Taxes, Healthcare and the American Way

Posted November 17, 2009 on 3:49 pm | In the category Europe, Germany, Healthcare | by Jeff

Living in Europe provided a particular view of the relationship between taxes and quality of life, both of which are higher in most European countries than they are in the United States. While Americans are always attracted to lower taxes they do not always seem to understand the relationship between what they pay in taxes and what they get – or don’t get – in services. The trade-offs became obvious to me during three years in Munich in which I paid higher taxes than I would have in the U.S. and enjoyed benefits mostly unknown in the U.S.

The healthcare reform debate currently deadening many American’s brains is a case in point. Talk to almost anyone in Germany about their healthcare and they wonder what the hell is going on in America. The figures are well known – we pay TWICE as much, per capita, for slightly worse outcomes when measured in terms of life expectancy, infant mortality, percent of those covered, etc. And, in Germany you would never worry about having your insurance cancelled for any reason. The payment for health insurance – which is mandatory and therefore covers everyone – is through a combination of taxation based on salary and employer contributions. Health insurance is viewed as a social contract among the German people unlike the U.S. where someone can opt out even though they fully expect expensive care when they need it – a kind of anti-social contract.

Taxes in Germany also pay for an excellent education system, roads and bridge maintenance that is unknown in the U.S., welfare nets that eliminate the worst consequences of poverty, and a healthy life style that includes six week vacations for most workers, generous medical leave policies, trains that run fast AND on time, airports that treat people as though they were human, and a food supply network that ensures healthy and fresh food.

While it may be hard for many Americans to understand just how bad they have it, what is worse is their unwillingness to consider alternatives; their belief that America is best in everything. Many Americans who complain about taxes focus on Reagan’s largely mythological welfare mothers or the current Republicans’ concern over costs of possible health care reform. In addition to the huge costs resulting from our lack of focus on preventive medical measures, Americans also typically ignore the overwhelming costs of our care and feeding of our military and military contractors, and the cost of misadventures like the Iraq War, both of which become exercises in jingoism which we willingly fund while much of American society seems to be crumbling.

The American press is of course part of the problem but at the end of the day the blame is ours for being too lazy to pursue the ramifications of our knee-jerk negative reaction to any suggestion that our taxes be raised..



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  1. How right you are, Jeff! Having lived in the most enlightened of European countries, I continue to be stunned anew by the knee-jerk terror that the prospect of higher taxes prompts in so many Americans. A segment on The Daily Show (last spring sometime) in which they sent a reporter to Sweden for a number of interviews shows just how happy the Swedes are to exchange a few tax kronor for top-notch universal health care. But here we can always count on Republican fear-mongering. Sigh…..

    Comment by Marilyn — November 27, 2009 #

  2. That the debate began only after Obama conceded that single payer health care would not be on the table is an indication of the fear and ignorance of the people on this subject – as well as an indication of the strength of our health insurance industry. The health care systems in Europe that are providing a level of medical care that we can only dream about are based on single payer or, at a minimum, a tightly regulated insurance industry. In any case, the discussion in Congress drags on – only to be decided by very highly respected congressmen and senators such as Say-It-Ain’t-So-Joe Lieberman.

    Comment by John — December 2, 2009 #

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