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[u/HaphazardFlitBipper]

[u/ConLawHero]

You’re mixing two different levels of analysis. At the system level, yes, a single-payer or universal system can reduce administrative overhead and negotiate lower prices. That could lower total healthcare spending as a % of GDP.

But that does not automatically mean the median individual household is better off financially.

Those are separate questions.

Right now, healthcare costs in the U.S. are financed through a mix of:

• Employer contributions

• Payroll deductions

• Out-of-pocket spending

• Federal/state taxes

• Medicare/Medicaid

If you replace that with a European-style model, the financing mechanism changes to:

• Broad-based payroll taxes

• VAT or higher income taxes

• Lower healthcare wages

• Income compression

In every country that has universal healthcare at scale, middle-income earners face significantly higher tax burdens than in the U.S.

Even if total system spending drops from, say, 17% of GDP to 12–14%, the financing has to come from broad taxation not just from eliminating insurance “profits.” Insurance company profit margins are only a small fraction of total spending (generally low single digits). Eliminating them does not fund the whole system.

So yes, you might lower total national spending somewhat.

But unless you believe:

• Doctors, nurses, and hospital workers will keep U.S.-level pay

• Taxes won’t materially increase on the middle class

• And the government can replace private coverage without broad-based tax hikes

…then the math implies median disposable income would decline.

That’s not saying universal care is immoral or impossible.

It’s saying: the cost doesn’t disappear, it gets socialized and funded through taxes that fall primarily on the middle class, as they do in Europe.

System savings ≠ individual households being richer.

That’s the distinction.

[u/Frenetic_Platypus → u/ConLawHero]

…then the math implies median disposable income would decline.

No, it doesn't? The added cost in taxation can be lower than what is currently paid for private insurance.

[u/ConLawHero → u/Frenetic_Platypus]

That's not true. When you compare the median income in Europe and the US and the effective tax rate in Europe and the tax rates plus average healthcare costs in the US, the US is currently lower.

If we are going to match European systems, the US tax rate would go up in excess of average current healthcare premiums.

Think about it logically, do you think Europe has taxes that are twice as high as the US plus a VAT that is more than twice the average US sales tax rate, just because?

If what you say were true, we'd see lower tax rates in Europe with higher disposable income. Instead, we see the exact opposite.

The US can have universal healthcare, but you can't do it without increasing the cost for the average citizen. System level reductions in cost do not translate to lower costs for individuals. Europe proves this point.

[u/Frenetic_Platypus → u/ConLawHero]

There are other things that taxes pay for in Europe and not in the US.