Lionel Shriver Lionel Shriver

The all give and no take of US taxes

Americans who earn anything to speak of get no childcare, healthcare or care in old age

Last week, the New York Times ran a very un-New-York-Times-y article, ‘Resentment Grows Over Who Gets Health Care Aid’. It contrasts two women in New Hampshire. Married with one child at 30, last year Gwen Hurd paid more than $11,000 for her family’s health insurance, purchased through the Affordable Care Act exchange. They had to shell out $6,300 per person — $18,900 — before the insurance kicked in. Both parents were working. Their pre-tax earnings just exceeded the $82,000 cut-off for government insurance subsidies. The couple dropped date night, and couldn’t save for retirement.

A few miles away, single and living at home, an aspiring opera singer of 28 is careful to keep her earnings just below $15,000, so she continues to qualify for Medicaid. Aside from dentistry, all her healthcare is free.

Americans are often horrified by ‘socialised medicine’. Yet between Medicare for the elderly, Medicaid for the poor, SCHIP for children and veterans’ benefits for the military, 42 per cent of the population is covered by the dread ‘socialised medicine’. Another 2.5 per cent buy often massively government-subsidised health insurance through the ACA exchange. The cost of these subsidies for only 7.6 million people has risen to an eye-popping $42.6 billion.

Asset rich but income poor, my brother gets subsidised insurance. To cover himself, his wife and two of his children (the other two qualify for Medicaid), he pays $4,600 per year. But the real annual cost of that insurance is $46,300. (!!!!! How many exclamation marks is that figure good for? Apparently Gwen Hurd bought her policy from the American equivalent of a pound shop.) Who pays the difference? As a US taxpayer, I do. Ms Hurd in New Hampshire does.

‘It seems to me that people who earn nothing and contribute nothing get everything for free,’ Ms Hurd complained to the Times.

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