this post was submitted on 13 Aug 2024
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Hey all, I'm British so I don't really know the ins and outs of the US healthcare system. Apologies for asking what is probably a rather simple question.

So like most of you, I see many posts and gofundmes about people having astronomically high medical bills. Most recently, someone having a $27k bill even after his death.

However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They're just some elaborate dance between insurance companies and hospitals. If you don't have insurance, the cost is lower or removed entirely. Supposedly.

So I'm just asking... How accurate is that? Consider someone without insurance, a minor physical ailment, a neurodivergent mind and no interest in fighting off harassing people for the rest of their life.

How much would such a person expect to pay, out of their own pocket, for things like check ups, x rays, meds, counselling and so on?

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[–] hendrik@palaver.p3x.de 28 points 1 month ago* (last edited 1 month ago) (6 children)

On average they actually spend $12.500 per year (total, PPP adjusted, at leat that's the number for 2022)

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

You as a Brit spend $5.500 (also adjusted) (And as a bonus, at the same time you're also expected to live 2.8 years longer than the average American.)

[–] AcesFullOfKings@feddit.uk 6 points 1 month ago* (last edited 1 month ago) (1 children)

You as a Brit spend $5,500

Eh, on average that may be true. But most people pay far less than that. The NHS's budget is £153bn, and the government raises £950bn in revenue. Of the 950bn, around 25% is from income tax.

So by that logic, the amount of my income tax that goes to the NHS is about 0.25*153/950 = 4.0%. Last year I paid £6644 in income tax, so that's about £265 to the NHS. I'm not counting National Insurance as those contributions are not for the NHS.

VAT is also 15% of government revenue, so if I wildly guess that I bought £10k worth of "stuff" last year then that's £2000 in VAT (@ 20% - it's not all necessarily 20% but to simplify), of which £300 went to the NHS.

So I'm still not even paying £600/year. There are some other small contributions that you could count, but it's not going to make much difference to the final figure. I'm far from rich but I'm more well-off than most people, so the majority of citizens are paying less than me.

What I'm saying is, for most citizens we actually pay relatively little and get huge value out of the NHS. The rich pay proportionally a lot more, which is how it should be.

[–] hendrik@palaver.p3x.de 1 points 1 month ago* (last edited 1 month ago)

The United Kingdom provides public healthcare to all permanent residents, about 58 million people. Healthcare coverage is free at the point of need, and is paid for by general taxation. About 18% of a citizen’s income tax goes towards healthcare, which is about 4.5% of the average citizen’s income. Overall, around 8.4 percent of the UK's gross domestic product is spent on healthcare (an amount of around 0.18984 trillion GBP). UK also has a
growing private healthcare sector that is still much smaller than the public sector.

( http://assets.ce.columbia.edu/pdf/actu/actu-uk.pdf )

So it should be more like £1.200 for you?!

And I think the study I linked is total healthcare expenditure. So it also covers the extra private insurance and the medication you buy that isn't covered at all. I'm not 100% sure.

But yeah, that's how statistics works. For everyone who pays less than the average, there has to be someone who pays more than the average. And I also think it should work with solidarity. Rich people can afford to pay more.

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