WOW, You Canadians and your Healthcare

[Iowa_Flames_Fan]

Originally Posted by nfotiu

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.

That's fair--and my effective tax rate was probably lower than 25% too. Of course, the two systems are hard to compare in that sense, since the effective tax rate in Canada depends on exactly how much of their income is subject to which tax rates. Also, child care costs in Canada are deducted from taxable income, so our example of a family of 4 making 50,000 dollars would probably have an effective tax rate much closer to 15%. (indeed, only 10,000 of their income would be taxed at 22%.

So that lowers the Canadian tax burden quite a lot, but much less so if you're making, say, 250,000 dollars. What concerns me in the U.S. is the burden on the middle class, which seems both unfair and a drag on the economy by reducing after-tax income among the people likeliest to spend the money that they have.

[Cactus Jack]

Originally Posted by Clever_Iggy

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.

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).

You are contradicting yourself here. Other than money, why would a doctor go to a country with more facilities and resources (obviously the US) to help people when he is only going to help a small elite percentage of the population? I don't think his oath was taken with that in mind. If you don't care about your fellow citizens fine, but that's what our system in Canada is based on.

Based on personal bankruptices and the unfathomable amount of debt terminally ill patients are expected to shoulder in the US are reason alone to have a single payer system.

And my horror stories are based on friends and family in the US. A girl getting hit by a car and waiting 6 hours for treatment at Columbia University hospital site, 8 hours waits in Manhattan to see a doctor for someone that is insured and friends that have been living in Canada for years that are afraid to move back to the US because they won't have health care coverage despite having been born and lived in the US for their first 30 years.

[Iowa_Flames_Fan]

Originally Posted by Clever_Iggy

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).

To me, the only system that's worse than Canada's is the U.S. system. It costs them 16% of GDP as opposed to 10%, and the outcomes are worse. That's really the only information you need in diagnosing the difference: Canada spends less for better care, regardless of anecdotes about rich people traveling to the mayo clinic and such.

The thing is, anecdotal experience is useless in these cases. You have to look at statistical outcomes across the board--and the numbers are not good for the U.S. Canadians see doctors more frequently, have 20% lower infant mortality, and on average live three years longer than Americans.

Not to mention that measured by real income, Canadians are wealthier than Americans on average. Anecdotal experiences don't change anything--the statistics are damning enough. Canadians pay less, live longer, have better health care outcomes and more money in their pockets than Americans.

That doesn't mean the Canadian system isn't broken, or couldn't be better. Of course it could--and reforming it should be the main goal of our political leadership over the next 10 years. But we can look to the U.S. as a cautionary tale: don't go down that path.

[redforever]

Originally Posted by Clever_Iggy

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).

On the contrary, too many Americans are influenced by Michael Moore.

[Cactus Jack]

Originally Posted by Iowa_Flames_Fan

That doesn't mean the Canadian system isn't broken, or couldn't be better. Of course it could--and reforming it should be the main goal of our political leadership over the next 10 years. But we can look to the U.S. as a cautionary tale: don't go down that path.

Absolutely, our system in Canada can and should be better. 4 years ago Harper said in his victory speech reducing wait times would be one of his 5 priorities and I'm still waiting. If we can reduce wait times and improve the efficiency of our system it would be gold and that is a realistic goal.

[Clever_Iggy]

Originally Posted by Cactus Jack

You are contradicting yourself here. Other than money, why would a doctor go to a country with more facilities and resources (obviously the US) to help people when he is only going to help a small elite percentage of the population? I don't think his oath was taken with that in mind. If you don't care about your fellow citizens fine, but that's what our system in Canada is based on.

Based on personal bankruptices and the unfathomable amount of debt terminally ill patients are expected to shoulder in the US are reason alone to have a single payer system.

And my horror stories are based on friends and family in the US. A girl getting hit by a car and waiting 6 hours for treatment at Columbia University hospital site, 8 hours waits in Manhattan to see a doctor for someone that is insured and friends that have been living in Canada for years that are afraid to move back to the US because they won't have health care coverage despite having been born and lived in the US for their first 30 years.

If you care so much, agree to raise your taxes significantly so the Canadian system can be as efficient and wonderful as you make it out to be.

Look, neither system is perfect. Canadians feel very very passionately about socialized medicine (didn't Canadians vote the guy who introduced socialized medicine as the "greatest Canadian") and Americans feel very strongly about their system where people look out for themselves and the government stays out of their way.

I grew up in Canada and thought the system was awesome and Americans were crazy. Then I came down here, received access to the US medical system, became involved with insurance carriers for medical claims (from a legal perspective, on both sides) and talked to doctors who practiced in Canada. I like it down here.

Doctors took an oath, but the doctors that moved from Canada were very frustrated that their hands were tied by the wait times for tests and access to specialists/technology. Stories about diagnosing a patient with X-disease/injury, sending them off for an MRI/specialist and not being able to get answers for 6-8 months. After the patient finally gets access, the injury/disease is significantly worse. So they moved to the US where they won't be able to treat everyone, but those they do treat will have the best chance to get better.

It's a divisive issue - between countries, citizens and political parties (even within political parties). It comes down to the fundamentals of the countries. That said, if you and I have the same injury/disease, I like my chances for survival/recovery down here a lot better than yours.

[redforever]

Originally Posted by Clever_Iggy

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).

Would you be giving us the same spiel if you had to pay for your own insurance for health care?

[Clever_Iggy]

Originally Posted by redforever

Would you be giving us the same spiel if you had to pay for your own insurance for health care?

Absolutely. I pay insurance premiums for my fiancee. Well worth it.

[redforever]

Originally Posted by nfotiu

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.

Who pays for those deductions? The Gov't right? Who is the Gov't? The people, right?

You don't get those deductions for free, just like we do not get our health care for free. You pay for them so factor them in. And a lot of those deductions, particularily on residential mortgages, are what got the US into big doo doo.

[Clever_Iggy]

Originally Posted by Iowa_Flames_Fan

That's really the only information you need in diagnosing the difference: Canada spends less for better care, regardless of anecdotes about rich people traveling to the mayo clinic and such.

You see, I disagree with that completely. I don't think Canada has better care and I don't need to look at "rich people traveling to the mayo clinic and such" to qualify that. I get better care. I pay less taxes than I did in Canada. Even if I had to pay my own insurance premiums, I would still be significantly ahead than when I worked in Canada.

I had to go to 3 specialists in the past 6 months. Wait time: 2-3 days depending on my schedule. I have injured my ankle so frequently, I need surgery to have it fixed (scar tissue removal, ligament repair, etc...). I have an appointment to meet with my surgeon later this week to discuss options. I tried to have the issue addressed in Canada 4 years ago and was told to "forget getting anything done until I'm older and have a real need." I asked for clarification and was told "like arthritis."

[Iowa_Flames_Fan]

Originally Posted by Clever_Iggy

It's a divisive issue - between countries, citizens and political parties (even within political parties). It comes down to the fundamentals of the countries. That said, if you and I have the same injury/disease, I like my chances for survival/recovery down here a lot better than yours.

Well, make that gamble if you want. But before making that bet, you may want to read this:

Canadian health care has many well-publicized limitations. Nevertheless, it produces health benefits similar, or perhaps superior, to those of the US health system, but at a much lower cost. Canada’s single-payer system for physician and hospital care yields large administrative efficiencies in comparison with the American multi-payer model.60 Not-for-profit hospital funding results in appreciably lower payments to third-party payers in comparison to for-profit hospitals61 while achieving lower mortality rates.62 Policy debates and decisions regarding the direction of health care in both Canada and the United States should consider the results of our systematic review: Canada’s single-payer system, which relies on not-for-profit delivery, achieves health outcomes that are at least equal to those in the United States at two-thirds the cost.

http://www.openmedicine.ca/article/view/8/1

[Cactus Jack]

Originally Posted by Clever_Iggy

It's a divisive issue - between countries, citizens and political parties (even within political parties). It comes down to the fundamentals of the countries. That said, if you and I have the same injury/disease, I like my chances for survival/recovery down here a lot better than yours.

I'll gladly take the bet, junior. I may have to wait a few months in the worst case for care, but statistically you are likely older, more obese, will have a shorter life expectancy and are debt ridden. And even though you are insuranced the chance of you being ineligible for treatment or having a pre-existing condition that will deny payment are quite good. Where do I sign up?

[Cactus Jack]

Originally Posted by Clever_Iggy

You see, I disagree with that completely. I don't think Canada has better care and I don't need to look at "rich people traveling to the mayo clinic and such" to qualify that. I get better care. I pay less taxes than I did in Canada. Even if I had to pay my own insurance premiums, I would still be significantly ahead than when I worked in Canada.

I had to go to 3 specialists in the past 6 months. Wait time: 2-3 days depending on my schedule. I have injured my ankle so frequently, I need surgery to have it fixed (scar tissue removal, ligament repair, etc...). I have an appointment to meet with my surgeon later this week to discuss options. I tried to have the issue addressed in Canada 4 years ago and was told to "forget getting anything done until I'm older and have a real need." I asked for clarification and was told "like arthritis."

What's your point? It was discovered recently that in my family there runs a genetic and potentially fatal heart condition. Thankfully I'm fine and within a month I found that out and was given a schedule of preventative measure and follow up appointments to ensure all is alright. I never had to wait more than a week to see my cardiologist in downtown Calgary and I saw him 3 times. I also went to see my family doctor choice a few months ago when I was feeling ill (20 minute wait time) where he sent to me to a lab to do blood work and some more exhaustive chest examinations (30 minutes wait) to which I got the results back the next day. I did all of that in 2 hours.

[Dion]

Originally Posted by Clever_Iggy

I tried to have the issue addressed in Canada 4 years ago and was told to "forget getting anything done until I'm older and have a real need." I asked for clarification and was told "like arthritis."

Last year a friend of the family went to see a specialist about a knee replacement. Was told he was too young and to come back when he was older

[Iowa_Flames_Fan]

Originally Posted by Clever_Iggy

Absolutely. I pay insurance premiums for my fiancee. Well worth it.

I don't know your situation--do you pay the full premium for your fiancee, or does she receive a family benefit from your employer, with a modest co-pay for which you are responsible?

Consider this: employers bear the lion's share of the burden of paying premiums to insurance companies. The average cost of family insurance is nearly 13,000 dollars a year. That's a cost that may be hidden for you, but it's still there; somebody has to pay it.

[Clever_Iggy]

Originally Posted by Cactus Jack

What's your point? It was discovered recently that in my family there runs a genetic and potentially fatal heart condition. Thankfully I'm fine and within a month I found that out and was given a schedule of preventative measure and follow up appointments to ensure all is alright. I never had to wait more than a week to see my cardiologist in downtown Calgary and I saw him 3 times. I also went to see my family doctor choice a few months ago when I was feeling ill (20 minute wait time) where he sent to me to a lab to do blood work and some more exhaustive chest examinations (30 minutes wait) to which I got the results back the next day. I did all of that in 2 hours.

You see. That's the problem. Go back through the thread and you'll find stories that are the opposite (Jiri's for example).

How's the medical care in Brazil?

[redforever]

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.

Absolutely not. For me, that is part and parcel of being a Canadian, taking care of all citizens, that is part and parcel of living in a kinder and gentler society.

This is no different than you asking why you should have to pay school taxes if you do not have children, or you asking why you should have to pay for a lot of the infrastructure that you never use, or you asking why you should have to pay for public transportation that you never use.....

and the list goes on.

[Iowa_Flames_Fan]

Originally Posted by Clever_Iggy

You see, I disagree with that completely. I don't think Canada has better care and I don't need to look at "rich people traveling to the mayo clinic and such" to qualify that. I get better care. I pay less taxes than I did in Canada. Even if I had to pay my own insurance premiums, I would still be significantly ahead than when I worked in Canada.

I had to go to 3 specialists in the past 6 months. Wait time: 2-3 days depending on my schedule. I have injured my ankle so frequently, I need surgery to have it fixed (scar tissue removal, ligament repair, etc...). I have an appointment to meet with my surgeon later this week to discuss options. I tried to have the issue addressed in Canada 4 years ago and was told to "forget getting anything done until I'm older and have a real need." I asked for clarification and was told "like arthritis."

You can't use anecdotal evidence to contradict statistical evidence.

I could as easily point out that in Boston I could not get a doctor to take my complaints of back pain seriously. I went to see my doctor several times, and each time I waited for an hour and a half to see him for 5 minutes while he pretended to listen and then quickly wrote a prescription for an NSAID that rotted my stomach away.

In Canada, I saw a doctor within a week, waited ten minutes and walked out with a referral for Physio--I was in physio within a week and feel a lot better already.

But the thing is, that's meaningless: it's an anecdote. You have to look at the statistical outcomes across the board, and that's where the news becomes grim for Americans.

Somewhere, in some office, there's an actuary who is estimating that I will live three years longer than you because I'm in Canada. There's a bet I'm willing to make.

[Clever_Iggy]

Originally Posted by Iowa_Flames_Fan

I don't know your situation--do you pay the full premium for your fiancee, or does she receive a family benefit from your employer, with a modest co-pay for which you are responsible?

Consider this: employers bear the lion's share of the burden of paying premiums to insurance companies. The average cost of family insurance is nearly 13,000 dollars a year. That's a cost that may be hidden for you, but it's still there; somebody has to pay it.

My employer covers me fully. I pay a $10 co-pay per visit. Since I'm a new employee and not yet married, my company doesn't fully cover my fiancee. But, because of how good our insurance is, we felt it was worth the expense to have her on the firm's medical plan, on my dime. Once I am employed for a certain period and we are married, the company covers 1/2.

I know the cost is still there; I pay for my fiancee's premiums! IMO (and now I think I'm just butting heads with you, redforever and Cactus) I get better access and better health care down here. You can through stats about infant mortality, life expectancy and all of that at me, and while it's somewhat valid, there are other factors influencing those stats. For me I like this system better. It's not perfect, it leaves lots of people out in the cold, it has it's downfalls, but for me it's great.

[Cactus Jack]

Originally Posted by Clever_Iggy

You see. That's the problem. Go back through the thread and you'll find stories that are the opposite (Jiri's for example).

How's the medical care in Brazil?

It's similar to the US in that there is a 2 tiered system. There is average care available for people who can't afford better and great care for those that can afford it. It's one of the things I'm not looking forward to when I move there but I wouldn't move there unless I could afford the good care. I'm sure I won't like it because their system is plauged by the same despairity in care that exists in the US.

The difference between the countries in this example being that the world's biggest economy and richest nation can't afford to or won't take care of the health of its people. Brazil is a latin american, middle income nation plauged with centuries of corruption and is still improving its situation.

Clever Iggy, I'm not here to fight man. If you like your system, that's great. I just think it's cold to shut out and not care about the people in your nation. I guess that's the main difference between Canada in the US.