Yes, especially for small outfits like yourself, the current system really discourages growth. Ten years ago I considered starting my own business, and after I inquired about the cost of healthcare, I immediately changed my mind. And I’m sure the price has only gone up in the meanwhile.

But who ultimately pays? The taxpayer pays, naturally. But if universal health care becomes a reality in the US, it won’t be a huge shock because the US taxpayer is already paying for healthcare, just in a weird and unfair way.

They’re paying because salaries are lower than they would be if employers weren’t expected to provide healthcare. They’re paying because medical insurance companies keep about 40 cents out of every dollar. They’re paying because uninsured people get emergency care in the ER and the hospitals make up for that by raising prices for paying customers. They’re paying because every time medical bills force a family into bankruptcy, that family’s dept is transferred back to their lenders, who then try and make up for it by leaning on their paying borrowers and, if that doesn’t work, with tax-payer bailouts designed to keep those lenders afloat.

Taxes will have to go up — there’s no way to magically avoid that. They’ll have to go up even without universal healthcare. (We have a huge population of baby-boomers hitting old age and an infrastructure that hasn’t gotten and update for decades. Not to mention two wars to pay for.)

But the Danish car tax will never happen in the US. Denmark is a tiny country with a great mass transit system, and a biking culture that is supported both in terms of culture and infrastructure. Denmark imposes very heavy taxes on cars in order to actively discourage people from buying cars. The idea is to keep popution and congestion down. (The tax is effectively about 200%, and the saying is ‘buy a car for yourself and buy two for the government’. And still, millions of Danes buy cars.)

Nor can the rest of the Danish tax code be easily compared to the US. On top of the car tax, the top income tax rate is 60%, and there’s a 25% sales tax across the board. But in exchange for that Danes have medical care paid for, are never in danger of starving or even being homeless, get paid to go to college, and get a year of maternity leave. Plus Denmark has a thriving economy.

I’m not saying Denmark is a utopia — there’s no such thing. Just that high taxes don’t not necessarily mean economic stagnation, and they provide some significant advantages.

Your analysis sounds alluring and I agree with some of it.

You say: “Better yet, if you want to quit your day job to launch a startup with a great idea you have, you can, and again it makes no difference in terms of health coverage. If you want to hire employees to help you with your idea, you can, and you don’t have to pay a dime for medical plans.”

That would work great for me and my business. But who ultimately pays?

In a conversation with you a few years ago you told me that the tax rate is so high that purchasing a new car amounts to purchasing 2 cars. One car for you and another for the government. That’s a bitter pill to swallow when you’re making a middle class salary.