Right I think a lot of upper income Americans don't understand how it compares globally.
Seeing what my UK colleagues deal with, a $200K income would land you solidly in the 40% marginal tax bracket over there, vs (if married) .. 22% here. US federal effective tax rate (before getting into deductions) would be like 17% on that 200k, for a $166k take home.. versus equivalent UK take-home would be as low as $123k (again not getting into deductions).
So UK similar income has $43k more in taxes.. to get you NHS? Doesn't seem like a great trade if in the US you have options starting from $14k?
> So UK similar income has $43k more in taxes.. to get you NHS?
Well, and all the other services those taxes provide.
They wind up spending a lot less on healthcare. https://commons.wikimedia.org/wiki/File:OECD_health_expendit...
They spend less because their nurses make poverty wages compared to the U.S. My sister in law is studying to be a nurse. Starting pay is around $70,000 here. In the UK it’s like $42,000. She could make that much being a nanny around here.
https://www.commonwealthfund.org/publications/issue-briefs/2...
> OECD Health Statistics data show U.S. registered nurses (RNs) earn 1.5 times the OECD12 average salary. These data are adjusted for purchasing power parity. Using numbers of RNs in the U.S. from the Bureau of Labor Statistics,22 we computed total RN earnings using average U.S. pay and OECD12 average pay. The difference was $79 billion, or about 2 percent of 2021 NHE, representing approximately 5 percent of excess U.S. spending when rounded to the nearest multiple of five.
It's not nothing, but it's hardly the only reason, or even a particularly big one.
That's not the actual tax burden in the US, though. Because we also have sales tax, property tax, state income tax, and various required fees.
Effective tax rates are not that easy to compare.
In fact, the portion of a US health insurance premiums IS a tax, based on your age! Not to mention the myriad ways tax policy (including the age rating factors that cause young people to pay a tax via their health insurance premium) vary among not only the 50 states, but the smaller jurisdictions within the states.
https://news.ycombinator.com/item?id=45800973
https://www.healthcare.gov/how-plans-set-your-premiums/
Sure. But if you make the calculation that granular, you also need to include employer-paid health insurance on the compensation side of the ledger. More than half of Americans have employer-paid health insurance, and employers contribute on average $17,000 per employee: https://www.business.com/articles/health-insurance-costs-thi...
Of course, that is why US employees should be able to have access to benefit costs in terms of dollars to be able to compare total compensation. Currently, that is usually only available after the end of a calendar year on form W-2 (box 12 code DD for health insurance premiums).
Technically, you have to get even more granular. If your employer subsidizes health insurance premiums, then you pay for health insurance with pre tax income. If your employer does not, then you have to buy with post tax income. The difference is thousands of dollars per year.
You even avoid FICA if you can max out your HSA via payroll withholdings, a decision solely made by your employer.
It’s actually amazing how many ways the US governments has come up with to screw young people and small businesses.