Taxes, Healthcare and Culture

The US is weird. "Oh, you haven't worked at all? Don't worry, your medical care is free! What's that, you have two minimum wage jobs to make ends meet and can't afford insurance? SCREW YOU BUDDY!"

@CorruptUser I know, right?

Yeah, paying taxes to benefit everyone, not just me!
Sheesh, it's like we're living in a society or something...

@DarkMage7280 And it also serves as a sort of insurance if unfortunate events happen to hit your life hard, e.g. losing your job. Gives you some alright financial and health support while you're trying to get back on your feet.

The best thing that has happened to the US attitude toward taxes in the last several years has been Donald Trump (and Warren Buffet's amazing smackdown thereof). All of the sudden, people are coming to the (really obvious but somehow never stated aloud) conclusion that paying your taxes is patriotic, and it's good for your country and all the people in it.

The notion that the government is inherently inefficient is deeply flawed, in that no one (in the media, at least) has ever bothered to point out that the alternative -- the free market -- is equally if not more inefficient. Only instead of paying $6,000 for a toilet seat, the free market does things like inspire a boatload of Wells Fargo employees to make up fake accounts and bill real people for things they never asked for and cannot afford, or employ an entire generation of people at a wage that cannot pay for their basic expenses because Wal*Mart and McDonalds have figured out that if they don't pay enough, the government will step in and cover the difference rather than let people actually starve to death on the streets.

Ultimately, there is exactly one reason to object to paying your taxes: because you are exactly the person that America represents in this comic. The person who demands help from the government when something goes wrong in their life, but thinks the government is stealing from them whenever April rolls around. The kind of person who has no idea what the Tragedy of the Commons is or why we need the government to avert millions of different instances of it in our everyday lives.

@Arananthi "The notion that the government is inherently inefficient is deeply flawed, in that no one (in the media, at least) has ever bothered to point out that the alternative -- the free market -- is equally if not more inefficient."

Please, put down the medical marijuana.

@MichaelZWilliamson He's right. Unless you get your news from the Mises institute, in which case a discussion is not even possible.

I live in th border with US and Mexico, and I'm seizure prone. The medicibe I take costs 13 dlls for 30 pills if I'm enrolled in a program (dont have insurance). That same medicine, in Mexico, costs 36 pesos (1.91 dlls) for 50 pills. Taking care of yourself in the US is so freaking expensive

@Mexdragon I was finally glad to get health-care from the Obama med thing, and every doctor I call either won't accept it, or theres so many limits on it, that its not worth having at all......30 years without health-care and I still cant get help even with it. Yeah the United States....we are so united.

'@Last1Alive' That's really just wrong, since that's really a matter of choice in USA. We can provide housing, electricity, food, health care and medication for everyone in these worst economic times, so can USA, but just won't in much better economical situation. Our poorest, unemployed people get more free money from government than average full-time McDonald's worker gets paid in USA and on top of that comes health care and dentist and other necessities (and free education, even money is given for students so they can eat and pay rent while studying). Other Nordics are even more generous.

EU should send development aid, huge ambulance planes and ships and European Red Cross should establish field hospitals all over USA like we do in Africa and make that operation so visible that the whole world sees it. Maybe that would be humiliating enough for US Congress to push them to take care of their people.

@real-cool-cat can we send some Cuban doctors, just to poke right wing people?

@Fabian
So long as they're not named Che.
...

@SeanR there are some Fidels to send if it is OK for you xP

T.T Bernie....... Bernie........ *sniffle* Finally get someone who cares over here and he gets shut down in the Primaries. Then we end up with the polar opposite. God Bless America...

@OneOfThemOregonians
Share your disappointment. Somehow we didn't have money when people wanted socialized healthcare or college, but when large businesses want a huge tax cut? Sure thing buddy! That was the last straw for me.

@Here2there ikr

@OneOfThemOregonians the white house is up for auction every 4 years.

I have seen first hand when Welfare is not used for what its intended and its use is corrupted. I can't say certain things because of HIPPA (Health Insurance Portability and Accountability Act), but I have been yelled at by someone who had 4 kids, a cart full of junk food and groceries, severely obese, and riding around in a motorized scooter that was brand new looking. The medication they had was $3.60 for a 90 day supply. It was over $1,400 without and demanded that I change the price since they shouldn't have to pay anything. They raised a stink how they cant afford it, that I was a monster for charging them, and that I was a "money grubbing Jew". This really upset me because I am Jewish, but mostly how I couldn't beat the stupid out of them. While later that week, I see the same older couple, sweetest people you may ever meet, paying $1,000 a month after insurance for cancer medicine.

I see instances of this everyday, of every month, of every year, and nothing is changing but the prices of the medications going up. American Welfare is broken just as bad as the Health System, but the Government needs to stop using Elmer's Glue and a hammer thinking that will fix it.

What you need to understand about America and their healthcare is that there is a huge amount of Just World Fallacy involved. Bad things happen to bad people, not good people, so if you were injured and had to go to the hospital and were saddled with a huge bill it's probably your fault somehow.

However, most Americans hold this subconscious belief only when not confronted with another actual human being. When they do meet someone decent who's had a run of bad luck, then that person automatically becomes a Good Person Who Was Dealt A Bad Hand, and out come the cookies and sympathy. It's a similar situation with people they already know, too. And of course on top of the JWF, the rightwing media were happy to spread a ton of misinformation about Obamacare (aka this poor old woman is completely without healthcare thanks to Obama's policies! Nevermind that she was offered help with signing up for her choice from several different programs that would have covered her and she rejected them.)

This only covers people who are ardently opposed to universal healthcare, or the tamer Obamacare. People who are for it - and there are quite a bit - want it desperately and were very happy when it was finally approved (despite the glitches of the system).

@SwingShift_CA Not to be mean, but my aunt did try to get help when Obamacare went out. She was getting Cancer treatment at the time but because of enrollment they took her off her treatment for 6 months. By the time they gave her coverage she was too far gone and died. My Grandma barely makes enough money for her bills, but she doesn't qualify for Obamacare. (She doesn't even make all of the money from her job. She also has to sell crafts and get money from friends.) My Dad got taken off my Mom's coverage when Obamacare rolled out. So, no I don't see it helping a lot of people. You need to make No money to qualify and the treatment seems pretty scattered to me.

@snowwolf Actually, there's a... gap. You need to make a certain minimum to pay in fees to be covered, lets say 10.000 USD a year (example, I have no idea how much you'd actually have to earn to be able to afford Obamacare). To qualify for medicaid, though, you need to at most earn, say, 3.000 USD. That means there's a gap between 3.000 and 10.000 that can't be covered. It should, however, be mentioned that the Obama administration offered states to pay... 80% was it? to have the people in that gap covered as well, but the states said no... mostly the states with a republican senator, to no surprise to.. anyone.

@Sigart We're very democratic in my state and if some one who can barely support themselves in their late 60's then I don't know who this is supposed to be working for.

@snowwolf I guess the best response I have here is that Obamacare helped a lot of people who made no money and desperately needed healthcare. It's not perfect, however, and I wish it had been closer to the ideal of certain European countries so that people who made ~just a little too much money~ could have qualified as well, like your grandma. Statistically, it did help a lot of people, but it's difficult to be enthusiastic about numbers when it doesn't help the people closest to you. I'm sorry your aunt passed away, and I'm sorry if my words seemed unnecessarily callous.

@SwingShift_CA It just seemed too rushed, and the fact that for the most part it was highly debated when it was pushed through make it seem, a little less then, philanthropic.

@snowwolf I recall little of reasonable debates beyond a lot of Republicans vowing to vote against it and anything else Obama was offering up at the time. I guess if half the room wants to dismantle something, that sort of ruins any sense of philanthropy it was meant to have. It's also difficult, because I had the exact opposite experience that you did; my mother was finally able to go the dentist and have a tooth that had been hurting her for more than a month removed, and since then has been well treated for her health problems (she's in her sixties now). Being a heart patient, I was eager to get some sort of medical care as well. So, it's rather difficult for me not to be extremely happy for it. But, again, I'm still hoping for "free" medicine the likes of which only certain Europeans know.

@SwingShift_CA I see, I guess it depends then, but for my experience it was pretty bad. From the numbers I've heard there's still a lot of people like my Dad though that lost their insurance and can't afford/find new insurance now.

Last medical bill was $600 after insurance. That was to see the doctor for 15 minutes, get paperwork signed for my job proving illness so I won't get fired and a prescription refilled. I'm pretty sure I have a torn rotator cuff, but just can't afford to find out. The whole infrastructure of our healthcare system is broken.

'@Neph23' Here, if you are working or have other income etc. you'll pay for doctor's visit the fee that is set by city (For example, 14 euros) and if you actually need to be in the hospital, payment is now something like 49,50€ per day (just has risen, used to be 33€).

However, if you are unemployed and have no income, all these are paid to you 100%, including all medication that doctor prescribes to you. And no matter how rich you are, the maximum medical expenses in hospital and/or health centre fees are 691€ per year and medication 610€ per year. If you exceed those, everything is free after that for the whole calender year, even if you do have money.

And I have to point out, that USA actually spends MORE money per capita in healthcare than we do. :D So American healthcare system is bad both for taxpayers and for less fortunate.

@real-cool-cat there are reasons for that, I'm afraid.

Healthcare is seen as a business, not as a public good. Private hospitals operate no different than, say, Apple. They have board members, stockholders, and investors. Therefore, they will charge patients more in order to maximize their profit.
Then there are the other factors, such as the debt load on a new physician, the costs associated with malpractice insurance, the costs associated with our medications (which are generally not subsidized or price controlled)...

'@Dena' It's not the worst thing that healthcare is seen as business. We have private doctor stations and so on as well. The thing is, if you need here hip replacement or angioplasty, the doctors don't even look that have you paid your medical bills, what is your insurance status or so on. The invoices are looked by completely different people and payment or insurance issues are worked out separately, even if you have million euros in unpaid debt, it won't affect your treatment. There is no fooling around with human life, money is just paper. You don't even have to be a citizen of Finland. If you collapse inside our borders and need a heart surgery or organ transplant, you'll get one. Life is not a matter of something artificial like money. (I've heard republicans talking about that life is sacred, but it apparently only applies to unborn humans).

I don't want to bash other countries, but it's eerie enough that in a rich country a lot of people are living in some mobile trailer homes like animals, not to mention letting people suffer or even die because of some insurance terms or financial troubles. Even a single case of this is just wrong and barbaric, and I've read that there is up to 45 000 annual deaths in US due to lack of health insurance. More than even gun deaths. All of those people could've been saved, but were not, so that tax rates stay slightly lower and people have a little more money to buy a little more useless plastic gadgets and other garbage to toy with for couple weeks and sell on garage sale after couple years. And I bet human suffering due to a lack of insurance is much bigger number than that. That's not just good old capitalism, that's a crime against humanity.

@real-cool-cat "The thing is, if you need here hip replacement or angioplasty, the doctors don't even look that have you paid your medical bills, what is your insurance status or so on."
Pure American business practice does look at that... and we do have rather greedy people at the top. And the system rewards such people rather than marginalize them. They can even get caught stealing from the Government-funded healthcare programs ... and suffer little except maybe some fines.

In fact, the current Florida Governor was CEO of Columbia HCA ... when it was fined US1.7 billion for committing health care fraud! Billing for services not provided. Illegally claiming various costs as a deductible expense. Billed for services patients didn't qualify for under the laws. No jail time. No criminal status.

"I've heard republicans talking about that life is sacred, but it apparently only applies to unborn humans"
Which gets quite silly. The Republican platform is anti-abortion, but then they're against welfare and family assistance; "If you got pregnant, that's your own fault. You have to pay for your mistake, not I." Then they'll turn around and deny funding to the organizations who work to reduce unwanted pregnancies ... because a small portion of the organization also aids women in obtaining an abortion in case of an unwanted pregnancy.

"I've read that there is up to 45 000 annual deaths in US due to lack of health insurance"
That was from a Harvard Medical School study back in 2009. http://www.pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf if you want to read. The actual number is probably harder to determine due to causal factors, but few people would argue about people without insurance delaying, or even avoiding, standard screening care for lack of funds; screenings that would catch fatal conditions before they became irrevocably so.

"it's eerie enough that in a rich country a lot of people are living in some mobile trailer homes like animals"
Unfortunately, unsurprising considering the mantra 'greed is good'. For the larger businesses, people are ... cogs in the machine. Replaceable parts.

The recent revelations regarding Wells Fargo's business dealings ... over 5000 people fired for doing what upper management pressured them to do (and punished whistleblowers) ... and the CEO? Resigned, and he's looking at over US100 million in retirement pay. For effectively stealing from people.

@Neph23 I had to go to the dentist for an emergency appointment because I had two huge cavities. Turns out both require a root canal treatment. They started the first one on the spot, and for that 45 min session the total bill I received (in mail, about 2 weeks after the appointment) totaled 30,30€. They still need maybe three more visits until both are completely fixed, but 4 times 30 for two molar root canals is a price I'm willing to pay even as a student..

@Neph23 Germany is a little different from Finland, as our healthcare relies on insurance. If you work, you pay about half your insurance (your boss pays the other half). If you are unemployed the state pays it for you. Children can use the insurance of their parents, even if the parents are unemployed. Only in rare cases you have to pay for the insurance without a job (because I'm studying past the age of 25 I have to cover my own costs between 80 and 200€/month which sounds much but you quickly reach the same amount of money with one emergency situation in the USA)

Then the insurance pays for all (well most) your medical bills. Hospital fees are low (just for bed/meals), you don't need to pay to visit a doctor, only small amounts for medication if any, cavities are treated without payment, even psychological therapy, etc. To me this is the best system... but of course it relies on the fact that people who do not get sick often and those who earn a lot of money overpay via their insurances.

@MrsMarzipan
That's mostly how it's supposed to work here.
How it really works is this.
You go in to the doctor. The doctor gives you a bill, it's high. You do have a co-pay, determined by your plan, (a down payment that you have to pay out of pocket, regardless. If the treatment is less or equal to the co-pay, you're paying for the entire treatment out of pocket. Same for the diagnosis.)
Your insurance gets it, and starts trying to figure out why they shouldn't have to pay for it. (Maybe you weren't prescribed medicine on the insurance company's "approved" list. Maybe your doctor and your insurance company don't do business.)
If and once it's determined that the diagnosis and treatment are covered by insurance, the company starts negotiating to lower the bill.
Finally, a month later, you get a copy of the bill. The insurance company was able to dicker your bill down from $XXX + co-pay to, ...copay. The amount you paid that the insurance didn't cover.

I've seen this happen with a loved one. I have to assume it's the normal course of events, as it's happened with him repeatedly.

Oh, and most plans are paid for in cooperation with your employer. Most people hop jobs like they're playing a game of musical chairs. You change jobs, you change plans. If you have a pre-existing condition, or a dependent does, you literally Can't Afford to change jobs.
At least that WAS true. Obamacare, for all it raises my ire that it exists, may have actually fixed that last one. I don't know.

@SeanR Let's not forget the out of pockets, either. In the ACA, an individuals' out of pocket can be as high as $7k.

ACA was supposed to keep pre-existing conditions from barring people from getting insurance, yes... but it does appear that the ACA market for insurers is shrinking, so the impact of that...

When I was getting treated for my allergies, I was seeing my regular doctor once a month, the allergist every 6 months. The only thing I had to worry about was the cost of the medicine.

I could get into an accident today, be taken to the hospital, treated for a broken arm, then walk out without paying a single cent. No worries about $3 each Aspirin , the cost of a cast, admittance fees (yes, they exist in the US). 4-6 weeks later I'd get a bill for the ambulance ride...maybe. It might take me a while to see a specialist or have elective surgery done, but I'm not going to go broke because I got sick. (Or start a meth lab because I have cancer--- Breaking Bad has no basis in Canada)

@RadBaron ... And then you got a mouth full of cavities, and need your mouth x-rayed... Have fun paying that! Or you suddenly start losing sight and need glasses... Once again have fun paying for that!

As a First Nations person, I know I don't have to pay that, or anything for my eyes, or prescriptions, or yeah... As far as I know its paid by the government, could be payed by the band, though I'm. Not sure...

This is very accurate. It is a very natural thing to help, but if you want some small talk or just a conversation out of it....that's a different story. For me at least, I'm just looking to help, not for a new friendship on some deep level shit. I think that goes for many Icelanders as well.