Poll

Percent of gross income spent on healthcare

Less than 3%
48 (49.5%)
More than 3%
49 (50.5%)

Total Members Voted: 97

Author Topic: US mustachians, what percent of your income do you spend on healthcare?  (Read 8796 times)

Mississippi Mudstache

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #50 on: August 14, 2018, 11:43:46 AM »
About 14%. That's not counting the portion that my wife's employer pays for our health insurance.

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #51 on: August 14, 2018, 11:44:10 AM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

Cranky

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #52 on: August 14, 2018, 12:07:48 PM »
It depends on what kind of plan you choose, and also on your income. (I've got to sign on this year, and am finding it very confusing. Like so many things, you need a crystal ball.)

You can choose traditional medicare and buy supplements, or you can buy into a plan that works more like an HMO, and covers more, but is geographically limited. My dh's retirement plan covers *his* supplemental insurance costs, but not mine. It's just as confusing as every other thing about insurance!

nkt0

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #53 on: August 14, 2018, 12:20:55 PM »
This isn't an economic problem*, it is a political one.

That's further complicated by the fact that something like 1 in 6 jobs in the US are in health care and health insurance. That's a huge portion of the economy and many of those jobs would be eliminated by single payer. I'm all for Medicare for all, but employment effects are another huge hurtle to overcome (and a big reason why costs are so high).

simonsez

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #54 on: August 14, 2018, 12:25:30 PM »
I think we will still have plenty of people 65+ decades from now as well.  ;-)

I know you are being snarky, but the reason i say it will be decades (and not never) is because of demographics. The millennial generation is substantially bigger than gen x and will eventually outnumber boomers as they die off. There will be a demographic moment where pre-medicare (youngish) voters outnumber medicare (old) voters and that will be the chance to reform the system…if it isn't killed off entirely before then.
My point is there will always be scores of millions of citizens aged 65+ or approaching the benefit age regardless of which generation they are born in. 

I don't think boomers are inherently against a program if they were younger (and to be fair, fiscal policy as to what would keep a program afloat is different in a ZPG [technically, the US is already in/near Stage 5 of the DT and only has population increase due to immigration] world than a growth economy), I just think whoever is approaching 65+ will largely be against paying more money for the same medical coverage.  Many are on or will be on fixed incomes and are largely past their prime earning/working years.  Gen x, millenial, whoever - whenever they get older they'll also be against raising taxes on healthcare after they've reached the age in which they receive benefits and will vote more frequently than they did when they were younger.  I don't see that pattern changing for awhile, especially as the TFR is under replacement and the proportion 65+ won't be decreasing dramatically.

I hope you're correct and all the whippersnappers will be able to implement healthcare policies that are financially viable and take care of every citizen.  I just think voting patterns that potentially alter the taxes/benefits for seniors are more age-based rather than cohort- or generation-based and that there will be am omnipresent silver tsunami force that resists paying more.

PDXTabs

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #55 on: August 14, 2018, 12:31:07 PM »
This isn't an economic problem*, it is a political one.

That's further complicated by the fact that something like 1 in 6 jobs in the US are in health care and health insurance. That's a huge portion of the economy and many of those jobs would be eliminated by single payer. I'm all for Medicare for all, but employment effects are another huge hurtle to overcome (and a big reason why costs are so high).

That is definitely true. As documented by David Graeber in Bullshit Jobs: A Theory, that was one of the reasons that Obama didn't push for single payer. That is, he didn't think that he had the political capital, especially in a recession, to trim that many jobs from the economy.

It's also true that you can't just trim 7.4% off of your GDP overnight or expect it to be pain free. But in the long run it seems like an obvious plus for the economy.
« Last Edit: August 14, 2018, 12:38:15 PM by PDXTabs »

nkt0

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #56 on: August 14, 2018, 12:31:41 PM »
I hope you're correct and all the whippersnappers will be able to implement healthcare policies that are financially viable and take care of every citizen.  I just think voting patterns that potentially alter the taxes/benefits for seniors are more age-based rather than cohort- or generation-based and that there will be am omnipresent silver tsunami force that resists paying more.

I wish that were what i was predicting. Unfortunately, i agree with you and don't think it's possible.

BicycleB

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #57 on: August 14, 2018, 01:06:31 PM »
I've heard highly conflicting numbers re cost of Medicare For All. Fwiw, here is an article quoting the author of a recent possibly Koch-funded study of the subject...that Alexendra Ocasio-Cortez has recently been quoting (misquoting, according the author).

https://www.factcheck.org/2018/08/the-cost-of-medicare-for-all/

TL;DR - it probably won't be cheaper overall than what we have.

That said, clearly the US system is the most costly and presumably inefficient of the national healthcare systems in prosperous countries, so surely we can and should improve it greatly. Medicare For All seems like a reasonable approach in that many aspects of it are similar to typical systems that work.

OP, sorry for all of the sidetracking.

jlcnuke

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #58 on: August 14, 2018, 03:08:20 PM »
The cost of medicare for all has been projected at anywhere from $1.4 trillion to $3.3 trillion per year.  In 2017, the combined payroll tax income for medicare, medicaid, and social security all together was about $1.1 trillion.  Since the employee + employer portion of social security, medicare, and medicaid is 15.3% of gross income, this means to raise $1.4 to $3.3 trillion would require a payroll tax increase of 19.5% to 45.9% in order to cover all costs via payroll tax.

I'm not sure about you guys, but I don't really like the idea of an additional 19.5% payroll tax and I am absolutely not on board with an additional 45.9% payroll tax.

The UK spends 7.7% of its GDP to make sure that every citizen has a decent level of basic care (source). The US is currently spending 8.5% of its GDP on Medicare+Medicaid+ACA. That isn't counting any of your private contributions, if you add private contributions in the US you get 17.1% of GDP (to the UK's 9.7%). That's insane. If you copied and pasted the UK system into the US we could have Medicare for all for $1.49T per year (in 2017 dollars, that obviously does not count social security). I'm not saying that we should pay for it with a payroll tax, I'm saying that it is insane that the UK pays so much less for health care than the US. This isn't an economic problem*, it is a political one.

* - Except that it is quickly becoming an economic problem for the US economy.

Exactly. Our health care spending is ridiculous compared to the rest of the world. Per capita, most of the developed world spends less to cover everyone than we do just on public costs, which is only about half our spending.


DreamFIRE

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #59 on: August 14, 2018, 05:01:02 PM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

@Mr. Green

I said "about" $11,000.  The actual figures were  $907 a month, $10,884 a year.  It wouldn't surprise me that some peoples would be a little less.

Interestingly, you actually responded about this in the other thread saying, "I feel like $10,000 is a reasonable amount of money..."

and I had responded to you, "That's $10,000 out of pocket per year.   That seems incredibly high to me."

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036831/#msg2036831


DreamFIRE

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #60 on: August 14, 2018, 05:09:20 PM »
i don't believe we will see Medicare for All happen because of the simple fact that the boomers already have Medicare

@nkt0

That simple fact is no fact at all.  Many boomers are 55 to 64 years old and do not have Medicare, with the youngest of them being nearly a decade away from receiving it.

Also, as I have stated earlier, Medicare isn't really free if you want decent coverage.  Premiums can be quite steep, and co-pays and significant deductibles would probably be included in any "for all" plan to reduce the enormous cost of the program needed to implement it, despite a hefty tax hike.
« Last Edit: August 14, 2018, 05:15:29 PM by DreamFIRE »

Veritasvosliberabit

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #61 on: August 15, 2018, 02:09:22 PM »
This is kinda a #fakenews comparison.

You can't just magically double the tax and replace employer subsidized insurance, which seems to be the inference from the OP.

As an aside the US spends roughly 16% of our GDP on healthcare which is about double what it was 50 years ago. We spend far above the next highest nation.

Magically, no...but Congress could pass a law that makes it happen. Or at least, a law that causes Medicare for All to replace employer subsidized insurance, with a tax rate approximately double the current 1.45%.

It would have to be determined through experience how close the new rate would be to exactly paying for the costs. Presumably if the variance is large, it would cause problems unless remedied, but that's different from requiring magic.

Fwiw, I assume the 1.45% employer share would also be doubled. So the total amount for expanded Medicare would be 5.8% of pretax wages.  That's much less than 16% of GDP, but wouldn't be expected to cover all costs. It would only replace medical premiums, copays and some deductibles (I think), plus the portion of medical cost currently covered by employer sponsored insurance...will accept correction from those with more detailed knowledge, but a substantial portion of costs was excluded by OP's proposal.

Plus Medicare is sort of efficient, perhaps offering some savings rather than a mere redistribution of costs. Not magic, just efficiency from standardization, eliminating some of the numerous private sector middlemen, and freeing the patient from the need to pay for private sector profits.

So the proposal is plausible, maybe even realistic. Not magic, at least.

Studies have shown that the biggest decrease in cost in "medicare for all" would be the 40% pay cut that healthcare providers (doctors, nurses, etc) would have to take.  There would be a one-off decrease in admin costs, which would lower the total cost by 10-15%, but "medicare for all" would not change the rate at which the cost of health insurance is rising each year.  Further, as medicare rates would become the norm, a decent percentage of smaller clinics would go out of business due to the much lower medicare reimbursement rates.

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #62 on: August 15, 2018, 02:16:41 PM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

@Mr. Green

I said "about" $11,000.  The actual figures were  $907 a month, $10,884 a year.  It wouldn't surprise me that some peoples would be a little less.

Interestingly, you actually responded about this in the other thread saying, "I feel like $10,000 is a reasonable amount of money..."

and I had responded to you, "That's $10,000 out of pocket per year.   That seems incredibly high to me."

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036831/#msg2036831
What I meant by $10,000 being reasonable was as a total cost for a couple. If we had Medicare and Medigap, or an equivalent, that meant we didn't pay a dime more out of pocket, I'd consider $5,000 per person per year to be a reasonable cost. And the best part is that your expenses would be the same every year so it'd be easy to budget for and a worry-free line item.

I know my grandparents pay a little less than $5,000 each for all their Medicare premiums, and that includes Medigap so that pay that and not a penny more. That's covered them through multiple joint replacements, heart surgury, etc.

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #63 on: August 15, 2018, 02:40:26 PM »
This is kinda a #fakenews comparison.

You can't just magically double the tax and replace employer subsidized insurance, which seems to be the inference from the OP.

As an aside the US spends roughly 16% of our GDP on healthcare which is about double what it was 50 years ago. We spend far above the next highest nation.

Magically, no...but Congress could pass a law that makes it happen. Or at least, a law that causes Medicare for All to replace employer subsidized insurance, with a tax rate approximately double the current 1.45%.

It would have to be determined through experience how close the new rate would be to exactly paying for the costs. Presumably if the variance is large, it would cause problems unless remedied, but that's different from requiring magic.

Fwiw, I assume the 1.45% employer share would also be doubled. So the total amount for expanded Medicare would be 5.8% of pretax wages.  That's much less than 16% of GDP, but wouldn't be expected to cover all costs. It would only replace medical premiums, copays and some deductibles (I think), plus the portion of medical cost currently covered by employer sponsored insurance...will accept correction from those with more detailed knowledge, but a substantial portion of costs was excluded by OP's proposal.

Plus Medicare is sort of efficient, perhaps offering some savings rather than a mere redistribution of costs. Not magic, just efficiency from standardization, eliminating some of the numerous private sector middlemen, and freeing the patient from the need to pay for private sector profits.

So the proposal is plausible, maybe even realistic. Not magic, at least.

Studies have shown that the biggest decrease in cost in "medicare for all" would be the 40% pay cut that healthcare providers (doctors, nurses, etc) would have to take.  There would be a one-off decrease in admin costs, which would lower the total cost by 10-15%, but "medicare for all" would not change the rate at which the cost of health insurance is rising each year.  Further, as medicare rates would become the norm, a decent percentage of smaller clinics would go out of business due to the much lower medicare reimbursement rates.
The 40% cut general statistic is misleading because half (56% I believe) of the healthcare received in the US already runs through Medicare and Medicaid.  So for providers with Medicare patients nothing would change for that subset. Yes funds received from patients previously carrying private insurance would decrease but, as you mentioned, there would be some decrease in administrative cost.

I strongly believe that Medicare for all would slow the rise in health Insurance costs because Medicare is already covering the sickest people in the country. Adding everyone else to the pool would be adding the healthiest set of people which would do the exact opposite of what everyone is afraid of with the ACA which is a death spiral. The healthier people not needing as much care would help fund the people needing care and costs would either slow there rise or possibly even go down. In addition to potentially reducing the cost of health insurance, the cost of care would likely go down as well because now there would be one huge entity with massive leverage to limit the cost of procedures.

Imagine a "non-profit" hospital that makes so much money (25% profit) that they are continually expanding infrastructure and adding "cancer wings" because they're making so much money they have to do something with it so that it doesn't look like they're making money hand-over-fist. Now that hospital has to negotiate with an entity that controls essentially 100% of its patient base. Do you think that profit margin is going to go down? There's a reason why private equity firms are diving into the hospital space and that's because the profits to be had are disgusting.
« Last Edit: August 15, 2018, 02:47:19 PM by Mr. Green »

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #64 on: August 15, 2018, 02:57:42 PM »
i don't believe we will see Medicare for All happen because of the simple fact that the boomers already have Medicare

@nkt0

That simple fact is no fact at all.  Many boomers are 55 to 64 years old and do not have Medicare, with the youngest of them being nearly a decade away from receiving it.

Also, as I have stated earlier, Medicare isn't really free if you want decent coverage.  Premiums can be quite steep, and co-pays and significant deductibles would probably be included in any "for all" plan to reduce the enormous cost of the program needed to implement it, despite a hefty tax hike.
Premiums for Medicare aren't steep at all. For most folks Part B is $134 a month per person for a couple making up to $85,000, and Part A is free. And the premiums are still reasonable as income rises above that. The average premium for the drug plan (Part D) is $30-some a month. Sure there will be co-pays and deductibles, just like there is for virtually all private insurance now.

The thing is, the Mercatus study showed we're already spending, as a country, every dollar it would take to implement medicare-for-all. so it would literally cost nothing to implement this program other than shifting around how and where the money is being spent. I could care less whether my taxes go up a little bit if that means I spend less out-of-pocket on Healthcare. At the end of the day where the money comes out of my pocket.

So if we could literally insure every person in the country for not one penny more than what we are spending already why would we not want to do that? There's only one answer and that is the healthcare industry lobby. That lobby is also the most powerful in the country which is why it will still be exceedingly difficult to get medicare-for-all despite it being a complete no-brainer.
« Last Edit: August 15, 2018, 03:30:09 PM by Mr. Green »

obstinate

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #65 on: August 15, 2018, 03:24:31 PM »
The Medicare portion of FICA tax is 1.45% of gross income (slightly more if you make over $200k). I have heard rumors that it would be cheaper to insure everyone under 65 than everyone over 65. So if we had a national health plan that extended coverage to everyone it would need to cost about 3% of everyone's gross income. (I know that this is an oversimplification and that medicare doesn't cover everything).
I am 99% sure that Medicare costs more than just the 1.45% FICA taxes. And, after looking it up, that hunch is confirmed.

https://www.kff.org/report-section/a-primer-on-medicare-how-is-medicare-financed-and-what-are-medicares-future-financing-challenges/

Only about 1/3rd of it is paid for via FICA. Also recall that the employer is also paying 1.45%, which ultimately, according to most economists, comes from your pocket in depressed wages.

Not saying we shouldn't have medicare for all. Just people need to get a little more realistic about what it would cost. Taxes would need to go up 10+ percentage points across the board to pay for it (or more for some groups and less for others).

PDXTabs

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #66 on: August 15, 2018, 03:44:13 PM »
Not saying we shouldn't have medicare for all. Just people need to get a little more realistic about what it would cost. Taxes would need to go up 10+ percentage points across the board to pay for it (or more for some groups and less for others).

Do you want to explain to me why? That is, we are already paying more than the UK pays for the entirety of their government healthcare system. Why would our taxes need to go up?
« Last Edit: August 15, 2018, 03:46:31 PM by PDXTabs »

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #67 on: August 15, 2018, 03:53:51 PM »
Not saying we shouldn't have medicare for all. Just people need to get a little more realistic about what it would cost. Taxes would need to go up 10+ percentage points across the board to pay for it (or more for some groups and less for others).

Do you want to explain to me why? That is, we are already paying more than the UK pays for the entirety of their government healthcare system. Why would our taxes need to go up?
Taxes would go up because your out of pocket spending on healthcare would go down. Medicare is more generous than essentially all the high deductible health plans out there now. In the end you aren't going to care if your taxes go up but your out of pocket healthcare spending goes down so that the net cost is the same.

DreamFIRE

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #68 on: August 15, 2018, 03:56:26 PM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

@Mr. Green

I said "about" $11,000.  The actual figures were  $907 a month, $10,884 a year.  It wouldn't surprise me that some peoples would be a little less.

Interestingly, you actually responded about this in the other thread saying, "I feel like $10,000 is a reasonable amount of money..."

and I had responded to you, "That's $10,000 out of pocket per year.   That seems incredibly high to me."

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036831/#msg2036831
What I meant by $10,000 being reasonable was as a total cost for a couple. If we had Medicare and Medigap, or an equivalent, that meant we didn't pay a dime more out of pocket, I'd consider $5,000 per person per year to be a reasonable cost. And the best part is that your expenses would be the same every year so it'd be easy to budget for and a worry-free line item.

I know my grandparents pay a little less than $5,000 each for all their Medicare premiums, and that includes Medigap so that pay that and not a penny more. That's covered them through multiple joint replacements, heart surgury, etc.

Yeah, $10,000 for a couple for Medicare is about $10,000 more than many seniors can afford.  It's ridiculously expensive - far from free as most people seem to think!

PDXTabs

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #69 on: August 15, 2018, 04:02:57 PM »
Not saying we shouldn't have medicare for all. Just people need to get a little more realistic about what it would cost. Taxes would need to go up 10+ percentage points across the board to pay for it (or more for some groups and less for others).

Do you want to explain to me why? That is, we are already paying more than the UK pays for the entirety of their government healthcare system. Why would our taxes need to go up?
Taxes would go up because your out of pocket spending on healthcare would go down. Medicare is more generous than essentially all the high deductible health plans out there now. In the end you aren't going to care if your taxes go up but your out of pocket healthcare spending goes down so that the net cost is the same.

So what you are saying is that the UK can provide health care coverage for every citizen for 7.7% of GDP but we couldn't possibly for 8.5% of GDP? Because economics work differently in the UK, or the actual medical devices, maybe UK citizens posses different anatomy? I reject the premise that the US magically necessitates higher healthcare costs than every other developed country on the planet, but I'm willing to listen to evidence.

DreamFIRE

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #70 on: August 15, 2018, 04:12:30 PM »
The Medicare portion of FICA tax is 1.45% of gross income (slightly more if you make over $200k). I have heard rumors that it would be cheaper to insure everyone under 65 than everyone over 65. So if we had a national health plan that extended coverage to everyone it would need to cost about 3% of everyone's gross income. (I know that this is an oversimplification and that medicare doesn't cover everything).
I am 99% sure that Medicare costs more than just the 1.45% FICA taxes. And, after looking it up, that hunch is confirmed.

https://www.kff.org/report-section/a-primer-on-medicare-how-is-medicare-financed-and-what-are-medicares-future-financing-challenges/

Only about 1/3rd of it is paid for via FICA. Also recall that the employer is also paying 1.45%, which ultimately, according to most economists, comes from your pocket in depressed wages.

Not saying we shouldn't have medicare for all. Just people need to get a little more realistic about what it would cost. Taxes would need to go up 10+ percentage points across the board to pay for it (or more for some groups and less for others).

1.45% increased to 10+%, which could be well above 10%, and it will need to be high to provide people with decent coverage along with the high out of pocket costs while not screwing over healthcare providers who are already losing money on existing Medicare patients, with many facilities already closing their doors.  Someone upthread mentioned cutting healthcare providers and employees' incomes by 40%.  That can't happen.  It's hard to make a profit and find good help as it is.

swampwiz

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #71 on: August 15, 2018, 04:25:30 PM »
As a Welfare Rother, I pay $0 for my ObamaRomneyHeritageCare Medicaid.

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #72 on: August 15, 2018, 04:30:20 PM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

@Mr. Green

I said "about" $11,000.  The actual figures were  $907 a month, $10,884 a year.  It wouldn't surprise me that some peoples would be a little less.

Interestingly, you actually responded about this in the other thread saying, "I feel like $10,000 is a reasonable amount of money..."

and I had responded to you, "That's $10,000 out of pocket per year.   That seems incredibly high to me."

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036831/#msg2036831
What I meant by $10,000 being reasonable was as a total cost for a couple. If we had Medicare and Medigap, or an equivalent, that meant we didn't pay a dime more out of pocket, I'd consider $5,000 per person per year to be a reasonable cost. And the best part is that your expenses would be the same every year so it'd be easy to budget for and a worry-free line item.

I know my grandparents pay a little less than $5,000 each for all their Medicare premiums, and that includes Medigap so that pay that and not a penny more. That's covered them through multiple joint replacements, heart surgury, etc.

Yeah, $10,000 for a couple for Medicare is about $10,000 more than many seniors can afford.  It's ridiculously expensive - far from free as most people seem to think!
I don't get the idea from my interactions with people that most think Medicare is free. It can also be substantially cheaper than $5,000 per year per person because that number included medigap. The basic cost for Medicare is $134 a month. That gets you Part A and Part B. The deductible on an inpatient hospital stay is $1,340 per year and you pay 0% coinsurance for the first 60 days in the hospital. The deductible on all other care is $183 per year and you only pay a 20% coinsurance after that. If you want a drug plan, add another $30-some a month for reduced drugs costs.

I dare you to find private insurance covering an individual for less than $200/month that gives you a low three-figure deductible and 20% coinsurance. I bet you can't get insurance that cheap as a 20-something year old.

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #73 on: August 15, 2018, 04:36:17 PM »
Not saying we shouldn't have medicare for all. Just people need to get a little more realistic about what it would cost. Taxes would need to go up 10+ percentage points across the board to pay for it (or more for some groups and less for others).

Do you want to explain to me why? That is, we are already paying more than the UK pays for the entirety of their government healthcare system. Why would our taxes need to go up?
Taxes would go up because your out of pocket spending on healthcare would go down. Medicare is more generous than essentially all the high deductible health plans out there now. In the end you aren't going to care if your taxes go up but your out of pocket healthcare spending goes down so that the net cost is the same.

So what you are saying is that the UK can provide health care coverage for every citizen for 7.7% of GDP but we couldn't possibly for 8.5% of GDP? Because economics work differently in the UK, or the actual medical devices, maybe UK citizens posses different anatomy? I reject the premise that the US magically necessitates higher healthcare costs than every other developed country on the planet, but I'm willing to listen to evidence.
I have no idea if our cost would be higher than the UK. I just know that taxes would go up to pay for the plan but out of pocket costs would go down, neutralizing the increase in taxes. What gets latched on to is people saying, "taxes will go up so see, they just want to take more money out of our pockets," without the other half of the equation which is that actual healthcare spending will go down. The Mercatus study basically showed us it's a zero sum game. I could care less how the money comes out of my pocket if, at the end of the day, the dollar amount doesn't change. Taxes, paying the doctor bill myself, insurance premiums. If it cost me $1,000 and you could change the whole system, insuring 30 million more people, and it still only costs me $1,000 for every facet of healthcare, tax away! The money is just coming from a different bucket.

PDXTabs

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #74 on: August 15, 2018, 05:06:32 PM »
Mr. Green,

I don't necessarily disagree with you. If I could pay the same as today for everyone to be well covered I would. But we should actually be able to do better than that. If we brought our healthcare spending on par with the rest of the world we could cover everyone without even raising taxes.

Irregular Joe

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #75 on: August 15, 2018, 06:01:06 PM »
Family of 3 with an HSA and a $5,000 deductible + $1,000 copay.  We pay $715 a month ($8,580 a year) in health insurance. 

We've also paid $2,700 out of pocket this year so far.  $2,100 of that was due to a trip to the ER after my toddler son fell and cut his head. Small cut, but we had to glue it shut.  The rest was miscellaneous childhood check-ups and vaccines. 

My wife is pregnant with our second child, so I expect to pay ~$4,000 out of pocket over the next 12 months to cover the C-section and related doctors visits, assuming baby and momma are healthy and no complications.  There's a cap of $7,000 out of pocket per year for an in-network doctor so at least we know the worse case scenario.

Thank goodness we're healthy or I don't know what our healthcare bills would look like.  I haven't been to the doctor, even for a check-up, in 6 years.

« Last Edit: August 15, 2018, 06:48:29 PM by Irregular Joe »

DreamFIRE

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #76 on: August 15, 2018, 07:27:03 PM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

@Mr. Green

I said "about" $11,000.  The actual figures were  $907 a month, $10,884 a year.  It wouldn't surprise me that some peoples would be a little less.

Interestingly, you actually responded about this in the other thread saying, "I feel like $10,000 is a reasonable amount of money..."

and I had responded to you, "That's $10,000 out of pocket per year.   That seems incredibly high to me."

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036831/#msg2036831
What I meant by $10,000 being reasonable was as a total cost for a couple. If we had Medicare and Medigap, or an equivalent, that meant we didn't pay a dime more out of pocket, I'd consider $5,000 per person per year to be a reasonable cost. And the best part is that your expenses would be the same every year so it'd be easy to budget for and a worry-free line item.

I know my grandparents pay a little less than $5,000 each for all their Medicare premiums, and that includes Medigap so that pay that and not a penny more. That's covered them through multiple joint replacements, heart surgury, etc.

Yeah, $10,000 for a couple for Medicare is about $10,000 more than many seniors can afford.  It's ridiculously expensive - far from free as most people seem to think!
I don't get the idea from my interactions with people that most think Medicare is free. It can also be substantially cheaper than $5,000 per year per person because that number included medigap. The basic cost for Medicare is $134 a month. That gets you Part A and Part B. The deductible on an inpatient hospital stay is $1,340 per year and you pay 0% coinsurance for the first 60 days in the hospital. The deductible on all other care is $183 per year and you only pay a 20% coinsurance after that. If you want a drug plan, add another $30-some a month for reduced drugs costs.

Don't forget Plan D (covers prescriptions) $78 a month and Plan F supplement (covers the 20% Medicare doesn't pay) $241.50 a month.   For some people, the cost is higher.  If you really want to be adequately covered, you need these parts/supplements.

Based on the OP, I'm comparing it to to my private insurance through work, which costs me $50/mo  (my cost, not employer's), and my deductible is $100.  Compare that to the Medicare couple paying $11,000 in Medicare premiums.

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #77 on: August 15, 2018, 07:44:35 PM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

@Mr. Green

I said "about" $11,000.  The actual figures were  $907 a month, $10,884 a year.  It wouldn't surprise me that some peoples would be a little less.

Interestingly, you actually responded about this in the other thread saying, "I feel like $10,000 is a reasonable amount of money..."

and I had responded to you, "That's $10,000 out of pocket per year.   That seems incredibly high to me."

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036831/#msg2036831
What I meant by $10,000 being reasonable was as a total cost for a couple. If we had Medicare and Medigap, or an equivalent, that meant we didn't pay a dime more out of pocket, I'd consider $5,000 per person per year to be a reasonable cost. And the best part is that your expenses would be the same every year so it'd be easy to budget for and a worry-free line item.

I know my grandparents pay a little less than $5,000 each for all their Medicare premiums, and that includes Medigap so that pay that and not a penny more. That's covered them through multiple joint replacements, heart surgury, etc.

Yeah, $10,000 for a couple for Medicare is about $10,000 more than many seniors can afford.  It's ridiculously expensive - far from free as most people seem to think!
I don't get the idea from my interactions with people that most think Medicare is free. It can also be substantially cheaper than $5,000 per year per person because that number included medigap. The basic cost for Medicare is $134 a month. That gets you Part A and Part B. The deductible on an inpatient hospital stay is $1,340 per year and you pay 0% coinsurance for the first 60 days in the hospital. The deductible on all other care is $183 per year and you only pay a 20% coinsurance after that. If you want a drug plan, add another $30-some a month for reduced drugs costs.

Don't forget Plan D (covers prescriptions) $78 a month and Plan F supplement (covers the 20% Medicare doesn't pay) $241.50 a month.   For some people, the cost is higher.  If you really want to be adequately covered, you need these parts/supplements.

Based on the OP, I'm comparing it to to my private insurance through work, which costs me $50/mo  (my cost, not employer's), and my deductible is $100.  Compare that to the Medicare couple paying $11,000 in Medicare premiums.
What you're paying isn't reflective of the true cost of insurance, it's being heavily subsidized by your employer. You're still paying for it in the form of lower wages, you just don't see it coming out of your paycheck.

DreamFIRE

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #78 on: August 15, 2018, 07:48:49 PM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

@Mr. Green

I said "about" $11,000.  The actual figures were  $907 a month, $10,884 a year.  It wouldn't surprise me that some peoples would be a little less.

Interestingly, you actually responded about this in the other thread saying, "I feel like $10,000 is a reasonable amount of money..."

and I had responded to you, "That's $10,000 out of pocket per year.   That seems incredibly high to me."

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036831/#msg2036831
What I meant by $10,000 being reasonable was as a total cost for a couple. If we had Medicare and Medigap, or an equivalent, that meant we didn't pay a dime more out of pocket, I'd consider $5,000 per person per year to be a reasonable cost. And the best part is that your expenses would be the same every year so it'd be easy to budget for and a worry-free line item.

I know my grandparents pay a little less than $5,000 each for all their Medicare premiums, and that includes Medigap so that pay that and not a penny more. That's covered them through multiple joint replacements, heart surgury, etc.

Yeah, $10,000 for a couple for Medicare is about $10,000 more than many seniors can afford.  It's ridiculously expensive - far from free as most people seem to think!
I don't get the idea from my interactions with people that most think Medicare is free. It can also be substantially cheaper than $5,000 per year per person because that number included medigap. The basic cost for Medicare is $134 a month. That gets you Part A and Part B. The deductible on an inpatient hospital stay is $1,340 per year and you pay 0% coinsurance for the first 60 days in the hospital. The deductible on all other care is $183 per year and you only pay a 20% coinsurance after that. If you want a drug plan, add another $30-some a month for reduced drugs costs.

Don't forget Plan D (covers prescriptions) $78 a month and Plan F supplement (covers the 20% Medicare doesn't pay) $241.50 a month.   For some people, the cost is higher.  If you really want to be adequately covered, you need these parts/supplements.

Based on the OP, I'm comparing it to to my private insurance through work, which costs me $50/mo  (my cost, not employer's), and my deductible is $100.  Compare that to the Medicare couple paying $11,000 in Medicare premiums.
What you're paying isn't reflective of the true cost of insurance, it's being heavily subsidized by your employer. You're still paying for it in the form of lower wages, you just don't see it coming out of your paycheck.
Did you read what I posted.? I specifically stated, "my cost, not employer's".  I'm staying on point here - OP asked to not include employer paid premiums.

I'm only paying $50/mo of the premium and $100 deductible.  And I'm comparing that to the extremely high cost comparable Medicare parts/supplemental that I mentioned that I would pay out of pocket.  That's in addition to the large tax hike (which is justified to pay for this expensive program).  I also reject the notion that I'm paying a lot more indirectly through reduced wages because I am certain that my employer would not suddenly pay me the difference if they were to stop paying their share of my insurance premium.  That would be extra profit for the business, sort of like how businesses that got big Trump tax cuts didn't pass those on down to employees via higher wages.
« Last Edit: August 15, 2018, 07:55:53 PM by DreamFIRE »

Mr. Green

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #79 on: August 15, 2018, 10:04:22 PM »
About 0.7% for me.  Family size =1   Employer based coverage, net cost after tax deduction

By the way, Medicare has pretty poor coverage unless you purchase the additional parts and supplementals. Someone in the ACA thread mentioned it was costing about $11,000 per year for Medicare premiums to get adequate healthcare coverage.
Something isn't adding up on that Medicare number. My grandparents had all the main parts (A, B, and D) and even Medigap (Part F?) And they paied less than that per year combined. And with Medigap that means they don't pay a penny more.

@Mr. Green

I said "about" $11,000.  The actual figures were  $907 a month, $10,884 a year.  It wouldn't surprise me that some peoples would be a little less.

Interestingly, you actually responded about this in the other thread saying, "I feel like $10,000 is a reasonable amount of money..."

and I had responded to you, "That's $10,000 out of pocket per year.   That seems incredibly high to me."

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036831/#msg2036831
What I meant by $10,000 being reasonable was as a total cost for a couple. If we had Medicare and Medigap, or an equivalent, that meant we didn't pay a dime more out of pocket, I'd consider $5,000 per person per year to be a reasonable cost. And the best part is that your expenses would be the same every year so it'd be easy to budget for and a worry-free line item.

I know my grandparents pay a little less than $5,000 each for all their Medicare premiums, and that includes Medigap so that pay that and not a penny more. That's covered them through multiple joint replacements, heart surgury, etc.

Yeah, $10,000 for a couple for Medicare is about $10,000 more than many seniors can afford.  It's ridiculously expensive - far from free as most people seem to think!
I don't get the idea from my interactions with people that most think Medicare is free. It can also be substantially cheaper than $5,000 per year per person because that number included medigap. The basic cost for Medicare is $134 a month. That gets you Part A and Part B. The deductible on an inpatient hospital stay is $1,340 per year and you pay 0% coinsurance for the first 60 days in the hospital. The deductible on all other care is $183 per year and you only pay a 20% coinsurance after that. If you want a drug plan, add another $30-some a month for reduced drugs costs.

Don't forget Plan D (covers prescriptions) $78 a month and Plan F supplement (covers the 20% Medicare doesn't pay) $241.50 a month.   For some people, the cost is higher.  If you really want to be adequately covered, you need these parts/supplements.

Based on the OP, I'm comparing it to to my private insurance through work, which costs me $50/mo  (my cost, not employer's), and my deductible is $100.  Compare that to the Medicare couple paying $11,000 in Medicare premiums.
What you're paying isn't reflective of the true cost of insurance, it's being heavily subsidized by your employer. You're still paying for it in the form of lower wages, you just don't see it coming out of your paycheck.
Did you read what I posted.? I specifically stated, "my cost, not employer's".  I'm staying on point here - OP asked to not include employer paid premiums.

I'm only paying $50/mo of the premium and $100 deductible.  And I'm comparing that to the extremely high cost comparable Medicare parts/supplemental that I mentioned that I would pay out of pocket.  That's in addition to the large tax hike (which is justified to pay for this expensive program).  I also reject the notion that I'm paying a lot more indirectly through reduced wages because I am certain that my employer would not suddenly pay me the difference if they were to stop paying their share of my insurance premium.  That would be extra profit for the business, sort of like how businesses that got big Trump tax cuts didn't pass those on down to employees via higher wages.
I guess it depends on the employer. I have worked for companies that paid the employee the difference if they didn't want to use the company's health insurance.

The only thing I was alluding to with the comparison if your cost to a retiree's cost with Medicare is that it isn't apples to apples. Your bill is being subsidized and the Medicare enrollee's isn't.

minimustache1985

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #80 on: August 15, 2018, 11:38:28 PM »
Not including the employer cost makes a huge difference, so I don’t understand excluding it.

I’m now a SAHM and when working for a Fortune 100 company we were on my employer plan which with our son ran us about 3.5k annually in premiums- having my son was 4K on top of that for my personal OOP max and would have been double if he’d needed NICU treatment.  Now through my husbands job our premiums are triple, though with lower deductibles, because they are a small business that can’t afford to cover 80% of the costs and don’t have the negotiating power of a large company.  I’m not including percentage because it isn’t a fair comparison since we obviously lowered our income with me leaving the workforce recently.

Medicare for all wouldn’t just save us money, it would allow small businesses to compete for talent with large ones, and allow would be retirees to open jobs (FIL is not a FIRE person but only works because MIL isn’t 65 yet) a few years earlier.

obstinate

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Re: US mustachians, what percent of your income do you spend on healthcare?
« Reply #81 on: August 16, 2018, 08:33:37 AM »
So what you are saying is that the UK can provide health care coverage for every citizen for 7.7% of GDP but we couldn't possibly for 8.5% of GDP? Because economics work differently in the UK, or the actual medical devices, maybe UK citizens posses different anatomy? I reject the premise that the US magically necessitates higher healthcare costs than every other developed country on the planet, but I'm willing to listen to evidence.
I think there is a very good chance that if we do Medicare for All, our per capita healthcare costs will go down. However, I think a more conservative assumption (the type we should generally use for budgeting purposes, both personally and nationally!) would be that they would stay the same.