Yes, that's my problem with high taxation, as someone who got burnt by it by virtue of living and paying taxes in the UK.
I don't mind paying my fair share of tax if it means I get good value out of it, but the state of our healthcare here means that in practice the public healthcare system is no longer fit for purpose, so we are being forced to pay for a system that doesn't work and end up having to go private (and thus pay again) when we do need timely healthcare.
I am generally in favor of fair, progressive taxation to ensure everyone has a good social safety net, but the taxation should be fair (it's no longer the case in the UK, since tax brackets haven't been adjusted for inflation) and the services paid for by those taxes should provide good value.
The danger with services funded by taxes as opposed to a private enterprise operating in a free market is that private enterprises are bound by competitive pressure - if they are delivering terrible service and stuffing their pockets with the money, you are free not to do business with them and a potential competitor (that stuffs their pockets a little less) can come along and get your business instead.
With tax-funded services, this pressure doesn't exist, so there's no incentive for politicians (and everyone else in the value chain) to deliver good service, since people generally can't opt out of taxes. This means that even if a service is currently good, there's no guarantee it will remain so since the pressure for it to remain isn't there. Thus, when you see high taxation, it's reasonable to be worried whether the service provided by those taxes is any good and whether it will remain so in the future.
The UK tax system (like many others) is not as fair or progressive as it is presented to be.
1. NI means that the real standard rate on earned income is substantially higher than the "income tax" rate. it is also not fair that unearned income is exempt from it.
2. Lots of purchase taxes, which are disproportionately paid by people with moderate incomes. People on low incomes spend a higher proportion in necessities which are (rightly) subject to lower levels. The more money you have (beyond a certain point) the less you spend on things subject to these taxes.
3. Too many loopholes.
> so we are being forced to pay for a system that doesn't work and end up having to go private (and thus pay again) when we do need timely healthcare.
Some of the NHS is good. NHS dentists can be very hard to find and waiting lists are long. Waiting times can be long too. Reform is prevented by the fear of a US type system and I think many people think that is the only alternative (and seem not to realise how things operate in most other developed countries).
> seem not to realise how things operate in most other developed countries
Genuine question, what do other countries do differently? The way I see it (and described in my original comment) is that the underlying factors behind the decline of government services (no accountability, no incentive to use tax money efficiently) are common across many countries.
Some countries may get away with it for now because they're still "early", but if there is no pressure to do well it's just a matter of time before they too suffer the same fate?
I'd argue that the decline in quality of services as been a phenomenon across many western countries and to significant degree been caused by a economic idiology and a deliberate campaign with a goal of privatisation of many public goods, started in the 1980s.
Essentially funding to services are being reduced to pay for tax reductions, until at some point the quality declines significantly, which is taken as the argument that private enterprise would deliver a much better service at lower cost. Services/infrastructure are then sold and a low price and after a short while costs for services go up, but because they are now private enterprises raising prices it is "the market".
The reason why the UK is worse I believe it's due to the political system which results in essentially 2 dominant parties with very little differences.
Singapore has an individual fund system if I understand it correctly, and that provides extremely good value for money.
One big difference is that these systems are less centralised and therefore less bureaucratic, less prone to political tinkering, and they reduce the problems of lack of accountability and incentives for efficiency.
Agreed, although this can be addressed by appropriate regulation. However, the ultimate issue is that the government should do its job well, and whether it's the task of adequately regulating a market vs providing the service itself, the problem that there's no pressure it to do it well still remains.
The key point to add is that (at least) 2 points must be true for this positive side of market to show:
1) There should be "forces" counterbalancing the move toward monopolies
2) It should be okay for the service to fail/die and/or it should degrade gracefully.
For example book publishing is a wonderful field that can gain from free market dynamics while prison management is a terrible field for free market dynamics.
While a dying publishing enterprise might print less books at a lower quality with deceptive marketing (and that is sorta okay) a dying prison management enterprise will squeeze every ounce of dignity/health/safety out of its wards.
Market dynamics for the economy are analogous to natural selection for evolution: both can produce wonderful things but they will require many more to die horribly.
This is not a statement against markets but I am calling for this tradeoff to be considered along with many other.
The same factor that makes private prisons problematic also makes taxation problematic - in both cases you've got a captive market that can't opt out thus no pressure to provide a good, efficient service. In a hypothetical world where inmates could choose whether to remain in prison and which one to be in, private prisons would be competing for service quality. Actually we've got that, they're just called "hotels".
I wonder if the solution there would be to force politicians and everyone involved to exclusively use government-provided services - so as a condition of going into politics, you can't use private healthcare, your kids can't go to private schools, and you need to spend a day every year in a random prison and so on. Then it would mean the decision-makers got at least some incentive to make sure these services are functional and fit for purpose.
> The same factor that makes private prisons problematic also makes taxation problematic - in both cases you've got a captive market that can't opt out thus no pressure to provide a good, efficient service.
What you should have are companies that offer their best prices/services to the government out of fear that they'll be passed over and those highly valuable contracts will be awarded to their competitors who do better. Governments are incentivized to select the best companies to award those contracts to because they risk being voted out if people are unhappy with the level of service they're getting for their tax dollars.
Prisoners can't kick politicians out of office when they're unhappy about the state of the prisons so that's a huge issue with prisons in general, but private prisons have another issue which is profit. Whatever it costs to keep dangerous people locked up, private prisons need all of that money plus they must extract a bunch of extra money from the public just to stuff their pockets with. If private prisons want to keep prices low to the public but also want to keep filling their pockets with money they need to provide substandard care to the people they are responsible for. A non-private prison needs only what it costs to do the job and nothing more.
> What you should have are companies that offer their best prices/services to the government out of fear that they'll be passed over and those highly valuable contracts will be awarded to their competitors who do better.
This requires a functional quality control system. It seems like it's cheaper to undermine/bribe (or just let decay whatever there is) the quality control system than to actually do better.
> because they risk being voted out if people are unhappy with the level of service
Votes only work if people are properly represented and have good alternatives to vote for, which doesn't seem to be the case in most countries despite them being considered democracies. Keep in mind that the leader of the DPRK is also "elected".
Somehow in the USA these theoretical competitors that lower the profit margin and provide better service seem not to materialize. We end up with whole industries all of whose participants are funneling money to the executives and investors at the expense of customers and society. It’s such a broad issue that half of inflation is attributed to this corporate greed which is not being mitigated by the invisible hand of capitalist competition.
Without proper regulation and enforcement capitalism devolves to monopolies and oligopolies and eliminate competition and subdue market forces.
private enterprise is not "bound by competitive pressure". Companies only compete by virtue of the government forcing them to. Are you arguing that humans, inventors of civilization, are too stupid to figure out how to cooperate?
I disagree that companies only compete thanks to regulation. Companies competing is the default - regulation sometimes (either as an unintended oversight or malicious intent thanks to lobbying/corruption) prevents it though.
There are many valid scenarios where competition is lacking, but generally speaking the reason it’s lacking is due to regulation/law making it impossible.
Telecoms for example is impossible because the incumbents have exclusive control of the physical infrastructure (poles/ducts under the street) or spectrum auctions where the price makes it impossible for a new entrant to enter.
Tech network effects are maintained by copyright law being abused to prevent adversarial interoperability.
Merging and forming cartels is still technically a choice. A company could decide not to do that and compete. It may require a near-infinite amount of money, but it's still technically possible.
In the absence of any regulation, if a company's objective is to maximise profits, and it acts as a rational actor solely focused on achieving that objective, joining cartels, and creating barriers for entry is the end state of the market for nearly all starting conditions.
Unless you want to get into the nitty gritty of economic policy analysis and measuring market externalities, value of public goods is pretty subjective. A healthy person might not see much value in public healthcare and a single adult with no kids might not care about education. Just because you don’t value something in the same way doesn’t mean it’s not highly valued by the people who voted on and implemented the policies.
My neighbors suck less when they're warm, full, and healthy. How do the anti tax folks get past that hurdle? I'm trying to live my most evil life here but I'm stuck on very selfishly wanting cool neighbors.
That is not the case for Germany. We have - even with all its shortcomings - a decent education system that's largely free and accessible for everyone, a decent healthcare system, a decent public transport system on local, regional and federal system, and a very decent social security network that covers unemployment, pension and elderly care.
The US in contrast has neither: parents have to pay five digits worth of money just for the birth of a child, pay through their nose for insurance, public schools are horribly underfunded, universities require six digits worth of debt, there's no high-speed rail worth the name, if you're unemployed you better have some savings, you have to take care about your 401k, and the best way if you need elderly care is to off yourself with a gun.
The only thing where the US actually is in front of Germany is allowing you to get a gun to off yourself. Here in Germany, it's almost impossible to own a gun, so people love to off themselves by jumping in front of a train, creating a huge mess for everyone else.
INOVA in Northern Virginia charges $3000 for an uncomplicated vaginal birth. They have a code which rolls up many services into that code. There are additional in-hospital expenses such as the newborn hearing test which aggregate to about $400. If you have insurance your maximum cost out of pocket for the calendar year is between 5 and 15 thousand dollars (insurance covers everything above it). If you can't pay it all at once there are charities and payment plans you can discuss with the provider. If you don't have insurance you can possibly negotiate the bill down sometimes drastically or if necessary declare Chapter 7 or 13 bankruptcy if you really can't pay the bills. Bankruptcy sounds scarier than it really is. Chapter 7 bankruptcy lasts about 3 months and Chapter 13 bankruptcy lasts about 5 years during which you pay everything above your normal average household expenses to a special account for the creditors. Medical debt is unsecured debt and can be defaulted on and purged by the court following bankruptcy proceedings. Bankruptcy is much more problematic in Europe for the individual. Americans can keep their assets in a Chapter 13 bankruptcy. Health insurance in America costs between $500-$1000 a month for an entire family.
I'm sure this was meant as a "oh, it's not so bad in the U. S." type post. But I read it, and am reminded of what a suck-ass system the U. S. has. Sure, almost everything said is true. But let's reiterate:
1. One might pay up to $15K out-of-pocket for childbirth.
2. If you can't pay it, you have to go out-of-band to seek a non-standard procedure of taking care of the debt. The system is not otherwise built to handle a situation that's probably pretty common given the expenses involved.
3. If all else fails, file for bankruptcy.
All just to have a child.
What you've described is not "not so bad", but rather the plot of a bad movie from the 70s about how corporations have taken over the country and we all live in this dystopian hell where you have to give all of your assets to the corporation to be allowed to have a child. Only it's not a bad movie from the 70s, it's the U. S. healthcare system.
And I don't know what kind of low-end plan one gets for $1000/month for a whole family, but I'd bet real money that the deductible would make my eyes water.
Anyway, comparing earning 175k USD to 162.37k EUR:
Germany, married with 2 children, Stay At Home Mom Scenario, Tax Category 3, Berlin Region:
Solidarity + Salary Tax is EUR 40.428,00
Pension Insurance: 8.314,20 €
Unemployment Insurance: 1.162,20 €
Care Insurance: 900,45 €
Total: 50.805 € = $54,706 before health insurance
Virginia, USA, same scenario as above, incl. 2 child tax credit of $4000, four state exemptions: FICA + Federal + State Tax - Child Care Credit: $44,162-$4,000 = $40,162 before health insurance
Germany costs $14,544 a year more for a family with two kids before health insurance. To be fair though, the differences are lesser for most Germans, as almost no common jobs pay over 120k EUR gross.
> INOVA in Northern Virginia charges $3000 for an uncomplicated vaginal birth. They have a code which rolls up many services into that code. There are additional in-hospital expenses such as the newborn hearing test which aggregate to about $400.
Free of charge in Germany
> If you have insurance your maximum cost out of pocket for the calendar year is between 5 and 15 thousand dollars (insurance covers everything above it).
In Germany, insurance covers everything over 0€. It depends on the insurance whether you have to pay extra for individual treatments (treatment methods without, or with disputed scientific evidence) or not. Rarely more than 100€. If expenses for illnesses exceed a certain amount in a year (about 3000€), it can be deducted from taxes.
> Health insurance in America costs between $500-$1000 a month for an entire family.
In Germany, it depends on your income how much the insurance costs for the entire family. 500-1000€ is also possible in Germany. But without all the extra expenses, negotiations with doctors, clinic, insurer, and bankruptcies...
> In Germany, insurance covers everything over 0€. [...] If expenses for illnesses exceed a certain amount in a year (about 3000€), it can be deducted from taxes
But how can you have anything to deduct if insurance covers everything over $0?
You can go to a private doctor even if you are not in a „private insurance“ and pay him by yourself (Selbstzahler). He can prescribe meds which are not covered by the public insurance. So you have to pay them by yourself. That’s just one example.
Yes, Germany has not the same level of health care. Most of the time it’s better than the US. According to studies and data. All sources are not from Germany:
„Germany would have tied Switzerland had we averaged our rankings of the nations instead of using head-to-head matchups in a bracket system (Switzerland eliminated Germany in the first round). It’s an example of how close the voting was.“
I don't care what the internet says. I know from my own experience it is 6 months, at least for some categories. Some sources say 30 days. A joke! I could call the office of my average XYZ doctor now and ask. And it will be 6 months, for sure.
"Most of the time it’s better than the US. "
The US has a lower live expectancy. Whatever the reasons may be. While this is concerning and not good, as long as you have a good insurance, Germany can not match the standard of US health care. Trust me on that one. With dentists it may be a different thing.
Yes, if you are poor or unemployed, your access to health care is likely much better than in the USA. But otherwise, not so much.
Not sure where you live. I (and the people I know, some of them 65+) never had to wait for 6 months - even for surgeries. And I can speak about a decently wide range of categories.
You also mention "at least for some categories", then you mention that "you could call the average XYZ doctor", as it that was applying to all categories. You seem to be generalising out of emotions, to be honest.
If Access to Health Care in the US is so great, why is infant mortality worse than in Cuba and they score dead last in every Health or Life Expectancy Metric among the G7?
None of these are primarily medical outcomes. Life expectancy, for example, is skewed by an anomalously high rate of fatal injuries when people are young, which has nothing to do with healthcare quality. For better or worse, trauma medicine in the US is arguably the best in the world because serious injuries are so prevalent.
There is also the practical matter that the US is a continent-sized country and regional effects matter. Some US States have life expectancy on par with the best European countries despite the anomalously high fatal injury rates among young people.
Nothing in that article actually addresses the point. The average life expectancy where I live is currently 83+, despite notably higher fatal injury rates.
In terms of actual medical outcomes -- survival rates for cancer, cardiovascular events, trauma medicine, etc -- the UK is quite a bit worse than the US. The only countries that stand out as consistently competing on medical outcomes are France and Switzerland.
It's a little more subtle than this, and of course subtlety is doesn't play well these days, but the US stats vary greatly across geography and ethnic lines. Cuba isn't a great comparison, beyond the shock of "they're worse than a bunch of commies!"
What insurance-speak calls max out of pocket is not what a normal person thinks max out of pocket means.
If you have a year of high medical bills you can easily pay much more out of your real pocket than your so-called "max out of pocket" in the insurance paperwork.
That is because the insurance company only credits what they feel like it towards their accounting of max out of pocket, not what you actually paid.
I don't have an insurance bill handy here to quote numbers but in their monthly or quarterly statements you can find what you have to pay and what they credit against your tally of yearly out of pocket. The latter is often less than the former.
> Health insurance in America costs between $500-$1000 a month for an entire family.
You're off by a lot. About $3500/mo here in CA for my family. Employers usually pay a good portion of that (but it varies) but if you go unemployed on COBRA, it's all out of pocket.
1) I doubt that you pay as much. I pay less than half of that and have a comfortable salary. Did you include the "Arbeitgeberanteil" (which is not part of what you are paying)?
2) You can't easily extrapolate that number to a whole family. Kids are usually insured for free if the higher-earning parent is not privately insured.
No, this is on par with what my friends in Germany pay for their family. The difference is Germans have nearly no deductible and there is little worry about in-network vs out-of-network treatments.
For eg: if you work for a Swiss or US employer and make more than 69k(?), say 100k, as a freelancer, and have a family, you have to pay around 14%(upper limit somewhere around 1000) of the income as health insurance contribution.
I think it is costly. It is difficult to digest for me that the health insurance costs more than housing.
6,000 dollar deductible per person with total 15,000 dollar out of pocket maximum for the family. My current health plan is better because my company found a partner that aggregates many smaller companies to get better rates from insurers. Before this I was uninsured and would call many different providers to negotiate the best cash price for various procedures such as wrist MRI with contrast. I got cash quotes ranging from $850 to $3500 and got exactly what I needed from a local provider for $850. I called up several providers in Canada and they offered similar cash prices (on the low end) so it wasn't worth the 8 hour drive each way.
> INOVA in Northern Virginia charges $3000 for an uncomplicated vaginal birth.
In Germany all of that is being covered by the government insurance scheme. The only thing you have to pay is stuff like a private room for postnatal recovery time [1]. Oh and you get a very long time paid post birth to recover and bond with your child. No such nonsense as giving birth and having to work the next day like it's common in the US.
> If you have insurance your maximum cost out of pocket for the calendar year is between 5 and 15 thousand dollars (insurance covers everything above it).
We don't have that at all, insurance covers everything, you never even see a bill or have to deal with stuff like "in network". The only thing is a 5-10€ co-pay per prescription (utter nonsense if you ask me, it was introduced as a "cost control" measure to prevent people from... diverting medication? idk, it's ridiculous but small enough that it's harmless).
> Bankruptcy is much more problematic in Europe for the individual. Americans can keep their assets in a Chapter 13 bankruptcy.
Agreed on that one. It's also a huge contributing factor into why Americans have it easier to start up side hustles.
> Health insurance in America costs between $500-$1000 a month for an entire family.
Assuming I were the sole earner and my wife would be a SAHM with an arbitrary number of children, I'd (at a gross wage of 52k/y) pay 340€ a month to health insurance and my employer another 340€, so in total (including a per-insurance surcharge of, in my case, .5%) my healthcare costs are capped at about 700€ - for all of us.
On top of that we'd get, like all parents in Germany, "Kindergeld" of 250€/month per childpaid by the government to assist in child rearing.
Pretty awesome if you ask me. I honestly don't know how y'all survive.
> In Germany all of that is being covered by the government insurance scheme.
Ok, but you agree, don't you, that $3000 is quite different from "parents have to pay five digits worth of money just for the birth of a child"? That is off by an order of magnitude.
> No such nonsense as giving birth and having to work the next day like it's common in the US.
I think you should stop consuming so much media from Russia Today :) Or maybe re-consider the trustworthiness of wherever you read that.
The fact is that, at the federal level, Americans may take 12 weeks (unpaid) time off work after giving birth under the FMLA, and it is prohibited to retaliate against an employee for taking that time.
Additionally, the majority of Americans live in states which mandate paid time off after giving birth, (usually 8 to 12 weeks) plus additional unpaid time. California, to use the most populous state as an example, mandates 8 weeks of paid time, plus 28 weeks unpaid. New York, on the opposite side of the country, goes even farther by mandating 12 weeks paid time.
Part of the reason you may be confused is that this is not always explicitly named as "maternity time". It is often called as "disability leave", and nearly all disability statutes include recovery from pregnancy as a disability.
Unless you are maybe trying to argue that Europeans are legally prohibited to work the day after giving birth, you are way off base here.
"a decent education system that's largely free and accessible for everyone"
I give your Universities a 2-3 (On a scale 1 Top, 5 fail). High schools are getting worse and worse due to the immigrants. So you would want to send your kid to a school without many immigrants, mainly due to language barriers.
"a decent healthcare system"
Again, I give you a 2-3. More and more people are sucking services, fewer people pay in. Hey, alone 1 Million Ukrainians are insured, while less than 25% have a job. How long do you wait to see a specialist? >6 months!
"a decent public transport system on local, regional and federal system"
Again grade 2-3. You have a functioning public transport system. But ask Switzerland what they think about it. Or look at China if you want to learn something about bullet trains.
"and a very decent social security network that covers unemployment, pension and elderly care."
Is on the brink of collapse. Pensions are great. For state employees. The rest gets retirement benefits. They are compared to the EU very low.
I don't have health insurance by the way. Germany has to take care of so many immigrants. Nothing left for me. And try to compete with them to find an apartment. The government pays for them. And the government is never late with payments, hence landlords prefer this.
This literally sounds like regurgitated shit from far-right politicians rather than thought-out analysis based on real statistics. In fact I would go so far as to suspect astroturfing.
2.
a) Currently don't find a better article. Biggest problem compared to China. Germany has the same tracks for bullet trains, local trains and freight trains. Often the bullet trains run a 120 or 160 km/h
https://www.businessinsider.de/tech/warum-es-ultraschnelle-z...
No but you pointed out or you wanted to point out it's not decent, yet you gave a score of 2-3 on a scale 1-5 where 1 is top. That makes it exactly decent/good, which is what the person said.
> Switzerland does everything better than Germany with far less taxes.
They have the advantage that the country is so small. Us Germans however have to deal with the fact that we have the 5th largest country of Europe of which a lot of is settled and has to be supported by the entire population.
And in any case, Swiss taxes aren't that much lower than Germany's either - average tax load in the country is ~29% [1], Germany is at 33.9% [2]. Switzerland's total load may be even higher because the German figure includes social security payments, Statista for Switzerland is only taxes.
You know Switzerland is all hilly or mountainy right? Building infrastructure is inherently much harder and more expensive and yet Switzerland does a much better job of it. Switzerland is also actually more diverse with it having 3 distinct languages. The federalization via cantons is smart and works well.
I'm certain your two sources are not measuring the same thing. Swiss taxes are much lower. Median income in Germany is 43k which results in a tax rate of 34% in bawu. Median income in Switzerland is 78k, that in Zürich gives a tax rate of roughly 12% (!!!).
Of course in Switzerland all health insurance is private so you end up having to pay more but this does not increase with more income!
Anyways the idea that the tax burden is the same is completely laughable.
The US actually has a good pension system relative to other developed countries. Retirement plans like 401k, IRA, etc are in addition to the pension system, they don't replace it, and are frequently superior to their European counterparts both in scope and flexibility.
There is plenty to complain about but pensions and retirement is one area that the US does comparatively well.
My initial reaction is - then why is the US leading in so many areas, if based on your chracterization it's such a laggard? I'd argue it has the best in all categories, it's just not close to even distributed. "Decent" is completely inadequate for education, healthcare and transportation. These are far too important for " good enough, usually" solutions.
Agreed. Additionally taxation in our modern Fiat currencies is a farce, since the central banks can literally take as much buying power as they want from you. Taxation is literally just an illusion to make you feel like you are directly paying for government services.The real taxation is inflation.
