WOW, You Canadians and your Healthcare

[Displaced Flames fan]

Originally Posted by vicphoenix13

Could Obama's plan be any worse than the Republicans do nothing approach? I have heard some of them say the system is fine. Well, I guess its alright for the politicians that are taking hush payments from the insurance companies. Even Democrats like Max Baucus are guilty of taking money from insurance companies. So I get suspicious when the Blue Dogs want to water down the bill because they all got bought off by insurance lobbyists.

Yes, frankly, it could be worse.

That said, the do nothing approach can't continue.

The argument that anything is better than the status quo is a failure everytime it is used. Things can always get worse.

Why do you assume that the Blue Dogs are all corrupt puppets of the insurance companies?

[Hack&Lube]

All this does is make me wonder why we never got an Episode of ER or House where the patients die or commit suicide or go bankrupt and suffer because they can't afford paying the pretty doctors and their TV diagnoses...or why these pretty doctors don't have any questions of conscience with these situations.

Every average joe that goes through all the tests and procedures and personal attention of Dr. House and his gaggle of doctors on staff must rake up like half a million dollars in medical bills per episode!!! Then everybody just high-fives or feels relief that House solved the mystery and nobody says anything about how that patient might be cured but is now in debt for 3 generations and lost their home and life savings because their insurance only covered the first ten grand...

[Cowboy89]

I missed the bulk of this thread because ironically enough I was in emergency at the Foothills dealing with an unfortunate fluke accident after the football game Saturday night. I was reasonably pleased with the care I recieved and was provided with most of the equipment needed to recover at home with no discussion of cost. Thank God for that, lord knows that if this had been in the US I probably could have shaved hours off of my stay but ultimately would have had to fork over thousands (which for me is affordable, but would have hurt).

One thing I've noticed is that our system overall is quite good at treating trauma. If you suffer a terrible life threatning injury, or develop a life threatning condition you get treated promptly, well, and do not have to foot the cost out of your pocket. However if you aren't in danger of dying within the week, have a condition that requires a lot of diagnostic work, or have a 'quality of life' issue our system tremendously fails you in completely unacceptable ways.

The reason why the cost is cheaper is because all those 'quality of life' things get pushed back and back when there is scarcity of resources thus care is rationed. If we charged a $500 deductable or something of that nature the province would be able to afford more minor care and diagnostics tests that are clogging up the system and bed blockers wouldn't even bother because it would cost them some cash. Yes there are people who cannot afford $500 and but we could have a program to ensure that anyone who truly cannot afford it can get covered.

[Cowboy89]

Originally Posted by fotze

"unfortunate fluke accident" = drunken fools move that will not be admitted to.

I won't pretend that I didn't have a few drinks that night, but the incident was indeed fluke.

I hopped the fence between Foothills Stadium and McMahon en route back to my buddies car as were numerous other people. It was about 6-8 feet tall. I leaped from the top of it and landed awkwardly with all my weight on my right heel. The fatty tissue inside my heel burst outside my skin on the inside of my foot on impact. I needed to go to the foothills to get it stitched up, x-rayed, and CAT scanned. Thankfully nothing is broken and the ligaments seem to be fully intact. I'm left with pretty gruesome looking stitches, and some amazing photos that will indeed win bragging rights with my friends for most disgusting wound!

[Ice]

You're not sharing the photos?

[Cowboy89]

Originally Posted by Ice

You're not sharing the photos?

I will in due time. I have to get them out of my friend's and my brother's phone.

[Calgaryborn]

Health care should not be a right. It opens up too many difficult questions: How much care do we provide? How much say does the patient get? How much responsibility does the user have to the State for their own life choices related to health? In poor economic times does the State lower standards or borrow against the future? The list is endless and none of the answers are satisfactory.

If any of you who live in the city think that the Canadian system is wanting you should try living in the country. The quality of care and the waiting list are killing people. What makes matters worse is Canada has been borrowing to maintain its declining system which mean less money later to service it. Added to that our population is ageing rapidly and will put more strain on the medical system. Logically the level of service we enjoy today will need to be further cut and drastically!

Of course the American System(or lack of one) isn't where I would like to see Canada go. As for America I just can't see them affording to do what Obama wants. They need to limit medical lawsuits which is a big part of the expense down there and isn't being addressed. They also should reward(tax breaks) companies that offer comprehensive health care to their employees. Medical insurance plans should be required to offer formally company insured employees the option of up to one year of medical at the group rate their former employer provided when they leave the job. Current sin taxes should be thrown into a fund that would provide an extra million in coverage for those who exceed the maximum coverage of health plans with a reasonable upper limit. A tax deduction should be provided for hospitals and physicians who provide/volunteer at free clinics. There is a lot that could be done to improve conditions for Americans without costing money the country simply doesn't have.

[driveway]

Originally Posted by Calgaryborn

Health care should not be a right.

If Life is going to be a right, then the care of it should also be a right.

[jayswin]

Originally Posted by Cowboy89

I will in due time. I have to get them out of my friend's and my brother's phone.

Yeah, and I have to get audio of me drunkenly screaming Blink182 lyrics out of your brothers phone.

edit: You are Lambeburger's brother right? I remember him saying it was cowboy something.

[Iowa_Flames_Fan]

Originally Posted by Table 5

Sure you pay higher taxes in Canada,

Table 5, I agree with most of your post. But the part quoted above I object to a little, having just recently moved from Boston to Calgary. I lived in Iowa, Pennsylvania and Massachussetts. The place where I paid the lowest taxes?

Calgary. By a couple hundred dollars a month.

And it gets worse: First Lady commented a long while back that the Canadian system isn't "free"--it's paid for with taxes. I agree. This is an important distinction. However, it comes with one very important proviso: in order for a cost comparison between the U.S. and Canada to make any sense whatsoever, you have to assume that private health insurance is a kind of tax. (sure, you could opt out, but doing so is highly risky, since even simple procedures can cost hundreds of dollars in the U.S. and anything worth driving to the hospital for costs thousands)

In that case, an apples-to-apples comparison of the cost to the middle-class consumer would have to compare the following:
For Canadians:
1. Total tax burden

For Americans:
1. Total tax burden
2. Average cost of private health insurance.

Private health insurance is generally around $283 a month for a family of four. (for the record, I paid 450 for a family of three in Massachussetts)

In 2007, the median family income was $50,233.00. What this means is that the U.S. health care system amounts to a tax on working families of around 3400 dollars a year, or nearly 7% of their income.

Even worse, that's just the portion paid by the middle-class worker. Most have insurance through an employer, who picks up the majority of the tab. What insurance companies actually charge for a family of four is closer to 13,000 dollars a year--with employers picking up thousands of dollars in the form of benefit compensation. So in addition to an income tax, health care in the U.S. amounts to a corporate tax as well, and small companies and middle-class families bear the burden of ballooning health care costs that are truly out of control.

So to crunch the numbers:
Canada (assuming Alberta, just because I live here):
Total tax burden (income + payroll) on 50,000 dollars:
Federal: 22%
Provincial: 10%
Payroll: 4.95%
Total: 36.95% (Pretty steep, I think).

U.S.A.
Total Tax Burden (income + payroll) on 50,000 dollars:
Federal: 25%
State (MA, just because I lived there): 5.3%
Payroll (not including State, which can be as much as 6%!): 7.65%
Health Insurance: 7%
Total: 44.95%. (OUCH!)

I'm making a few looseish assumptions, but anyone can crunch these numbers for themselves: http://www.nchc.org/facts/cost.shtml

[Iowa_Flames_Fan]

Originally Posted by Displaced Flames fan

Yes, frankly, it could be worse.

That said, the do nothing approach can't continue.

The argument that anything is better than the status quo is a failure everytime it is used. Things can always get worse.

Why do you assume that the Blue Dogs are all corrupt puppets of the insurance companies?

It can always be worse. And the U.S. government is expert at finding cures that are worse than the disease--it's sort of a specialty of theirs.

With that said, here are three things I think about the health care bill:
1. It's got too many different fingerprints on it, and not enough of them are Obama's. I've been impressed with him overall, but he either can't or won't take the bull by the horns and push for genuine health care reform. What's being proposed is the equivalent of putting a bandaid on a sucking chest wound.
2. This is one of those situations where I wonder if we don't vastly overestimate any president's influence. With that said, Obama promised reform and if he can't deliver it that's his own fault.
3. A costly system that is fair is better than a costly system that is unfair. That my by the choice Americans face right now. Obviously, a system that is both fair and efficient would be better. It doesn't seem to be on the table.

[nfotiu]

Originally Posted by Iowa_Flames_Fan

Table 5, I agree with most of your post. But the part quoted above I object to a little, having just recently moved from Boston to Calgary. I lived in Iowa, Pennsylvania and Massachussetts. The place where I paid the lowest taxes?

Calgary. By a couple hundred dollars a month.

And it gets worse: First Lady commented a long while back that the Canadian system isn't "free"--it's paid for with taxes. I agree. This is an important distinction. However, it comes with one very important proviso: in order for a cost comparison between the U.S. and Canada to make any sense whatsoever, you have to assume that private health insurance is a kind of tax. (sure, you could opt out, but doing so is highly risky, since even simple procedures can cost hundreds of dollars in the U.S. and anything worth driving to the hospital for costs thousands)

In that case, an apples-to-apples comparison of the cost to the middle-class consumer would have to compare the following:
For Canadians:
1. Total tax burden

For Americans:
1. Total tax burden
2. Average cost of private health insurance.

Private health insurance is generally around $283 a month for a family of four. (for the record, I paid 450 for a family of three in Massachussetts)

In 2007, the median family income was $50,233.00. What this means is that the U.S. health care system amounts to a tax on working families of around 3400 dollars a year, or nearly 7% of their income.

Even worse, that's just the portion paid by the middle-class worker. Most have insurance through an employer, who picks up the majority of the tab. What insurance companies actually charge for a family of four is closer to 13,000 dollars a year--with employers picking up thousands of dollars in the form of benefit compensation. So in addition to an income tax, health care in the U.S. amounts to a corporate tax as well, and small companies and middle-class families bear the burden of ballooning health care costs that are truly out of control.

So to crunch the numbers:
Canada (assuming Alberta, just because I live here):
Total tax burden (income + payroll) on 50,000 dollars:
Federal: 22%
Provincial: 10%
Payroll: 4.95%
Total: 36.95% (Pretty steep, I think).

U.S.A.
Total Tax Burden (income + payroll) on 50,000 dollars:
Federal: 25%
State (MA, just because I lived there): 5.3%
Payroll (not including State, which can be as much as 6%!): 7.65%
Health Insurance: 7%
Total: 44.95%. (OUCH!)

I'm making a few looseish assumptions, but anyone can crunch these numbers for themselves: http://www.nchc.org/facts/cost.shtml

I do agree to an extent that higher Canadian taxes is a bit overstated (especially in Alberta), and I did notice my taxes were higher when I first moved to US as a single guy.

However, now that we are a dual income family of 4 with a mortgage, I assume are taxes are much lower in the US.

Here's how my taxes break down for our family (income in mid-low 6 figures) from my last tax return in Virginia.

Fed Tax 16%
State tax 4.5%
payroll 6.9%
Health care 2%

Total - 29.4%

[smith12]

So we pay for our health care through taxes which means we spread the cost of health care throughout the country right?

Does anyone else have a problem with the fact that we do this? I mean, I live a very healthy lifestyle, I stay fit, don't smoke and workout all the time. I rarely have to go to the hospital and when I do it's usually a sports related injury. Now why should I have to pay for someone's cancer due to smoking? Why should I pay for some overweight guys cardiac arrest b/c they CHOSE to not live a healthy life style.

In the States, I wouldn't be flipping the bill for people that choose to live like that.

[Pastiche]

Originally Posted by smith12

So we pay for our health care through taxes which means we spread the cost of health care throughout the country right?

Does anyone else have a problem with the fact that we do this? I mean, I live a very healthy lifestyle, I stay fit, don't smoke and workout all the time. I rarely have to go to the hospital and when I do it's usually a sports related injury. Now why should I have to pay for someone's cancer due to smoking? Why should I pay for some overweight guys cardiac arrest b/c they CHOSE to not live a healthy life style.

In the States, I wouldn't be flipping the bill for people that choose to live like that.

You are describing perfectly why our system, the single payer system, is cheaper.

It boils down to a term called 'adverse selection.' What that means is that people who are more likely to need insurance will seek it out making the costs of providing insurance much higher. For example, a healthy person like yourself may find little need in buying health care, so you select out of buying it while an overweight smoker recognizes that it's probably a good idea to buy healthcare because they will most likely need it.

The effect is that the costly-to-insure people self-select into a pool that makes paying for all the health care much more expensive.

In a single-payer system, everyone must join health insurance. This ensures that the people who don't need it and will use it less pay to be in and lower total per-user costs. It doesn't necessarily over-burden the healthy because they still will need health insurance for unforeseen issues etc.

[millhouse11]

Originally Posted by Hemi-Cuda

you just contradicted yourself. the more doctors in private clinics the less there are available for the public, and if a doctor coming out of med-school has to choose between a private practice for more money or public for less, what do you think he'll choose?

We'd probably have more doctors around and not have doctors leaving to work in the states. A friend from home became a doctor and chose to take a job down south for a few years before coming back to Canada. It allowed him to pay off his university bills that much quicker. I'm sure he's not the only one.

[snowdude]

I just started reading the thread so forgive me if this has been mentioned. There is one massive benefit of the Canadian system that people forget about because it's more of an ephemeral (like many economic benefits) one.

The universal coverage allows workers in Canada to be more mobile because they're not tied to jobs or provinces so they can have the ability to move to find work, or go back to school to improve their human capital. One only needs to think of Northern Alberta and the massive migration of people from the Atlantic provinces to see this in action.

In the US many people are locked into jobs that don't maximize their abilities or happiness simply because they need the health care coverage. This prevents mobility (along with underwater mortgages which is another issue) and people from getting better jobs (for them) or going back to school.

So, this mobility allows the Cdn economy to become much more efficient than it might otherwise be (something people only looking at the accounting cost always forget about). This of course says nothing about the equity arguments for universal/ single payer health care.

[Iowa_Flames_Fan]

Originally Posted by nfotiu

I do agree to an extent that higher Canadian taxes is a bit overstated (especially in Alberta), and I did notice my taxes were higher when I first moved to US as a single guy.

However, now that we are a dual income family of 4 with a mortgage, I assume are taxes are much lower in the US.

Here's how my taxes break down for our family (income in mid-low 6 figures) from my last tax return in Virginia.

Fed Tax 16%
State tax 4.5%
payroll 6.9%
Health care 2%

Total - 29.4%

Alberta has a flat tax, so it's unlikely you'd ever pay more than 35% of your income in tax--though that doesn't include CPP.

One thing I didn't include was state Unemployment Insurance, and I made what turns out to be a very modest assumption of 5% State Income tax. Some state payroll tax premiums can be as high as 6.5%, though most are quite a bit lower. State income tax can also be as high as 10%, though I think around 5 is more the norm.

The thing is that Health Insurance costs aren't indexed to income--their variation depends on other factors, such as where you live, your group benefits plan, etc. So as your income rises, health care costs as a percentage of income will drop.

I used 50,000 dollars for one simple reason: it's the median household income in the U.S. The median household income in Canada is higher--it was 66,000 dollars in 2006, so perhaps I should have assumed that for Canada--though I doubt it would make much difference, especially in Alberta.

[nfotiu]

Originally Posted by Iowa_Flames_Fan

Alberta has a flat tax, so it's unlikely you'd ever pay more than 35% of your income in tax--though that doesn't include CPP.

One thing I didn't include was state Unemployment Insurance, and I made what turns out to be a very modest assumption of 5% State Income tax. Some state payroll tax premiums can be as high as 6.5%, though most are quite a bit lower. State income tax can also be as high as 10%, though I think around 5 is more the norm.

The thing is that Health Insurance costs aren't indexed to income--their variation depends on other factors, such as where you live, your group benefits plan, etc. So as your income rises, health care costs as a percentage of income will drop.

I used 50,000 dollars for one simple reason: it's the median household income in the U.S. The median household income in Canada is higher--it was 66,000 dollars in 2006, so perhaps I should have assumed that for Canada--though I doubt it would make much difference, especially in Alberta.

The point I was trying to make is that after deductions, which are much greater in the US, most Americans are paying more like in the mid 20% income tax at most. Alberta is not a great example to compaer either, as their budget is highly subsidized with oil money.

Your point stands though that someone making 40-50,000 a year or less is going to pay a much higher percentage of their income to health care, than someone making 200k in the US. Someone making 200k in the US is paying a lot less towards health care than someone making the same in Canada.

EDIT: I don't pay any state payroll taxes, btw.

I do think my point stands that I'd be paying at least 10% of my income more to taxes(inc health care) even in Alberta than I am paying in Virginia.

[Cactus Jack]

Originally Posted by wooohooo

Well by paying, you're going to be neglecting someone that can't necessarily afford the costs. So who is it to say the rich deserve to live and the poor don't?

This is the schism right here. People in the US don't care enough to put everyone in the same boat so that everyone pays for healthcare with their taxes and everyone benefits when they need it. I think it's a very selfish attitude to take, in Canada we are all from the same country and I like that my tax dollars save someone from financial devestation because I know that when I need it (and we all will), I will be covered with great care.

Originally Posted by Clever_Iggy

I love the US system. Obviously I'm in the "have" group and it's wonderful. Both systems are broken in their own way, but, if I'm going to pay either taxes or medical insurance premiums for coverage, I'd rather be down here and get proper medical care.

I think the only plausible option for the US other than the current system, but stays within the capitalist structure of their society and away from anything too socialist, is a tiered system: minimum care available for everyone, but an option to have your own private insurance that provides superior insurance. Have the minimum approximately what Canada enjoys (long waits, lack of specialists, lack of access, etc....) and the "upper tier" have access to what is presently available.

Isn't that exactly what the US has now?

Originally Posted by Clever_Iggy

Isn't it ridiculous that someone has to travel outside a major city to receive medical care?

Canada's "free healthcare" and blind support for it is obviously a contentious issue and Canadians get very very defensive when the system is questioned. The US system is far from perfect, or acceptable. But frankly, Canada's medical system = major epic fail, too.

In Canada we pay marginally more taxes (depending on your region) but get health care covered. Our taxes also subsidize drug costs, which is why prescription drugs are cheaper in Canada. There may be long wait times but the care is excellent and there is no bankrupting cost. If you're elite and rich in the US, enjoy the great care you receive but I wonder how many of you take the time to think about the millions that don't receive care, or the millions that pay for insurance and are denied coverage because of pre-existing conditions, or the millions that the system bankrupts. I'm sure that will make you feel better while you're in a plush suite at a hospital watching DirectTv. The sheer financial devestation and bankruptcy the US health care systems causes should enough be reason to scrap it. It seems like people don't care about their fellow man any more. I'll gladly take this "socialist" system any day.

[Clever_Iggy]

Originally Posted by Cactus Jack

In Canada we pay marginally more taxes (depending on your region) but get health care covered. Our taxes also subsidize drug costs, which is why prescription drugs are cheaper in Canada. Theremay be long wait timesbut the care is excellent and there is no bankrupting cost. If you're elite and rich in the US, enjoy the great care you receive but I wonder how many of you take the time to think about the millions that don't receive care, or the millions that pay for insurance and are denied coverage because of pre-existing conditions, or the millions that the system bankrupts. I'm sure that will make you feel better while you're in a plush suite at a hospital watching DirectTv. The sheer financial devestation and bankruptcy the US health care systems causes should enough be reason to scrap it. It seems like people don't care about their fellow man any more. I'll gladly take this "socialist" system any day.

I really want there to be a true comparative study on taxes between the US and Canada. I live in California, a very heavily taxed state compared to other regions in the US, and I don't pay nearly what I did or would in Canada.

Personally, I don't care how freaking great the care is in the end, if I'm dying, in pain or my long term health is in jeopardy because I have to wait so everyone in line can be seen, I'm not interested in that system.

I know several doctors that have moved their practice to the US from Canada. Obviously the reasons do include money, but a very important benefit to practicing medicine in the US over Canada is that doctors have access to equipment and facilities in order to give their patients the best possible care. The wait for MRIs in Canada is embarrassing. To get one, as stated in this thread, people have to go out of pocket anyways... how is that a great system or different from the US?

As a patient, I thoroughly enjoy the access I have to specialists, technology, doctors, etc... But, I also worked hard to put myself in a position where I can benefit from that. I pay taxes, have a job that pays insurance premiums and pay premiums for my fiancee. So, I think I deserve what I've earned.

Too many (Canadians) are influenced by popular media, horror stories from US ER rooms, and Michael Moore. I'm sure you could cherry-pick horror stories from the Canadian medical system that are equally troubling (which opponents of Obama's plan are doing currently).

Canada's system is broken, no question. I think the problem is that it's caught between a US system and a European system: equal healthcare for all, but the citizens of Canada aren't willing to fund it properly (see: higher taxes).