Health Care for Everyone

[TheCracker]

Thanks for that. It comes right up to my question and stops though.

And if they're not. Eventually they become a health problem down the line if not replaced. At that point it is a medical need. Are they covered then? So... hypothetical time to make this clear.

- Porn Star gets breast implants to further her career (paid for privately).
- After her career, one implant gets ruptured (or has other complications) requiring it to be removed. At that point it is a health issue resulting in pain or even more serious health complications.
What is covered by the NHS?

If a porn star had implants done to further her career, then i very much doubt it was done on the NHS. But:

If the clinic where you had your implants fitted won't help you because it has closed or is unwilling to do so, you may be able to have your implants removed free of charge on the NHS. ... If you had PIP breast implants originally fitted on the NHS, you may be able to have them removed and replaced by the NHS at no cost.

I believe that your own local GP would end up being the gate master when it comes down to whether your circumstances fulfil the NHS's criteria for doing so.

 

[Danoff]

If a porn star had implants done to further her career, then i very much doubt it was done on the NHS. But:

Ok, so the answer is no then.

That's a bit of a tricky situation - because when your implants are used up, you genuinely need new ones. It's not really an option to just remove them and be done with it. You're left with essentially deformed breasts at that point. The NHS is I guess saying that this was your choice, to deform your breasts. But I'd argue that in some cases a heart attack might be a personal choice as well.

Such a minefield.

 

[mustafur]

Thanks for that. It comes right up to my question and stops though.



And if they're not. Eventually they become a health problem down the line if not replaced. At that point it is a medical need. Are they covered then? So... hypothetical time to make this clear.

- Porn Star gets breast implants to further her career (paid for privately).
- After her career, one implant gets ruptured (or has other complications) requiring it to be removed. At that point it is a health issue resulting in pain or even more serious health complications.
What is covered by the NHS?

Cosmetic Surgery is not covered by Medicare. It is very clear that any surgery not identified as “necessary” or for medical purposes will not be considered. This means anything labeled as being for cosmetic purposes will not be claimable.

However, a practitioner may apply to the Department of Human Services on behalf of a patient for any proposed surgery. They need to identify that surgery is necessary for medical reasons, and may have to provide photos and clinical details to convince the Department that it is essential surgery for the wellbeing of the patient.

https://www.plasticsurgeryhub.com.au/medicare-cover-plastic-surgery/

Under Australias Medicare system, Yes but it needs approval.

 

[Danoff]

Cosmetic Surgery is not covered by Medicare. It is very clear that any surgery not identified as “necessary” or for medical purposes will not be considered. This means anything labeled as being for cosmetic purposes will not be claimable.

However, a practitioner may apply to the Department of Human Services on behalf of a patient for any proposed surgery. They need to identify that surgery is necessary for medical reasons, and may have to provide photos and clinical details to convince the Department that it is essential surgery for the wellbeing of the patient.

https://www.plasticsurgeryhub.com.au/medicare-cover-plastic-surgery/

Under Australias Medicare system, Yes but it needs approval.

Thanks. Here we go, I bolded the important part from your article:

Augmentation Mammoplasty
Breast augmentation for cosmetic purposes only is not covered. However, there are the following exceptions.
(i) Breasts with asymmetry larger than 10% (one breast is 10% larger than the other);
(ii) Breast Ptosis (drooping or sagging breasts) – following pregnancy and lactation (not less than a year or more than 7 years after the end of pregnancy);
(iii) Malformation of breast tissue;
(iv) Disease or trauma of the breast (not caused by previous cosmetic surgery);
(v) Following a mastectomy;
(vi) Nipple or Areola Reconstruction;
(vii) Breast prosthesis (and replacement) – a silicone mould resembling the shape and weight of the breast.
(viii) Breast reduction – this is generally not covered, however your surgeon may apply on your behalf if you have proven physical (medical) and mental issues resulting from your “condition”.

The schedule notes that no breast surgery will be performed purely for cosmetic purposes, or to correct any previous cosmetic surgery.

So you're on your own then. If you screw up your breasts with cosmetic implants, any correction needed later is on your own dime. That's so tricky. A person can really screw themselves with this. Someone who gets implants (like the aforementioned hypothetical porn star) may later find themselves in a lot of pain and appear essentially malformed (as a result of a rupture), and if they don't have the money to pay for it, they must simply live with that pain or go in to medical debt to alleviate pain.

Why is this not applied to smokers who get lung cancer? Or certain heart attack situations? These are again the results of your own choices...

 

[TheCracker]

Ok, so the answer is no then.

That's a bit of a tricky situation - because when your implants are used up, you genuinely need new ones. It's not really an option to just remove them and be done with it. You're left with essentially deformed breasts at that point. The NHS is I guess saying that this was your choice, to deform your breasts. But I'd argue that in some cases a heart attack might be a personal choice as well.

Such a minefield.

On the whole, with exemption to the physical and phycological aspects that i quoted from the NHS's website - because mental health is also treated by the national health service, cosmetic surgery in the UK is paid for by the patient at a private clinic. Much like it is in the US. The eventual replacement or total removal of implants is explained to the patient beforehand and those further costs are for that patient to stump up for again. It is after all another procedure. Unless theres an imminent health risk, in which case the NHS steps in.

 

[Danoff]

Unless theres an imminent health risk, in which case the NHS steps in.

...but only probably to remove the implants. So I guess if the person is in debilitating pain (which is possible from an implant rupture). The NHS might surgically remove the implants. And then you're left with deformed breasts and must pay for the reconstruction in yet another surgery to replace them, when the NHS could have replaced them in the first place.

Does it not seem to you that this is an arbitrary "this was your choice" whereas other areas like lung cancer, diabetes, heart attacks, etc. could also be self-inflicted?

 

[mustafur]

Thanks. Here we go, I bolded the important part from your article:



So you're on your own then. If you screw up your breasts with cosmetic implants, any correction needed later is on your own dime. That's so tricky. A person can really screw themselves with this. Someone who gets implants (like the aforementioned hypothetical porn star) may later find themselves in a lot of pain and appear essentially malformed (as a result of a rupture), and if they don't have the money to pay for it, they must simply live with that pain or go in to medical debt to alleviate pain.

Why is this not applied to smokers who get lung cancer? Or certain heart attack situations? These are again the results of your own choices...

Because 2nd hand smoke exists, and to actually work out who did or didn't smoke can sometimes be impossible, but you can't get a 2nd hand defective Breast job as far as I know of.

 

[Danoff]

Because 2nd hand smoke exists, and to actually work out who did or didn't smoke can sometimes be impossible, but you can't get a 2nd hand defective Breast job as far as I know of.

It's not defective, they don't last forever. A perfect boob job may need replacement in 20 years. If you get one at age 21, you may be getting one at 41, 61, and... then have some tough decisions at 81. They can also last as little as 15 years (or less, obviously, but that can be considered a "success"). So then 21, 36, 51, 66 and more tough decisions at 81 if you were unlucky.

So what if you could? What if you could work out that this person chain-smoked every day for 20 years and had almost certainly caused lung cancer? What if you could be absolutely certain that someone's self-inflicted obesity caused their diabetes?

 

[TheCracker]

...but only probably to remove the implants. So I guess if the person is in debilitating pain (which is possible from an implant rupture). The NHS might surgically remove the implants. And then you're left with deformed breasts and must pay for the reconstruction in yet another surgery to replace them, when the NHS could have replaced them in the first place.

Does it not seem to you that this is an arbitrary "this was your choice" whereas other areas like lung cancer, diabetes, heart attacks, etc. could also be self-inflicted?

Oh, it's a definite moral minefield, that's for sure. But again, it comes down to that initial clause. If the 'free' removal is likely to cause deformities and therefore physiological issues - then that's probably covered on the NHS...

 

[mustafur]

It's not defective, they don't last forever. A perfect boob job may need replacement in 20 years. If you get one at age 21, you may be getting one at 41, 61, and... then have some tough decisions at 81.

So what if you could? What if you could work out that this person chain-smoked every day for 20 years and had almost certainly caused lung cancer? What if you could be absolutely certain that someone's self-inflicted obesity caused their diabetes?

Because they are both different scenarios they are treated differently?

Do court cases treat every crime case the same?

 

[Danoff]

Oh, it's a definite moral minefield, that's for sure. But again, it comes down to that initial clause. If the 'free' removal is likely to cause deformities and therefore physiological issues - then that's probably covered on the NHS...

That seems like a big back door, which the AU website was really trying to shut.

Because they are both different scenarios they are treated differently?

Do court cases treat every crime case the same?

Now you're just disengaging from the conversation.

 

[Scaff]

So what if you could? What if you could work out that this person chain-smoked every day for 20 years and had almost certainly caused lung cancer? What if you could be absolutely certain that someone's self-inflicted obesity caused their diabetes?

A strong argument exists that a means tested system (which this would be a form of) can cost as much to manage as it would potentially save.

Nor is it every clear cut, my wife is Type 1 diabetic (auto immune), yet when she was first undergoing diagnosis she didn't present clearly as either type 1 or 2, which is not uncommon is slow onset diabetes. Its not until the auto immune system has fully stopped the pancreas' ability to produce insulin that it's posable to be sure, which in slow onset can take months or even years.

What if the obese person is eating unheathely due to another condition such as stress or depression, which category do they fall into and do we keep charging them until we know, which would make the underlying condition worse. Resulting in a self defeating means test.

What about drug abuse, its been shown that the most effective treatment is not penal, but medical. That however is again self inflicted (or again is it, what was the underlying cause), yet most in these circumstances would not have insurance or the means to pay themselves.

As such the idea that every cases true root cause could be determined with absolute certainty is simply an impossible target to reach.

 

[Danoff]

A strong argument exists that a means tested system (which this would be a form of) can cost as much to manage as it would potentially save.

Nor is it every clear cut, my wife is Type 1 diabetic (auto immune), yet when she was first undergoing diagnosis she didn't present clearly as either type 1 or 2, which is not uncommon is slow onset diabetes. Its not until the auto immune system has fully stopped the pancreas' ability to produce insulin that it's posable to be sure, which in slow onset can take months or even years.

What if the obese person is eating unheathely due to another condition such as stress or depression, which category do they fall into and do we keep charging them until we know, which would make the underlying condition worse. Resulting in a self defeating means test.

What about drug abuse, its been shown that the most effective treatment is not penal, but medical. That however is again self inflicted (or again is it, what was the underlying cause), yet most in these circumstances would not have insurance or the means to pay themselves.

As such the idea that every cases true root cause could be determined with absolute certainty is simply an impossible target to reach.

Then why are nationalized health systems playing this game with boob jobs? Because honestly, I can make at least as much of a case of medical need or benefit (to improve self-esteem, stave depression, etc.) as any of what you wrote above. And especially so for someone who is facing having to replace essentially used up breast implants 15 or 20 years after they made a decision, for whatever reason, earlier in their lives.

I'm not disagreeing with you, I'm saying that it doesn't solve the issue.

 

[HenrySwanson]

https://www.nuffieldtrust.org.uk/news-item/why-has-the-nhs-not-been-copied-spoiler-it-has

That post lists countries that have "copied" the NHS, then proceeds to introduce caveats for each one..

 

[UKMikey]

That post lists countries that have "copied" the NHS, then proceeds to introduce caveats for each one..

And...?

I'm really failing to see how different countries adapting a health system for different needs makes it worse than the Chinese or US systems or "proves" the NHS is bad. You do realise "copy" doesn't have to mean "exact copy", right?

 

[HenrySwanson]

And...?

I'm really failing to see how different countries adapting a health system for different needs makes it worse than the Chinese or US systems or "proves" the NHS is bad. You do realise "copy" doesn't have to mean "exact copy", right?

And....they aren't really copies. Even a cursory look at each of the countries' health care models on wiki can show that.

Remember my original statement was that if it was so good it would be copied elsewhere - I didn't say it proves the "NHS is bad". Your link doesn't show that any countries copied it.

Just think: we're repeatedly told the NHS is the "envy of the world", yet even in countries that are claimed to have "copied" it, they aren't reflections of the NHS as it is now.

 

[Danoff]

Just think: we're repeatedly told the NHS is the "envy of the world", yet even in countries that are claimed to have "copied" it, they aren't reflections of the NHS as it is now.

If you're trying to show that it is not the "envy of the world", demonstrating that it was not copied verbatim is not showing that. I'm not sure what else you could be trying to show, but I'd recommend just packing this one in. You're not making any real point here.

 

[Scaff]

And....they aren't really copies. Even a cursory look at each of the countries' health care models on wiki can show that.

Remember my original statement was that if it was so good it would be copied elsewhere - I didn't say it proves the "NHS is bad". Your link doesn't show that any countries copied it.

Just think: we're repeatedly told the NHS is the "envy of the world", yet even in countries that are claimed to have "copied" it, they aren't reflections of the NHS as it is now.

You seriously expected an exact, feature by feature match?

Seriously!

https://www.nuffieldtrust.org.uk/news-item/why-has-the-nhs-not-been-copied-spoiler-it-has

 

[PocketZeven]

Just think: we're repeatedly told the NHS is the "envy of the world", yet even in countries that are claimed to have "copied" it, they aren't reflections of the NHS as it is now.

Who is saying that?

 

[UKMikey]

Remember my original statement was that if it was so good it would be copied elsewhere - I didn't say it proves the "NHS is bad".

The opposite of "good" isn't "bad"? Maybe I should've said "not good"...

Your link doesn't show that any countries copied it.

Sure, let's move the goalposts from "nobody has copied it because it's bad not good" to "nobody has made an exact, 1:1 carbon copy therefore it's bad not good".

So much agenda, bro.

 

[Rallywagon]

While I am on the fence about a universal healthcare program, I will say this. Our government wastes, literally wastes more money a year on ******** (literally seen it with my own eyes in the army, millions wasted on vehicles that were never used, at one base alone), and hands out billions to subsidized corporations. If our gov has to money to waste on nothing, then surely it can clean up its act a bit and use that money to help its citizens instead. If we are going to waste money, let's "waste" it on improving lives instead of filling parking spots with tanks or making sure billion dollar business keep making those billion dollar profits.

 

[Danoff]

I'm going to use myself as an example here because it makes it easy to talk details and really explain the issues I want to talk about. I recognize that it will be tempting to try to jump in and make an internet-armchair medical diagnosis, but don't bother, I understand the underlying issues here. So I have a minor issue with my teeth that leads to grinding. Super common I know. I've been chatting with my dentist about it. Here are my options:

Night occlusal guard (currently have, currently hate) - $0 for current one, $700 for new.
File down a tooth, remove some existing (beautiful) dental work, and re-do with more material to adjust bite - $1k
Orthodontics - $3k

*all prices above are after insurance pays their bit

I don't know what happens in a universal healthcare system that covers dental. Perhaps they just say "deal with your occlusal guard". To which I'd respond.... it keeps me awake, I hate it, and it gives me headaches. I suppose I'd just keep getting them replaced until I gave up? I've gone through 4. For the last one I stopped paying the dentist and did online ($150) and it worked out best - but still not quite good enough. But in a universal system do they even present options? Or do they just not even tell you the stuff that's not covered. I assume that ortho for this kind of issue would be a no-go for a universal system. I'm not dying after all, so why spend $3k on me when other people have more pressing needs.

I really don't want to go through re-doing the dental work that would need to be redone just to add some material to get a bite adjustment (the re-do is triggered by the file-down). That sounds terrible. Honestly orthodontics sounds like the best option (I'm trying a new occlusal guard first). But I assume I wouldn't even necessarily know about that option in a universal system. I might not even know about the bite adjustment option.

This is one of the big problems with a universal system. Prices can go up an order of magnitude depending on your personal preferences, there is no one-size fits all solution. Occlusal guards are a non-issue for tons of people. They just happen to be a problem area for me - partly because of the need for a bite adjustment actually, which ironically is what causes the grinding.

I love that I know my choices. I love that I have choices. I can decide what I'm comfortable with, how much procedure and recovery I want to do. But also, in addition to choices, I have prices - which reflect how much cost I'm going to incur with my choices, so that I can properly weigh what it's really worth to me to move between those choices. Only I can do that. I don't want anyone telling me that it's not worth ortho in this situation, that's my call.

It's helpful if you can still get private insurance in a nationalized system, and can still opt for an outside-the-public-system procedure (such as ortho above). But I'm still concerned that some folks will get railroaded into a solution that doesn't work as well for them because it's cheaper, never knowing that there was a right way to do it.

If you have a nationalized system, and ban private coverage, then you can say "no, you must deal with occlusal guard, end of story". And then the final procedure costs $700 (not my $150 online solution), and you can declare that you have saved money and reduced the overall cost of healthcare in the US. Because I didn't spend $3k on ortho. In exchange, I get to be a little bit more miserable - but the stats look better!

Also, I don't need any of the above. I could just ignore the issue, deal with a small amount of pain, and wait until I need tooth restoration.

So this is one of my big concerns with a national system. Understanding the options, and being able to make a personal decision, accounting for the difference in cost, to come to the right medical solution.

While I am on the fence about a universal healthcare program, I will say this. Our government wastes, literally wastes more money a year on ******** (literally seen it with my own eyes in the army, millions wasted on vehicles that were never used, at one base alone), and hands out billions to subsidized corporations. If our gov has to money to waste on nothing, then surely it can clean up its act a bit and use that money to help its citizens instead. If we are going to waste money, let's "waste" it on improving lives instead of filling parking spots with tanks or making sure billion dollar business keep making those billion dollar profits.

This is just more room to waste. The government isn't going to stop wasting in one area so that it can do something else. It's just going to waste more.

 

[Rallywagon]

I'm going to use myself as an example here because it makes it easy to talk details and really explain the issues I want to talk about. I recognize that it will be tempting to try to jump in and make an internet-armchair medical diagnosis, but don't bother, I understand the underlying issues here. So I have a minor issue with my teeth that leads to grinding. Super common I know. I've been chatting with my dentist about it. Here are my options:

Night occlusal guard (currently have, currently hate) - $0 for current one, $700 for new.
File down a tooth, remove some existing (beautiful) dental work, and re-do with more material to adjust bite - $1k
Orthodontics - $3k

*all prices above are after insurance pays their bit

I don't know what happens in a universal healthcare system that covers dental. Perhaps they just say "deal with your occlusal guard". To which I'd respond.... it keeps me awake, I hate it, and it gives me headaches. I suppose I'd just keep getting them replaced until I gave up? I've gone through 4. For the last one I stopped paying the dentist and did online ($150) and it worked out best - but still not quite good enough. But in a universal system do they even present options? Or do they just not even tell you the stuff that's not covered. I assume that ortho for this kind of issue would be a no-go for a universal system. I'm not dying after all, so why spend $3k on me when other people have more pressing needs.

I really don't want to go through re-doing the dental work that would need to be redone just to add some material to get a bite adjustment (the re-do is triggered by the file-down). That sounds terrible. Honestly orthodontics sounds like the best option (I'm trying a new occlusal guard first). But I assume I wouldn't even necessarily know about that option in a universal system. I might not even know about the bite adjustment option.

This is one of the big problems with a universal system. Prices can go up an order of magnitude depending on your personal preferences, there is no one-size fits all solution. Occlusal guards are a non-issue for tons of people. They just happen to be a problem area for me - partly because of the need for a bite adjustment actually, which ironically is what causes the grinding.

I love that I know my choices. I love that I have choices. I can decide what I'm comfortable with, how much procedure and recovery I want to do. But also, in addition to choices, I have prices - which reflect how much cost I'm going to incur with my choices, so that I can properly weigh what it's really worth to me to move between those choices. Only I can do that. I don't want anyone telling me that it's not worth ortho in this situation, that's my call.

It's helpful if you can still get private insurance in a nationalized system, and can still opt for an outside-the-public-system procedure (such as ortho above). But I'm still concerned that some folks will get railroaded into a solution that doesn't work as well for them because it's cheaper, never knowing that there was a right way to do it.

If you have a nationalized system, and ban private coverage, then you can say "no, you must deal with occlusal guard, end of story". And then the final procedure costs $700 (not my $150 online solution), and you can declare that you have saved money and reduced the overall cost of healthcare in the US. Because I didn't spend $3k on ortho. In exchange, I get to be a little bit more miserable - but the stats look better!

Also, I don't need any of the above. I could just ignore the issue, deal with a small amount of pain, and wait until I need tooth restoration.

So this is one of my big concerns with a national system. Understanding the options, and being able to make a personal decision, accounting for the difference in cost, to come to the right medical solution.

So, dont do it because of the fear of the unknown? Doesnt seem like a productive approach to things.

This is just more room to waste. The government isn't going to stop wasting in one area so that it can do something else. It's just going to waste more.

Seems like you've come to embrace a defeatist sort of attitude in this post.

 

[Danoff]

So, dont do it because of the fear of the unknown? Doesnt seem like a productive approach to things.

It's not entirely unknown to me. I don't pull those problem areas out of a hat.

Seems like you've come to embrace a defeatist sort of attitude in this post.

It is the nature of government.

 

[TJ13]

So if Bernie Sanders gets elected and have universal health care and minimum wage to 15$/hr
These are some numbers.

15$ x 40 week = $600
600$ x 52 weeks = $31,200

Would raise taxes to 52% on anyone that makes over 29,000/yr

52% of 31,200 = 16,224 in tax
31,200 - 16,224 = 14,976 pay.
14,976 / 52 weeks = 288 per week.
288 / 40 hr = 7.20/hr.

So while minimum wage would go up to 15/hr you'll be making only 7.20/hr in reality.

 

[Danoff]

So if Bernie Sanders gets elected and have universal health care and minimum wage to 15$/hr
These are some numbers.

15$ x 40 week = $600
600$ x 52 weeks = $31,200

Would raise taxes to 52% on anyone that makes over 29,000/yr

52% of 31,200 = 16,224 in tax
31,200 - 16,224 = 14,976 pay.
14,976 / 52 weeks = 288 per week.
288 / 40 hr = 7.20/hr.

So while minimum wage would go up to 15/hr you'll be making only 7.20/hr in reality.

No, the "bracket" is usually applied only to the amount over the threshold. So in this case the 52% gets applied to everything over 29,000.

 

[Famine]

Would raise taxes to 52% on anyone that makes over 29,000/yr

52% of 31,200 = 16,224 in tax
31,200 - 16,224 = 14,976 pay.
14,976 / 52 weeks = 288 per week.
288 / 40 hr = 7.20/hr.

So while minimum wage would go up to 15/hr you'll be making only 7.20/hr in reality.

On anything over $29,000/y. So that'd be 52% of $2,200 - or $1,144.

 

[MatskiMonk]

So this is one of my big concerns with a national system. Understanding the options, and being able to make a personal decision, accounting for the difference in cost, to come to the right medical solution.

In the UK the NHS has three cost bands for dental, but it's only for work clinically required. If you want cosmetic work there's plenty of dentists that will undertake the work on a private, paid basis. In practice, in your position, the process here would be to pay for a consultation at your NHS dentist (£22.70), have some work done there if it's clinical (£62.10 / £269.30) usually a waiting list, or take their report to a private clinic and pay them to do whatever work you feel you want between the NHS dentists report and the Private clinics advice - prices for this can easily be thousands.

https://www.nhs.uk/common-health-qu...t-is-included-in-each-nhs-dental-band-charge/

Essentially we have options, with the more common clinically required ones being subsidisied by the NHS.

 

[Danoff]

In the UK the NHS has three cost bands for dental, but it's only for work clinically required. If you want cosmetic work there's plenty of dentists that will undertake the work on a private, paid basis. In practice, in your position, the process here would be to pay for a consultation at your NHS dentist (£22.70), have some work done there if it's clinical (£62.10 / £269.30) usually a waiting list, or take their report to a private clinic and pay them to do whatever work you feel you want between the NHS dentists report and the Private clinics advice - prices for this can easily be thousands.

https://www.nhs.uk/common-health-qu...t-is-included-in-each-nhs-dental-band-charge/

Essentially we have options, with the more common clinically required ones being subsidisied by the NHS.

So how do you get that information though? Before I knew my options, I had to get impression of my teeth, and a mockup of my jaw was used to figure out how to adjust my bite. After all that work, I finally knew what my options were. I'm guessing the NHS doesn't just shell out hundreds of dollars for this kind of investigative work on a whim. And if it's known ahead of time that the option is not going to be covered (like ortho), do they even talk to you about it? Or you just have to know that ortho might work for you, and go investigate that on your own.

 

[Scaff]

So if Bernie Sanders gets elected and have universal health care and minimum wage to 15$/hr
These are some numbers.

15$ x 40 week = $600
600$ x 52 weeks = $31,200

Would raise taxes to 52% on anyone that makes over 29,000/yr

52% of 31,200 = 16,224 in tax
31,200 - 16,224 = 14,976 pay.
14,976 / 52 weeks = 288 per week.
288 / 40 hr = 7.20/hr.

So while minimum wage would go up to 15/hr you'll be making only 7.20/hr in reality.

Nice copypasta of a meme that's false.

https://www.snopes.com/fact-check/sanders-tax-plan-52-percent/

"Does Sanders’ Medicare for All plan raise taxes to 52% on incomes over $29,000?
In short, no. One proposal offered by Sanders would raise the tax rate to 52% on earnings over $10 million. Sanders also proposed that the first $29,000 of a person’s income would be exempt from taxes, and a 4% income-based premium would be applied to earnings over $29,000.

The meme asserts that Sanders made this claim “at the debate last night.” As this meme started circulating in mid-February 2020, we’ll assume that timing refers to the Democratic presidential debate held in Las Vegas on Feb. 17, 2020. Although Sanders did say that he wanted to raise the minimum wage to $15 during that debate, he did not say that he would pay for his health care plan by raising “taxes to 52% on anybody making over $29,000 a year.”