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Old 07-26-2023, 09:58 AM   #13701
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I don't know how common that refrain actually is...far more common to me seems to be "throwing more money at it won't fix it".

Which is backed up by the notion that we are spending more than ever, which may or may not be true depending on how you factor inflation and/or population growth, but it definitely does not consider what healthcare actually looks like and how it is used compared to past decades (when medicine was pretty much just for old people are pregnant women)

The options are in fact:
- throw money at it
- reduce breadth and depth of service (which is effectively what we do with long wait times)
I’m in the reform the system and throw more money at it camp. I’m also in what I would imagine is a small minority of voters would be okay with increasing the GST to 10 per cent and introducing a 5 per cent PST to pay for it.

I believe Canadian voters have demonstrated that they’re unwilling to be taxed at the rates required to fund the increasing demands of public health care. What I don’t believe is that the capacity crisis is due to governments with sinister agendas deliberately starving the public system.
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Old 07-26-2023, 09:59 AM   #13702
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I've heard that doctors are notorious for getting scammed/hosed by shady investment advisors more than one would would expect given their much higher intelligence. Usually just don't have the time to check stuff out. Not sure if that is horsecrap though.

Mind you, a guy I graduated engineering with went back to school to become a Doc/Radiologist in Edmonton, last I talked to him he had like seven houses and was doing really well, I imagine he's added a few more on the list (not that owning houses is 100% successful). Smart as fata fellow.
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It's possibly that, but some doctors have told me that they're just plain busy and terrible with money. I don't think that's peculiar to their profession though because a lot of professionals would fall into that category.
In my experience, doctors and dentists are some of the worst "businesspeople" out there. They love the fancy stuff, bougie clinics, etc. Though their earning potential is high, they tend to take on alot of liability with very little upside attached to it.
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Old 07-26-2023, 09:59 AM   #13703
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And I can confirm that alot of my lawyer colleagues aren't much better, albeit a bit more risk adverse.
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Old 07-26-2023, 10:11 AM   #13704
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The issue is that Alberta Health Care payments have not increased much in a decade. For myself I have seen about a 3% increase over the past 8 years, which is a far cry from inflation. Ballooning Real Estate costs, higher staff costs and a need to keep up with high end equipment makes it really hard to rely on Health Care alone to pay for your costs. There is a reason all your family docs are joining into groups like the Primary Care Network.

Luckily, In my profession Alberta Health Care only makes up 20% of revenue with the rest coming from private insurance and product purchases. I can also balance bill over and above health care. Which, unfortunately is necessary to ensure we can pay for equipment that meets the current Standards of Care.

Family Medicine does not have very many avenues to bill over and above what Health Care will pay. If you do not want to see things shift to a two-tier system then you need lobby the government to increase health care payouts or have them matched to inflation.

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Old 07-26-2023, 10:47 AM   #13705
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I believe it's common for most people, especially the highly skilled and super busy types, that they tend to do whatever necessary to improve their skill level to earn as much money as possible, then do very little to adequately invest the money they make. The least they should do for themselves is read "The Wealthy Barber". And incidentally there is a modern up to date version call "The Wealthy Barber Returns". Granted it's no substitute for a top-notch wealth advisor.

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Old 07-26-2023, 11:07 AM   #13706
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I’d be curious to hear opendoor’s suggestions for increasing resources. What’s the political path to Canada reaching substantially higher levels of public health spending? We could follow Japan’s lead and run massive, historically unprecedented budget deficits year after year. Or adopt Northern European taxation models - but which political party is campaigning on raising the GST to 15 per cent and across-the-board income tax hikes, and what are their odds of getting elected on such a platform?
I'm not sure how popular changes would be politically, but then again a failing healthcare system also isn't going to be popular. If it was up to me, I'd increase payroll/social security taxes and bump the GST back to 7%; that would generate a fair bit of revenue. Canada is 31st in the OECD in social security contributions as a % of GDP and 35th in goods and services taxes, so I think it's fair to say that there's room to increase there and it really wouldn't change a whole lot from the average person's perspective. The CPP changes basically went unnoticed by most people.

I'd also be significantly more aggressive about clawing back OAS and divert the savings to healthcare. The fact that a couple earning $170K in retirement can get full OAS is asinine. As is the fact that a couple earning almost $300K could get anything at all.

I'd also probably tie the eligibility in to wealth. There's no reason a retired couple earning $100K in retirement who are sitting on a paid off $2M house and a $1M stock portfolio needs a dime from the government. The fact that OAS and GIS are soon going to be a bigger expense than healthcare for the Federal government is clearly unsustainable, and there is zero argument that paying more money to seniors who don't need it will generate more public good than a stronger healthcare system.
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Old 07-26-2023, 11:23 AM   #13707
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nm

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Old 07-26-2023, 11:46 AM   #13708
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I'm not sure how popular changes would be politically, but then again a failing healthcare system also isn't going to be popular. If it was up to me, I'd increase payroll/social security taxes and bump the GST back to 7%; that would generate a fair bit of revenue. Canada is 31st in the OECD in social security contributions as a % of GDP and 35th in goods and services taxes, so I think it's fair to say that there's room to increase there and it really wouldn't change a whole lot from the average person's perspective. The CPP changes basically went unnoticed by most people.

I'd also be significantly more aggressive about clawing back OAS and divert the savings to healthcare. The fact that a couple earning $170K in retirement can get full OAS is asinine. As is the fact that a couple earning almost $300K could get anything at all.

I'd also probably tie the eligibility in to wealth. There's no reason a retired couple earning $100K in retirement who are sitting on a paid off $2M house and a $1M stock portfolio needs a dime from the government. The fact that OAS and GIS are soon going to be a bigger expense than healthcare for the Federal government is clearly unsustainable, and there is zero argument that paying more money to seniors who don't need it will generate more public good than a stronger healthcare system.
Another obvious one is the small business tax needs to go back up. UPC lowered it under Kenney. We can raise it a couple percentage points and still be the lowest in Canada. Dump all of that into healthcare.

We also need way higher income taxes after something like $500k/year. Like, go to a 90% rate. Let people get wealthy still, but JFC, it's getting too hard for too many people and once you get to a certain level of wealth it just keeps building and widening the gap. Such a terrible and unfair system.
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Old 07-26-2023, 11:53 AM   #13709
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I think part of the problem is government doesn't want to make choices/decisions that may not get them elected again. Any party that puts GST back to 7% is not getting re-elected. Any party that increases certain tax brackets, isn't getting elected again. Governments are too interested in pandering to their so called base, making idealogical decisions, and trying to ensure they get elected again. This happens with the Liberals, the UPC, the NDP. There's examples across the board. And then there's the fact that Federal government will do X and provincial governments want to do Y, and so opppose X.

Don't even get me started on the whole performance politics garbage.
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Old 07-26-2023, 12:01 PM   #13710
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Another obvious one is the small business tax needs to go back up. UPC lowered it under Kenney. We can raise it a couple percentage points and still be the lowest in Canada. Dump all of that into healthcare.

We also need way higher income taxes after something like $500k/year. Like, go to a 90% rate. Let people get wealthy still, but JFC, it's getting too hard for too many people and once you get to a certain level of wealth it just keeps building and widening the gap. Such a terrible and unfair system.
I'm not sure that >$500k/year at 90% would lead to a positive outcome in healthcare. There are a lot of specialists that would hit that threshold and the giant vacuum of US healthcare would probably look a lot more appealing to them if you start kneecapping their already (relatively) modest earning potential.
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Old 07-26-2023, 12:01 PM   #13711
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I'm just here for 2 back to back posts calling them the



party.
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Old 07-26-2023, 12:12 PM   #13712
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I'm not sure how popular changes would be politically, but then again a failing healthcare system also isn't going to be popular. If it was up to me, I'd increase payroll/social security taxes and bump the GST back to 7%; that would generate a fair bit of revenue. Canada is 31st in the OECD in social security contributions as a % of GDP and 35th in goods and services taxes, so I think it's fair to say that there's room to increase there and it really wouldn't change a whole lot from the average person's perspective. The CPP changes basically went unnoticed by most people.

I'd also be significantly more aggressive about clawing back OAS and divert the savings to healthcare. The fact that a couple earning $170K in retirement can get full OAS is asinine. As is the fact that a couple earning almost $300K could get anything at all.

I'd also probably tie the eligibility in to wealth. There's no reason a retired couple earning $100K in retirement who are sitting on a paid off $2M house and a $1M stock portfolio needs a dime from the government. The fact that OAS and GIS are soon going to be a bigger expense than healthcare for the Federal government is clearly unsustainable, and there is zero argument that paying more money to seniors who don't need it will generate more public good than a stronger healthcare system.
It's not that I disagree, because I don't, but people want every dime they can get "for free" from the government. Just the move by Harper to delay OAS to 67 was met with derision and anger. I've explained to a lot of people that you don't pay into OAS and it comes from general revenue, but they take the view that they've been funding this for decades with their taxes and when it's their turn, they want it.

It's political suicide to consider cutting this, at this point. Will that change when todays 40 year olds are ready to retire? I doubt it. People want all of their entitlements!
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Old 07-26-2023, 12:22 PM   #13713
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I'm not well versed in it at all, but I always thought that OAS was meant as a safety net, so if people taking home that much money yearly are still getting payouts it seems poorly thought out. Agree that it is hard to retract something like that though, if anything has been well proven it is that people are generally quite selfish/short sighted.
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Old 07-26-2023, 12:30 PM   #13714
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It's not that I disagree, because I don't, but people want every dime they can get "for free" from the government. Just the move by Harper to delay OAS to 67 was met with derision and anger. I've explained to a lot of people that you don't pay into OAS and it comes from general revenue, but they take the view that they've been funding this for decades with their taxes and when it's their turn, they want it.

It's political suicide to consider cutting this, at this point. Will that change when todays 40 year olds are ready to retire? I doubt it. People want all of their entitlements!
Well that's the problem. Conservative parties will implement tax cuts that often provide little benefit and not really consider how to pay for them long term, while the Liberals/NDP will happily increase benefits (often for people who don't really need them), again without really considering the long-term cost. And both of those things are far, far harder to reverse than they are to enact.

So what will likely happen is we'll needlessly let it get to crisis territory, at which point the public will be more accepting of dramatic changes. Unfortunately, one side of the political spectrum's idea of dramatic changes seems to involve making the system even less efficient through introducing more privatization and profit motives.

That's why I think more hidden changes like payroll taxes and changes to OAS clawbacks for people who don't need the money would be more palatable in the short term than an increase in income taxes.
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Old 07-26-2023, 12:38 PM   #13715
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I'm not well versed in it at all, but I always thought that OAS was meant as a safety net, so if people taking home that much money yearly are still getting payouts it seems poorly thought out. Agree that it is hard to retract something like that though, if anything has been well proven it is that people are generally quite selfish/short sighted.
Yes, people making up to $82,000 (going to 87,000 next year) each get full oas. They get some of it up to $133,000 each.

Wealthy seniors plan for this if they can by taking out minimum rrif payments, income splitting pensions etc. All completely legal but set up to give them the advantage.

And the government will never change it because these seniors are their golden goose when it comes to election time.
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Old 07-26-2023, 12:38 PM   #13716
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One of the issues I see is that parties on the left can't even bring up the idea of tax increases because they are instantly and loudly shouted down by the right. A reasonable discussion can't be had in media or parliament becuase the right won't allow it. For a recent example, see Notley's "tax increase". And people are so stupid they just parrot Conservative leaders, pundits and disinformation "media" until everyone is so wound up we just accept tax increases are impossible.

Hell, Smith's entire radio career was exactly this position. Taxes are too high, people can't pay taxes, we can't increase taxes, we pay more than the US in taxes(using her incompetent math)

Cliff likes to pretend that no one political entity is at fault here, but the facts point to one side who for 25 years has made the possibility something you can't discuss. This goes all the way back to Manning, the Reformers and Harper. Before then, changes in tax policies and rates happened in both directions. Since then? Basically only tax cuts.
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Old 07-26-2023, 12:40 PM   #13717
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I'm not well versed in it at all, but I always thought that OAS was meant as a safety net, so if people taking home that much money yearly are still getting payouts it seems poorly thought out. Agree that it is hard to retract something like that though, if anything has been well proven it is that people are generally quite selfish/short sighted.
Yeah, it's stupid. I remember when my grandparents sold an investment property they had owned in Vancouver for decades. They had something like $2M in capital gains which made them temporarily ineligible for OAS. But then the next year they were right back to getting $16K (or whatever the equivalent was then) in taxpayer subsidies that they had absolutely no need for.

I don't have a problem with OAS remaining in some form, because people have planned their retirements around it existing. But there's clearly a point where the money offers little benefit to the retiree and zero benefit to society, and that point is well below the existing income cutoffs. And anything that doesn't take assets into consideration is useless as well.
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Old 07-26-2023, 12:43 PM   #13718
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One of the issues I see is that parties on the left can't even bring up the idea of tax increases because they are instantly and loudly shouted down by the right. A reasonable discussion can't be had in media or parliament becuase the right won't allow it. For a recent example, see Notley's "tax increase". And people are so stupid they just parrot Conservative leaders, pundits and disinformation "media" until everyone is so wound up we just accept tax increases are impossible.

Hell, Smith's entire radio career was exactly this position. Taxes are too high, people can't pay taxes, we can't increase taxes, we pay more than the US in taxes(using her incompetent math)

Cliff likes to pretend that no one political entity is at fault here, but the facts point to one side who for 25 years has made the possibility something you can't discuss. This goes all the way back to Manning, the Reformers and Harper. Before then, changes in tax policies and rates happened in both directions. Since then? Basically only tax cuts.
Well really...that was the dumbest possible campaign plank. Whoever designed that strategy and thought it was fine ought to never work in the field again. I'm far from a political strategist, but of course the attack on the NDP is their financial prowess and that angle. So they trot out a tax and spend platform? It's brilliant in it's sheer stupidity.
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Old 07-26-2023, 12:45 PM   #13719
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Well really...that was the dumbest possible campaign plank. Whoever designed that strategy and thought it was fine ought to never work in the field again. I'm far from a political strategist, but of course the attack on the NDP is their financial prowess and that angle. So they trot out a tax and spend platform? It's brilliant in it's sheer stupidity.
Thanks for proving my point. I didn't think it would happen so quickly or succinctly.
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Old 07-26-2023, 12:47 PM   #13720
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Yeah, it's stupid. I remember when my grandparents sold an investment property they had owned in Vancouver for decades. They had something like $2M in capital gains which made them temporarily ineligible for OAS. But then the next year they were right back to getting $16K (or whatever the equivalent was then) in taxpayer subsidies that they had absolutely no need for.

I don't have a problem with OAS remaining in some form, because people have planned their retirements around it existing. But there's clearly a point where the money offers little benefit to the retiree and zero benefit to society, and that point is well below the existing income cutoffs. And anything that doesn't take assets into consideration is useless as well.
Perhaps reclaiming it through death taxation would work well? If you claim OAS and die with assets(over a certain amount), the government reclaims all OAS payments at your death. If you don't want that, you can opt out of the payments.
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