# Health Insurance is a Racket
By Paul Krugman
Published: December 18, 2024 | [**Krugman wonks out**](https://paulkrugman.substack.com/p/health-insurance-is-a-racket)
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This is a pretty short article (which might be the nature of his Substack posts given his posting frequency), but there were a few bits of information in here that I felt were worth remembering. Additionally, there are several graphics he shows us that represent critical information for understanding the larger picture of health insurance in America.
**Here are some important takeaways:**
- Employer's provide almost *half* the healthcare coverage (48.6%)
- While private insurers account for 29% of payments by insurers, ***a significant part of that effectively comes from the taxpayers*** (*what in the fuck?!*)
- This is because employer-sponsored care premiums are exempt from income and payroll taxes due to their status as a "**tax expenditure**", which is a "defacto subsidy" to the tune around ***$300-fucking-billion-dollars*** ([TaxPolicyCenter.org](https://taxpolicycenter.org/briefing-book/how-does-tax-exclusion-employer-sponsored-health-insurance-work))
- Additionally, those who get plans through the ACA exchanges receive some subsidies as well, which total up to around **$90 billion**
So, what does this really mean? In actuality, it means that **taxpayers pay around 80 percent of health insurance in the United States**. We have a system where we bear the brunt of healthcare costs but, for whatever dumbass reason, the money is mostly paid through insurance companies.
>"*So you could make the case at this point private health insurance is, in large part, a parasitical racket*." - Paul Krugman
Despite this setup, most adult Americans give their insurance coverage a positive rating. This makes it incredibly difficult to get any sort of massive reform passed to fix this system. The messaging gets warped by [[The Trump Party]] into, "*we are going to take away the coverage you like and you just have to trust us that the replacement we provide will be better*." See why Obamacare was such a big deal and why Clinton's attempts were essentially *disasters*?
# Images
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