story
Also, it's not like the fact that the private insurance model failed in the US means that it can't work at all. For instance, not all countries in Europe have single payer. In some the health insurance system is privatized to a much higher degree than in the US, no equivalent of Medicaid/Medicare with governments directly subsidizing insurance premiums for low-income individuals.
There are clear problems with the current system, and we paid quite a bit out of pocket to evade substandard care this past year with our insurance company threatening to not cover it at all at every step. We called their bluff by enrolling in clinical trials and they folded. Most can't afford to do so, and some never will, but I wish I lived in a country where more could.
And sure, a more transparent private system could work, in fact, utter transparency should be a requirement from the get-go given what is happening with the public/private mix in Canada. But we have 50 individual states in which to experiment yet good luck with that in the current media/political environment. Not giving either party a break here.
I'm certainly not asserting that. However, first of all, 'Medicare For All' only makes sense if it's mandatory, which means additional taxes. Yes, considering the social, political, and economic reality, the likeliest outcome would be a two-tier system, with those who can afford it getting additional insurance in some way. I'm not sure what's so great about that?
> And sure, a more transparent private system could work, > experiment yet good luck with that in the current media/political environment. Not giving either party a break here
Would passing an extended ACA II with way fewer compromises and more effective regulation than the Obamacare version be really harder than instituting Medicare for All (so either a significant increase in federal income tax or a new tax altogether)?
My marginal rate in California is 53+%. That IMO is ludicrous given the horrendous condition of California and its budgetary planning. But...
I don't think the marginal rates are the real problem here. I think they're just peachy. The problem is we have an effectively ~20 page tax code with 4,980+ pages of bespoke deductions for individuals, corporations, and economic segments. Lose them all and start over with alt-min with far fewer exceptions (if any). I'm already taxed higher than most of the world* including most European Socialist Democracies without any of the perks and returns. It's not about the marginal rates. Which is to say we don't need new taxes, we need fewer loopholes to escape the existing tax rates. And we're not going to get that either. It's way too nuanced and esoteric a platform to gain traction with the sorts that think anyone making $100K in 2023+ is a plutocrat, so once again, I... give... up...
Also, California just loves multiple agencies competing for the same table scraps of tax money, but that's a different thread because all those redundant bureaucrats are getting paid on our dime.
*https://nomadcapitalist.com/finance/countries-with-the-highe...
I'm not sure that's true in general. e.g. at around 300k the effective income tax rate in CA is ~34% (26% + 8.0% state) +5% (SS etc.) = 39%. That's quite low by European standards, if you go down to 150k the total is just 35%.
In Germany for instance you'd already be paying ~42% on 100k
Anyway, that wasn't my point at all, I'm just unsure how politically feasible it would be to accomplish this on the federal level.
> European Socialist Democracies
There is not a single country in Europe left which would describe itself as a "socialist" democracy (thankfully most of them collapsed around ~1990).
