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According to "US Workers Are Highly Taxed If You Count Premiums" (2019-04-08):

Finally, we can go back to the OECD NTCP data and compare the US to other developed countries. When we do that, we find that only the Netherlands — with its compulsory private health insurance and compulsory private pension — has a higher labor tax burden by this measure.

Question: Is it true that US workers are relatively highly taxed if we include their health premiums?

closed as primarily opinion-based by Christian, Fizz, Jan Doggen, fredsbend, rjzii Apr 9 at 19:46

Many good questions generate some degree of opinion based on expert experience, but answers to this question will tend to be almost entirely based on opinions, rather than facts, references, or specific expertise. If this question can be reworded to fit the rules in the help center, please edit the question.

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    The article you linked to is far more detailed than any answer here should be, complete with a lot of sources to back it up. What else do you want here? – pipe Apr 9 at 12:23
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    I'm not seeing why you think this is questionable as a fact. It's simple arithmetic and comparing some numbers. The data source (OECD) is as good as it gets for this kind of data. I guess one could argue that the addition is not relevant to policy or some such, but that's not really a suitable topic here (try politics SE). – Fizz Apr 9 at 13:14
  • After looking at the article more closely, I see the OECD doesn't include the premium data for the US, which some fairly obscure technical reasoning, whereas the article you linked does add that from MEPS. I guess you could salvage this question if you asked if it's common or uncommon to add premiums to US taxes for the purpose of comparing with other countries. – Fizz Apr 9 at 15:16
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    Kind of a difficult claim to assess or take at face value. Quality and quantity of care makes for a lot of differences that are hard to control for. Hence, the biggest claim from the other side is that quality and quantity will wane if the US nationalizes healthcare. It's hard to prove that wrong before the fact. – fredsbend Apr 9 at 16:40
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    I actually disagree that this is opinion based. The justification of the analysis is entirely dependent upon the not-at-all-opinion based legal status of ACA mandates. Though I concede that this may not be an appropriate question for Skeptics. – Joe Apr 9 at 20:15
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No, because the underlying assumption behind this analysis is no longer true

The underlying assumption of this article is that private health insurance payments are "Non-Tax Compulsory Payments"

But formal labor taxes are limited because they omit “non-tax compulsory payments” (NTCPs). NTCPs are payments workers and employers are legally compelled to pay to private parties. NTCPs are no different from taxes except that NTCPs are made to private corporations like health insurance companies rather than to the government.

Occasionally the OECD publishes information that combines formal taxes and NTCPs together in order to allow researchers to compare “compulsory payment rates” across countries. The last time they did this was in 2018. The 2018 OECD publication acknowledges that employer health insurance premiums in the United States are NTCPs because they are mandated under Obamacare’s employer and individual mandates.

The mandate under the Affordable Care Act was repealed in 2017 with the passage of a tax reform bill at the end of that year. This repeal took effect as of 2019, and its explicit goal was to make the purchasing of insurance no longer compulsory.

  • Compulsory has nothing to do with whether something is a tax or not. If a bill is passed that raises prices for everyone then that's a tax, regardless of any technical nuances one might want to claim that hides the fact that it's a tax. Politicians have learned that taxes are unpopular so they've gone the route of using regulations or taxing companies to backdoor the tax into place because they know the overwhelming majority of voters are too ignorant to understand the games politicians play. The typical middle-class family pays a minimum of 300% more than prior to ACA. That's a tax. – Dunk Apr 15 at 21:28
  • @Dunk That’s not how the argument of the source in the question is premised. – Joe Apr 15 at 22:02

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