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ahiromu
ahiromu
Joined: Jan 15, 2010
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March 15th, 2010 at 11:21:48 PM permalink
Wait lists and overcrowding are semantics, doesn't matter.

Yes I understand the whole employer thing, I went out with friends after I wrote my response and couldn't stop thinking about the math. Let me say I disagree that it is a tax. We have much more say over what happens with our health care, so yes even though we are kind of "forced" to pay for it we have our decisions to make. If I want to go to doctor A because doctor B is an asshole, or I want to pay an extra grand and get my MRI done at location B instead of A I (usually) can. I do not know enough about the specifics, but as much as I have heard our ability to choose our doctors better than Canada isn't under contest by anyone.

Let's say that it is a tax. This means that that health care money, let's call it additional income, is added onto our current income. So in the end, instead of making... 45k? we have a per capita of 53k. In the end, yes we would have a higher marginal rate. Let's not look at marginal rate though, because what really matters is your bottom line, how much money you have at the end of the month which goes back to how much you are taxed on personal income. Neither of us argue that Canadians pay more in taxes, thus have a lower bottom line. Therefore, you Canadians pay extra taxes for what we get for "free". Healthcare for us, yes, is kind of a hidden cost. If businesses stopped paying for it we would A. Get paid more and B. Have more jobs. I also guarantee you that if people actually saw the cost of their healthcare here, prices would plummet. We American love our money.

Side story: I come off of my parents' insurance plan in June. I wear glasses and was going to just buy one box of contacts to have them for emergencies. But, because of how our insurance is setup, I am going to buy 5 boxes instead and not see a dime come from my wallet. This is a microcosm of why health care is too expensive in the US.

Do you know why I ignored your "statistic" about un/underinsured people? Statistics like that are completely bogus, it's like Obama's "saved or created" jobs statistic. I have a friend who came from a very poor family, she had/has lupus and is currently ~28. When she wasn't working at this dentist's clinic who is very nice to her (She's on their medical even though she only is able to work like 15 hours a week) she was able to sign up for medicare/social security. I know, sample size of one, but there are services for these people.

On your healthcare points:
1. Regulating costs and services only lowers the supply. It adds an increased invisible "cost" that the consumer never sees. There is a big problem in the US right now with doctors refusing to see Medicare patients because they aren't reimbursed enough. This would only get worse when the government has an even bigger monopoly.
2. America already does this with flu shots, ever wonder why there's always a shortage? We pay full price for prescriptions, if we stopped that and started collective bargaining for drugs, then the quality and/or quantity would go down I assure you for the whole world.
3. State by state is fine, but Mass. and Cal. have done that and the prices are ridonculous. Maybe not exactly to your personal liking, but it is currently being attempted and not doing too well. Hey, just like Communism.
4 & 5. Seeing as I don't see healthcare as a fundamental right, this one really comes down to personal opinion. These two conditions would hinder any attempt at affordable healthcare.

Personally I have no problem with Canada, if my interests didn't lie in the defense industry / aerospace I wouldn't mind living up in Vancouver for a bit. Also you have to remember the basis of the two countries: America saw (what was perceived as) its rights being trampled on, therefore we fought to protect these important and few rights. We (still the majority) have a different view of government and its proper size. I don't know enough about Canadian independence, but aren't they still under the queen?
Its - Possessive; It's - "It is" / "It has"; There - Location; Their - Possessive; They're - "They are"
boymimbo
boymimbo
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March 16th, 2010 at 5:24:40 AM permalink
I've lived both in Vancouver and Seattle and am married to an American so I've experienced both the health care and mind set on both sides of the border. To be biased, I've worked in Canadian health care for years and one of my good friends works in health care in Seattle.

Canadians in general pay roughly the same taxes as the United States up to a certain point. When we get to 80K or so, we start to pay more taxes and our marginal rate goes up to between 41% and 44% (depending where we live) that you say while yours stays between 28 and 37%. And we pay sales taxes and/or GST (which is a VAT). Alot of it.

You can't just wipe away the fact that are a bunch of studies that say that 45 million Americans are uninsured. You can't ignore the fact that America has the most expensive health care in the world. And you can't ignore the number of bankruptcies created for medical reasons. And you can't ignore the deficit and national debt which is sitting at about 85% of GDP. These statistics are not bogus and you can't simply say that it's not a problem the people at Fox News or you don't see it from your experience of the world.

I completely admit that when you do have health insurance, it's great. The problem is when you don't. The problem is the premiums that you have to pay when your employer stops or forces you to pay for part of the coverage (which happened to me, at my employer, while I was living there) or all of your coverage.

At that point, it becomes a tax. Whether the cost of the health care is borne by the employer or by you, it is not paid as an income tax (as it is here), it is paid for via a premium (per capita, $8,100/year). Whether that premium is borne by you or by your employer (who adds it to their cost structure making them uncompetitive), it still must be paid if you want adequate care. In Canada we add it to our taxes and our government pays for our adequate (certainly not perfect) health care. In the States the cost of health care is borne outside of the tax system. So our tax system includes health care and yours does not.

What really bothers me about US politics and US news today is the polarity on both sides of the fence. Fox News hosts these tea parties and calls their news "fair and balanced". CNBC is completely on the other side of the fence, while CNN, stuck with awful ratings, gets most of its news seemingly from Twitter and Facebook but still reports from the opposite side of the fence as Fox News. PBS and the networks and 90% of the media is seen as "liberal". There seems to be no truly unbiased news source out there so it's difficult to believe news you hear and believe that it's true. But the truth is out there. You just have to dig, use your research skills, and find out the truth for yourself. You're a college student. Figure it out! You're America's future!!!
----- You want the truth! You can't handle the truth!
AZDuffman
AZDuffman
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March 16th, 2010 at 8:14:18 AM permalink
Quote: boymimbo



I think you attack health care by:

(1) regulating costs and increases by health insurance policies to a cap.
(2) have the government take over prescriptions and have governments negotiate rates to be lower.
(3) have the states offer a form of public insurance that is low cost or borne through an employer or state tax with premiums being paid by a sliding scale.
(4) no more denial of service.
(5) no more preexisting conditions with the exception of travel insurance.



The first three of your solutions are just more government. Why do we need to regulate everything? The more things get regulated the more they don't work. A better way is to let the market work by:

(1) Get rid of most or all "mandates" on what insurance covers. When you mandate that "health insurance" covers things like screenings; psyciatric care, etc you blow up the cost for everyone. Let people just buy INSURANCE. Coverage for major medical hospital stays with say a deductible of $5,000 or so. Those that want all those other coverages may add them on if they wish.

(2) Take the savings and let or even require people to set up Health Savings Accounts. Set it up on a MC/Visa card that can only be swiped at a provider. (eg: at Walgreens the card will work at the Rx counter but not at the front checkout.)

(3) Require providers to post cost for treatments or Rx drugs both online and in a conspicuous place in their office. What and how they charge is up to them. A doctor could give Cadillac service for $10,000 per year all-you-can-eat style down to a clinic with bare-bones service and low prices. Since *you* pay *you* choose. THIS IS A RETURN TO FEE-FOR-SERVICE, a simple concept that worked years ago!

(4) Let people buy AFLAC-style long term disability coverage for missed wages. This solves the bankruptcy problem.

(5) De-regulate medicine so that it is easier to set up clinics, in-store even, and let nurses and physicians assistants handle routine things and prescribe most drugs. Thus if I have a cold and know I just need the better cough syrup and some antibiotics I go to the Walgreen Clinic and am out in minutes.

That's it. No government involvement. Less government involvement than we even have now. Choice but with responsibility. Of course, buying the LTD and setting up the MSA mean you may have to live a little mor emodest. But better that than everyone expecting their neighbor to pay their way.

Best part is the plan is self-rationing. You have a cough instead of running to the doctor because the co-pay is $10 you decide if it is worth $50 to you. All of the sudden it might not be.
Tolerance is the virtue of believing in nothing
AZDuffman
AZDuffman
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March 16th, 2010 at 8:19:24 AM permalink
Quote: ahiromu



Personally, I will always be at least 2-3 times the poverty line. If I continue in my field of choice (I'm a student, yes a far right conservative college student in Seattle) I will probably be making 6 figures easily in 15-20 years. I would be destroyed in Canada, but in the US I would not have as many of these funds stolen from me by the government.



Wow. I've now found two actual conservatives up there. And coincidently I found both thru gambling websites.
Tolerance is the virtue of believing in nothing
boymimbo
boymimbo
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March 16th, 2010 at 8:47:01 AM permalink
The problem with this entire debate is that you really don't get a choice whether you get sick or not. Yeah, a cough is a cough, and a broken bone is just that, but what about cancers, brain tumors, heart attacks, strokes, or even appendicitis. None of these are easily preventable, and it is just a roll of the dice whether you get this or not.

So, say you have a heart attack. Your health care plan covers it, but your doctor tells you that you need to take time off work to recover, so you do. When it comes time to get back to work, your employer decides that you are no longer needed and you're done. So you go on COBRA for a while, paying your own premiums, decimating your savings, while you go look for new work.

So you find a new job, but the employer doesn't have health benefits. You take the job and go shopping for self-paid health insurance. But because you've had a condition (heart attack, cancer, stroke, insert life-shortening, recurring condition here), you have to pay, oh, $50,000 a year for coverage. You declare bankruptcy because you can't pay the premium, or you cancel health care coverage and pay for the heart drugs out of pocket, because that's what the market dictates. The stress of having to pay $$$$$ for medication gives you another heart attack. You're dead, because you'd rather be dead than pay the ambulance bill after you dial 911. The market works!!!

Earlier we talked about enslavery and how people are enslaved to the government to pay taxes. For me, I have no problem socializing medicine. All of us posting have been lucky so far. We're gainfully employed, we have health insurance that the employer pays, or we're rich enough and healthy enough to pay our own way. We say that hey, let's let the "market" dictate things, which is fine for us, because we don't pay the premium.

However, the moment we become unemployed or the health care benefit becomes a shared cost with your employer, it starts to become prohibitedly expensive. And god forbid that something bad happens, because holy crap, you have sevened out in the worst imaginable way. Getting cancer or other life-threatening / expensive to treat diseases is not something that the individual can control. So why should the individual have to pay the market cost of getting that treated and be exposed to incredibly high premiums that will inevitably kill them anyway?

I guess it's a matter of deciding what society you want to live in. One where you live your own life, paying for everything as you go, and hoping that nothing bad happens to you and if something does, you are forced to use up all of your wealth, declare bankruptcy, and live on the street? (But hey, at least you're responsible). Or one where you count your lucky stars and pay into a system that covers both the lucky and unlucky equally, where if you get sick, you can take time off work to recover, and not have to worry about financial ruin? I prefer the latter, by far. It's just more humane.

That said, what I think would work for America is a blanket group insurance policy that covers everyone regardless of condition, age, preexisting conditions, etcetera. You could buy different policies like the Yugo (they send you to Kosovo for treatment), the Bombardier (they send you to Canada), the Corolla (the coverage never stops), or the Cadillac (overpriced treatment, they send you to Detroit for every single procedure). You pay the rate, no questions asked, no one is denied. Employers could pay it. Employees could pay it. It's affordable. The government would give you a tax credit/rebate for premiums you paid based on your income, (meaning that the Yugo policy would be essentially free for everyone). At that point, you remove the unfairness of the whole insurance program while keeping it privatized. And maybe, maybe, competition would drive the price downward. Perhaps governments would need to put caps on premium increases and regulate the insurance companies somewhat.
----- You want the truth! You can't handle the truth!
AZDuffman
AZDuffman
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March 16th, 2010 at 9:22:12 AM permalink
Quote: boymimbo

The problem with this entire debate is that you really don't get a choice whether you get sick or not. Yeah, a cough is a cough, and a broken bone is just that, but what about cancers, brain tumors, heart attacks, strokes, or even appendicitis. None of these are easily preventable, and it is just a roll of the dice whether you get this or not.



This is why you buy insurance. But we have two problems in the USA. First, people want insurance to cover *everything.* So they load up the benefits. Then people expect the cost of the insurance to be minimal. There seems to be about 35-40% of the USA population who gets totally POed when they are asked to pay for their own care. This has to cahnge.

Quote:

So, say you have a heart attack. Your health care plan covers it, but your doctor tells you that you need to take time off work to recover, so you do. When it comes time to get back to work, your employer decides that you are no longer needed and you're done. So you go on COBRA for a while, paying your own premiums, decimating your savings, while you go look for new work.

So you find a new job, but the employer doesn't have health benefits. You take the job and go shopping for self-paid health insurance. But because you've had a condition (heart attack, cancer, stroke, insert life-shortening, recurring condition here), you have to pay, oh, $50,000 a year for coverage. You declare bankruptcy because you can't pay the premium, or you cancel health care coverage and pay for the heart drugs out of pocket, because that's what the market dictates. The stress of having to pay $$$$$ for medication gives you another heart attack. You're dead, because you'd rather be dead than pay the ambulance bill after you dial 911. The market works!!!



Lots of cherry picking here on your part. First, the USA has the FMLA so you get time off the job and must be taken back by law. Second, most employers offer LTD plans very inexpensively. But guess what? Most people decline coverage again because they are expected to pay for it themselves. They would rather let Uncle Obama send a check. Finally you assume a person will not find a new job with health benefits. Guess what? Most employers do offer health insurance. But if we went to my system in a previous post it wouldn't matter because you would pay for your own coverage then it is not job-dependent. And all of this without socialized medicine and its long wait times.



Quote:

Earlier we talked about enslavery and how people are enslaved to the government to pay taxes. For me, I have no problem socializing medicine. All of us posting have been lucky so far. We're gainfully employed, we have health insurance that the employer pays, or we're rich enough and healthy enough to pay our own way. We say that hey, let's let the "market" dictate things, which is fine for us, because we don't pay the premium.



No, I am not "lucky" to have a job and health insurance. I went to college to get skills and then hunted for a good job. Most everyone who gets a job did the same. Just like in BJ you need to play this basic strategy to overcome the "house edge" of life.

Quote:

However, the moment we become unemployed or the health care benefit becomes a shared cost with your employer, it starts to become prohibitedly expensive. And god forbid that something bad happens, because holy crap, you have sevened out in the worst imaginable way. Getting cancer or other life-threatening / expensive to treat diseases is not something that the individual can control. So why should the individual have to pay the market cost of getting that treated and be exposed to incredibly high premiums that will inevitably kill them anyway?



Plenty of life is not controlable yet must be dealt with. And again, if you could just buy a major-medical type plan with a high deductible the cost of the plan would plummet.

Quote:

I guess it's a matter of deciding what society you want to live in. One where you live your own life, paying for everything as you go, and hoping that nothing bad happens to you and if something does, you are forced to use up all of your wealth, declare bankruptcy, and live on the street? (But hey, at least you're responsible). Or one where you count your lucky stars and pay into a system that covers both the lucky and unlucky equally, where if you get sick, you can take time off work to recover, and not have to worry about financial ruin? I prefer the latter, by far. It's just more humane.



He who trades his freedom for security will have neither. If everyone is under a government plan, how long before some government actuary (no offense, Wiz) says, "You don't get this treatment because you ate Big Macs and got fat." Or, "We require a certain % of care to go to minorities, you don't qualify." Or, "You are out of shape, if you don't lose weight you will need to go to fat camp. It's for the common good after all."

Quote:

Perhaps governments would need to put caps on premium increases and regulate the insurance companies somewhat.



Price controls never work. If you cap the price at a low lwvel people and companies simply stop selling the product or service.
Tolerance is the virtue of believing in nothing
boymimbo
boymimbo
Joined: Nov 12, 2009
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March 16th, 2010 at 9:32:50 AM permalink
Quote: AZDuffman

No, I am not "lucky" to have a job and health insurance. I went to college to get skills and then hunted for a good job. Most everyone who gets a job did the same. Just like in BJ you need to play this basic strategy to overcome the "house edge" of life.



You are lucky that (1) you were able to pay for college (2) were smart enough to go to college (3) secure and maintain a job that provides health insurance (4) haven't had some condition where you had to leave work for an extended period of time. Some people just aren't that fortunate.

MOST employers offer health coverage. What if you are thrown out of work (like the 10% who are unemployed today)? What if you work for a small business that doesn't offer insurance? What if you have a preexisting condition? Throw em under a bus?


Quote: AZDuffman

He who trades his freedom for security will have neither. If everyone is under a government plan, how long before some government actuary (no offense, Wiz) says, "You don't get this treatment because you ate Big Macs and got fat." Or, "We require a certain % of care to go to minorities, you don't qualify." Or, "You are out of shape, if you don't lose weight you will need to go to fat camp. It's for the common good after all."



None of that has happened here in Canada yet in the 45 years we've had socialized medicine nor in any other socialized country that has socialized medicine so why do you think it will be that way in the States? Why does it have to be that way?
----- You want the truth! You can't handle the truth!
AZDuffman
AZDuffman
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March 16th, 2010 at 9:46:00 AM permalink
Quote: boymimbo

You are lucky that (1) you were able to pay for college (2) were smart enough to go to college (3) secure and maintain a job that provides health insurance (4) haven't had some condition where you had to leave work for an extended period of time. Some people just aren't that fortunate.



Again, I don't call it "luck." I look at is more along the lines of "The Ant and the Grasshopper." Or put another way, The Roman Empire wasn't planned, but neither did it "just happen."


Quote:

None of that has happened here in Canada yet in the 45 years we've had socialized medicine nor in any other socialized country that has socialized medicine so why do you think it will be that way in the States? Why does it have to be that way?



Why do I think it will happen in the USA? I have my eyes open. There are already crazies talking about banning salt in restaurants; taxing soda pop and fatty foods; and the USA Government is obsessed with setting aside things for "diversity" representation. So imagining what I wrote as part of a socialized medicine plan is not even a stretch of the imagination but rather a projection based on current government behavior.

I still ask if socialize dmedicine is so great, why do so many important people come to the USA when they need good and fast care.


PICK ANY TWO OF THE FOLLOWING FOR YOUR MEDICAL CARE OPRIONS:

(A) GOOD
(B) FAST
(C) CHEAP
Tolerance is the virtue of believing in nothing

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