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Why we needed health-care reform, in one graph

Insured-OECD-500x433.jpg

That's health-care coverage in every OECD nation -- all 33 of them -- from the ’90s till today. It's really hard to see about 29 of them. That's because they're all clustered at the top, which means pretty much every resident in the country has health-care coverage. We're the big red line in the middle. We're doing better than Chile, Mexico and Turkey, but that's about it. And how often does America pat itself on the back for being number 30?

Graph credit: Aaron Carroll

By Ezra Klein  | October 27, 2010; 2:35 PM ET
Categories:  Charts and Graphs  
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Comments

We are speaking about choices. According to the same OECD we are below the other nations in taxes:

"The United States is among the OECD countries that levy a low tax burden on labour income. Single taxpayers at average earnings, for instance, take home more than 70% of what they cost to their employer (“total labour costs”). The average tax wedge (average income taxes plus employee and employer social security contributions minus cash transfers as a percentage of total labour costs) for all US taxpayers is considerably below the OECD average. The tax wedge for lone parents with 2 children at low earnings and one-earner married couples with 2 children at average earnings is even more than 12 percentage points below the OECD average."

So the situation with healtch care is one part of a complicated story.

Posted by: 54465446 | October 27, 2010 2:50 PM | Report abuse

Very troubling, I guess you misseed cbo's director stating that the most important econmic factor of Obama care will be to drive workers out of the work force.

Posted by: tomkat2 | October 27, 2010 4:33 PM | Report abuse

tomkat2, I did miss that. Where and when did he say that?

As for 54465446's comment, what does that have to do with the health insurance coverage of the 29 OECD countries who are ahead of us?

Posted by: steveh46 | October 27, 2010 5:18 PM | Report abuse

Oh right, all those evil affluent young folks who voluntarily forgo health insurance needed saving.

Posted by: theo2709 | October 27, 2010 5:29 PM | Report abuse

CBO Director Says ObamaCare's “Most Significant Economic” Effect Will Be To ...
Weasel Zippers - ‎7 hours ago‎
... Congressional Budget Office Director Douglas Elmendorf said the most significant economic effect of President Barack Obama's health care reform package ...

Posted by: tomkat2 | October 27, 2010 5:36 PM | Report abuse

(CNSNews.com) – Congressional Budget Office Director Douglas Elmendorf said the most significant economic effect of President Barack Obama’s health care reform package will be to drive people out of the job market.

“For the economy outside the health sector, the most significant impact of the legislation will be through the labor market,”Elmendorf said on Oct. 22. “We estimated that the legislation, on net, will reduce the amount of labor used in the economy by roughly half a percent, primarily by reducing the amount that people choose to work.”

Elmendorf made the remarks at a conference sponsored by the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California.

He explained that people would choose not to work because they could subsist on the generous federal insurance subsidies and Medicaid payments contained in the health care overhaul.

“Some provisions of the legislation will discourage people from working more hours or entering the workforce, and other provisions will encourage them to work more,” he said, adding that “[t]he net reduction in the supply of labor is largely attributable to the substantial expansion of Medicaid and the provision of subsidies through the new insurance exchanges.”

Elmendorf’s analysis of the health care law’s economic impact seems to support House Speaker Nancy Pelosi’s (D-Calif.) seemingly off-the-cuff remark in May when she said that because of the subsidies in the health care bill, people could quit their regular jobs and pursue their artistic dreams because the government would now provide for their health care.

Posted by: tomkat2 | October 27, 2010 5:45 PM | Report abuse

theo2709, what young affluent people forgo health insurance? That is not true. But hey we make up crap as we go along. I get it.

Posted by: bschloemer | October 27, 2010 5:45 PM | Report abuse

steveh46:

How do you think those countries PAY for their health insurance? Higher rates of taxation.

Posted by: 54465446 | October 27, 2010 6:35 PM | Report abuse

"How do you think those countries PAY for their health insurance? Higher rates of taxation."

54465446, your original quote said, ""The United States is among the OECD countries that levy a low tax burden on labour income."

It doesn't say the US has the lowest tax burden. It also doesn't say that the US spends more per capita for health care and a far greater share of its GDP on health care than any other OECD nation (or any other country in the world) all while excluding tens of millions from health insurance rolls.

In other words, you don't show any relation between the two things. The US has higher health costs but not because it has lower taxes.

Posted by: steveh46 | October 27, 2010 8:19 PM | Report abuse

tomkat2 thanks for the cite. It's always better to refer to the primary source which is http://cboblog.cbo.gov/?p=1478

The entire quote is, "We estimated that the legislation, on net, will reduce the amount of labor used in the economy by roughly half a percent, primarily by reducing the amount that people choose to work. That net effect reflects changes in incentives that operate in both directions: Some provisions of the legislation will discourage people from working more hours or entering the workforce, and other provisions will encourage them to work more. Moreover, many people will face the same incentives regarding work as they do under current law. The net reduction in the supply of labor is largely attributable to the substantial expansion of Medicaid and the provision of subsidies through the new insurance exchanges. Other provisions in the legislation will also affect the supply of labor or firms’ demand for certain types of workers, but their impact is likely to be small in the aggregate as well."

It's a tiny change caused as much by people not having to work more to qualify for or afford health insurance.

Posted by: steveh46 | October 27, 2010 8:24 PM | Report abuse

It's a tiny change caused as much by people not having to work more to qualify for or afford health insurance.

Posted by: steveh46
-------------------------------------------
And who knows what sort of people make up the tiny change. Maybe it will mean more moms or dads staying at home to raise their children. But it seems that they will most likely be painted as "entitlement" leeches by Conservatives.

Posted by: ashotinthedark | October 28, 2010 8:51 AM | Report abuse

I won't deny that we need health care reform, but I will state unequivocally that we don't need this type of health care reform. We spend too much on useless procedures, repeat procedures, get average quality for our money. Reform the delivery of care first, then use the savings to expand coverage.

Posted by: Glider21 | October 28, 2010 9:18 AM | Report abuse

steveh:

Nearly all of the countries cited above are single payer government run health care. Where do you think the governments get the money? Through higher rates of taxation of course. This isn't brain surgery. If you want 100% coverage there is a cost involved.

Please don't tell me that you're one of those people who bought the line that the changes in health care would not raise our premiums? Mine are going up about 12% this year, as are most peoples'.

Posted by: 54465446 | October 28, 2010 9:23 AM | Report abuse

"Nearly all of the countries cited above are single payer government run health care. Where do you think the governments get the money?"

54465446 you obviously don't know what you're talking about. Germany isn't a single-payer country, Japan isn't, Denmark isn't, Switzerland isn't, the UK isn't. Really, the only country on the list that I'm sure is single-payer is Canada. If you want to talk about the subject you ought to find out more about how other countries actually run their health care systems.

"Please don't tell me that you're one of those people who bought the line that the changes in health care would not raise our premiums? Mine are going up about 12% this year, as are most peoples'."

What happened to your insurance premiums last year? Went up a lot I'll bet. And the year before that? And the year before that? Been going up for a long time. The reform bill has had few changes take effect so far. If your bill is shooting up, and it probably is, reform has next to nothing to do with it.

Posted by: steveh46 | October 28, 2010 12:05 PM | Report abuse

steve:

You are completely uninformed on your subject. No matter what title they go under, all of the above are government funded plans.

Also you are completely misinfotmed to say nothing of illogical about the rise in premiums. How did you propose health insurance companies were going to add hundreds of thousands or millions of people to their rolls (as they did starting in October) and NOT raise rates substantially?

That was the Dem fantasy. Look at the exchange between Lamar Alexnader and the President at their health care round table or whatever they called it. It's on youtube. Alexander is colorless and non-charismatic, but a very smart guy. He ate the President's lunch on that one.

Posted by: 54465446 | October 28, 2010 1:18 PM | Report abuse

"You are completely uninformed on your subject. No matter what title they go under, all of the above are government funded plans."

54465446, welcome to the real world where facts matter. How many years have you worked on health policy? None I'll bet, compared to my 15+ years.

Here are some facts from various sources: "Japan uses a "social insurance" system in which all citizens are required to have health insurance, either through their work or purchased from a nonprofit, community-based plan. Those who can't afford the premiums receive public assistance. Most health insurance is private; doctors and almost all hospitals are in the private sector."

"Germans are free to buy their insurance from one of more than 200 private, nonprofit "sickness funds."

In the Netherlands "For all regular (short-term) medical treatment, there is a system of obligatory health insurance, with private health insurance companies."

Switzerland has private health insurers that cover their population.

Single payer is the exception in the developed world, not the rule.

Here's a quote from the US insurers trade group: Robert Zirkelbach of the insurance industry trade group America's Health Insurance Plans concedes that, despite what some have claimed, the law isn't the major driver of premium increases for next year. "In fact, the evidence is very clear that the rise in medical costs is a key factor in driving up health insurance premiums," he says."

What else do you want? Millions of new people have not been added to the health insurance rolls yet. The major drivers in premium increases are the same as they have been for decades and all that pre-dates the reform. You're looking for a scapegoat and you don't know what you're talking about.

Posted by: steveh46 | October 28, 2010 2:26 PM | Report abuse

Steve:

As of October, per-existing condition are out and adult children are in. I confess that I do not know the exact numbers, but that they are covered and were not before is indisuptable.

Also, that you cannot add large numbers of members without increasing premiums is also indisputable.

I don't know the gentleman you quote and who he represents. There are various trade grorps, some pro adminstration and some anti. I know that the head of the FEHB and UHN have said the opposite. I have already received my literature in the mail from UNH.

As far as foreign health care the governmnet directly subsidizes those plans, no matter how they list themselves. You pointed out the UK in your earlier post. There is no dispute whatsoever that it as a government funded plan.

Posted by: 54465446 | October 28, 2010 3:07 PM | Report abuse

Steve, you also don't address the fantasies in the budgetary projections

For instance the 21& decrease in premiums to Medicare providers based on the SGR formula has been waived the last 6 times by Congress both R and D. Yet, it is in the CBO estimate of savings in the new legislation. This is the sheerest fantasy and Medicare provider payments will INCREASE, not DECREASE.

Posted by: 54465446 | October 28, 2010 3:46 PM | Report abuse

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