Many of us, if not all – have seen this little post floating around the interwebs, especially after the Bern-dog decided he wanted to run for POTUS again.

And let me tell you – it makes me crazy! And probably not for the reason you think (pump the brakes Repubs!)

First of all – I am 100% for the fact that we HAVE to solve the ability to pay for/cost of healthcare in the US AND that it can/should come in the form of federal implementation and will NOT be met by the private sector – especially with the influence of insurers on the policy of our country. People on the right think there is competition in health insurance leading to maintaining/controlling the “low” cost – which is laughable. In the US, we have expensive, middle-of-the-road care (#37 according to the WHO) and we are the leaders in the clubhouse when it comes to diseases that are preventable through lifestyle choices.

Not exactly hitting it out of the park. 

(With that said, we also lead the world in medical research, have more effective, available and timely specialty treatment and have a vibrant experimental drug culture for chronic and deadly ailments. Those are all things that exist here because of our current system that does not exist at the same rate in other countries)

What’s the point, Greg? That you like to type in run-on sentences?

The point is: I absolutely hate that this little post/bullshit is floating around and people are pumped about it because it supports the narrative that healthcare should be “free” or darn near it.

Let me say this – the Scots have a pretty darn decent solution for healthcare in their country with a 100% “free at the point of use” approach and a regionalized approach to care management (meaning that different regions of the country can tailor their spending/administration to the needs of that community). That’s super cool – especially the regional model of management, I dig it.

What’s wrong with this post about the aforementioned Scottish universal healthcare is that it is actually 33% (!!) of the income tax that is spent on healthcare. As per this fancy chart developed by the Scottish gov’ment themselves:

Secondly, your income tax is a percentage of income, not a flat fee (which makes this whole thing a hoodwink). Using the math of this Scottish gentleman (albeit obviously inaccurate), he’d pay about $325 a month in taxes – which means he has an income of approximately $34,900 (we’re going with that – even if his math is fuzzy).

So just a quick review of this particular dude (I am assuming it’s a dude, age 32, non-smoker and not pregnant in these examples):

In the US:

• He’d get $144/month in premium assistance from the gov’t
• He could select a plan with as low a premium as $156/month (after the assistance)
• That plan has a $6,750 deductible.
• In a terrible health year for him – he could spend $8,622 on healthcare in the US!
  • This represents about 25% of his gross income
• In a great health year for him – he could spend as little as $2,300
  • Assumes he only needs preventative care + a couple of simple illnesses and prescriptions
  • This represents about 7% of his income

In Scotland (using the actual math published by the Scottish gov’t, not the fake math):

• He would pay about $3,900 in total income tax
• He would pay about $1,320 in income tax for healthcare – no matter his medical need.
  • This represents about 4% of his income

The point is that Scotland’s healthcare system is obviously better than the US from an individual financial perspective – but also to note that margin is not quite as wide as the post would have you think ($13/month vs $110/month).

None of that really matters – because what matters is that we tackle this healthcare issue with the broader country and our future in mind. The power in a post like this (for those making it) is that people translate Universal Healthcare to “this will make healthcare cheap/free for ME“ when that is not necessarily the case and it certainly shouldn’t be the way in which we make policy decisions — but it sure does strike a cord and drive ‘shares’.

In the Scottish (albeit very basic math) tax setup today, if I did the same math this guy did (only I used the correct percentage of 33%) – my family healthcare cost for 2019 would be nearly $10,000 more in Scotland and that includes the fact that we’re pretty Dr. crazy AND we’re having a baby!

For the sake of clarity – Let’s do the same exercise we did above, but this time we can look at a 32-year old making an upper-middle-class wage of $75,000/year.

In the US:

• He would NOT be eligible for any premium assistance
• He could select a plan with as low a premium as $299/month
• That plan has a $6,750 deductible.
• In a terrible health year for him – he could spend $10,338 on healthcare in the US!
  • This represents about 14% of his gross income
• In a great health year for him – he could spend as little as $4,000
  • Assumes he only needs preventative care + a couple of simple illnesses and prescriptions
  • This represents about 5% of his income

In Scotland (using the actual math published by the Scottish gov’t):

• He would pay about $16,000 in total income tax
• He would pay about $5,280 in income tax for healthcare
  • This represents about 7% of his income

The point is – it’s not free. The scary about this for me is that I fear that we’ll end up with a voting public that is completely misinformed.

The narrative is going to be – “FREE UNIVERSAL HEALTHCARE FOR ALL!” vs. “OBAMACARE CAUSED MY PREMIUMS TO GO UP – WE NEED LESS REGULATION AND MORE COMPETITION!”

Neither of which solves for the issue that was made clear in this small (OK, not small at all) blog post – the math shows you that we have a major issue in the US today when it comes to the cost burden that we’re placing on those Americans making less than the US median income. The fact that a healthy 32-year-old male can spend 25% of their GROSS income on healthcare is an issue that needs to be solved holistically. The notion that the gov’t will act like Oprah and give out healthcare does nothing to get us closer (You get healthcare and you get healthcare!)

We HAVE to solve this and do it very soon – but junk like this floating around can only hurt our chances of coming up with a plan that has a long-term positive effect on our country. This post only serves to incite anger at those that disagree with you and react with fire and fury to anyone who would go against it.

And FWIW, that sort of thing makes up 99% of what is out there today and what gets shared all over social media – It’s either fear the worst of the worst (criminals are coming across the southern border in record numbers!) or creating FOMO of some utopia (All the other Western countries have it better than us – we’re missing out!).

It’s always black or white, never grey. Liberal or Conservative, never America.

All this – to make you do one of two things: Get mad about what you’ve been told and make a snap judgment/angry comment or feel coddled in your opinion because you can now say “See! I told you I was right all along! I know more than you!”

Anyway – one more thing on the list of things that make me wonder what the future really looks like.

See ya.

G