If you wrote down single payer on a napkin, it would look something like this…
Total medical expenses for entire US in 2015 landed near $3.2 trillion. Total population estimates at 2015 were 320 million. Therefore in 2015 we averaged $10,000 per person for medical expenses....
(There are nuances within those totals.)
Therefore if we want health care quality to remain exactly the same from a consumer's point of view, under single payer we would need $3 trillion yearly to pay as we go....
In 2015, total wages were around $14 trillion... Making health care 3/14 of our total intake or around 21%....
If we taxed ourselves this 21%, we could have single payer . Health-care profits continue and doctors see no loss in income.
Does that seems high? 21%? If you are making $10 an hour, then $2 every hour goes to your health. Meaning you would be really working for $8, as far what you would see as putting money in your pocket.
That can be alleviated somewhat through progressive tax structures which tax only that amount of money not needed for a minimal comfortable standard of living.
Which means a hedge fund manager making $40 billion a year is putting $8 billion into the health care pool and covering the expenses of ($8 billion / $10,000 per person) 800,000 of his fellow citizens. Since far more than that are being gouged out of them for his excessive income, that is only fair, right?
It also means that $15 dollars an hour will now becomes necessary as the new standard for minimum wage. The “non-healthy” (pun) take from an hour of work would then be $12.. which is tight but better than making $8 with no free health benefit now that Medicaid is disappearing.
Furthermore,under this new plan, that Medicare payroll deduction can disappear. After all that is covered now under this $10,000 a year costed-out by single payer insurance for EVERY AMERICAN. Therefore that gain in your tax withholding could be limited (combined between employer and employee) to an 18% increase instead of 21%.
This brings up anew whether we should continue to share that cost between employee and employer. Isn't it better to pay the employee much more and then deduct their entire amount, instead of hiding from the employee of how much they actually cost their company by to quietly paying half or part of the insurance premium?... to not include it in employee's salary and wages?
I argue for honesty. Pay the higher wage; let the employee also pay their full cost so all are aware how much we actually get paid and how much we actually get out of our insurance. To those who will tell us they shouldn't be paying for anyone else's health-care, we can reply. "it's your mum and dad you are paying for".
However, to be fair (and to make this number work), this tax should be on all incomes, not just wages from ones employer. This includes capital gains and investment income all being taxed at the same percent.
Another quality option if we ever get a progressive super majority in Congress, would be to tax all corporate income to cover health insurance as well. Looking down the road to a future of full automation and robotic workforce, putting these policies in effect now would be brilliant.
Corporate profits currently fluctuate between $1.4 trillion and $1.6 trillion per quarter or average out to roughly $6 trillion a year.
Taking a "healthy" cut off the top (21%) of corporate profits would garner another $1.2 trillion which, if added to the mix, now gives us a surplus of money taken in over the $3.2 trillion we currently use. We could use that either as bank for the future, a rainy day fund, or to pay down our salaried cost which if done would drop our overall taxed contribution for health from $3.2 trillion down to $2 trillion, (or 2/14 of our total wages instead of 3/14th.)… This would hit us at a deduction rate of 15% instead of 21%... (or 13% instead of 18% with Medicare gone)...
Coupled with the 12.4% Social Security per employee tax, we would be investing roughly 25% - 28% to entitlements of what our company pays us, in order to live comfortably to a ripe old age....
This would require wage inflation to do this, but still even at that, it is very doable. And those nuances I causally disregarded above? Well they all apply downward efficiencies to lower the cost per person if we chose to go that way.. Meaning if we can afford to pay for the top line, we can certainly afford to pay for the average or cost-saving line as well.
The only thing stopping us is the clout of 140,000 individuals who have enough money to buy Congress 10 times over. But keep in mind, they only have 140,000 individual votes spread across all 50 states, so if we can properly message this to every American,.... what this means, how much this costs, how much it benefits them, it can almost be implemented with no harm to anyone ....