private insurance industry, saving more in premiums than would be the increase in taxes. The next time someone says that we cannot afford the taxes for a single payer system - clue him or her in. Let everyone know that it is time to demand much greater value for the enormous amount of taxes that we are already paying for health care.

[Autumn]

1. I like the way this lays it out.

[slipslidingaway]

2. knr thx nt

[Old Codger]

3. True

The taxpayers are subsidizing the payments for insurance, the so called ACA (affordable care act) does not do one damn thing to cut health costs,all it accomplishes is to maintain the status quo while making sure there is a large ready made,forced clientele... It still costs a small fortune to get medical care, one visit to emergency still costs someone thousands of dollars in someones money... insurance rates may sound low and are more available to lower income people and do end up giving medical care to more people but it is still very very expensive if you end up hospitalized

[mhatrw]

4. Probably the most government spending in the world per capita

because of all the corporate profiteering that the USA and only the USA allows in the healthcare industries!

[hill2016]

5. lol

how disingenuous the post is.

shifts from "paying for" to "tax expenditures". If you read the fine print, "tax expenditures" means "government collecting less in taxes than it might otherwise" on higher income employees health benefits.

that's like saying because you can deduct your mortgage interest, the housing market is financed by the government.

Why have such a dishonest argument?

[eridani]

7. Anyone who will not stand up for universal health care is cheerleading for mass murder

And anyone who would rather pay a $900/month "premium" than a $200/month "tax" shouldn't be allowed to run around outside without adult supervision.

[Wilms]

6. ^