Canadians: tell us about your health care system

[Jon Grider]

I'm interested in what you Canadian Creekers think about your health care system. This topic generates much acrimony from both political sides here and I'd just like to here from those who actually live and use Canada's health care to tell me generally how you like it, and in your real life experiences, the pros and cons of government supplied care.
I'm asking that this not turn into an American liberal/conservative debate, let's just hear what our northern neighbors have to say.
I hope this doesn't cross any forum rules, moderator, feel free to delete if it does.

[Paul Ryan]

I am curious as well. When ever the health care debate comes up around here all I here from the other side is how BAD canadians have it. They wait in lines, cannot get proper care because the back log in the system, blah blah blah. Tells us how it is. What is good, and what needs improving.

[Rod Sheridan]

Well, here goes the condensed version

- I have a family doctor who I visit as required, same as you, I phone, get an appointment, go visit him, no out of pocket expenses.

- I have two children in their twenties, childbirth was at a hospital for both, out of pocket costs were about $20 to $30. The youngest had to stay a few days extra due to some complications.

- Diann (wife) had her appendix removed about 15 years ago, just before she left for a month long motorcycle trip to Europe. Her doctor wanted it done before she went, so she had an operation two days after diagnosis.

- I had an eye injury, immediate emergency attention including some surgery, out of pocket expenses about $30.

- My Mom is in the final stages of throat cancer, when she was diagnosed a couple of years ago, she was scheduled for Chemotherapy and radiation treatment, 2 week waiting period for treatment to begin.

Mom had four weeks of treatments, only out of pocket expenses were parking.

Mom is visited by a palliative care doctor every week now, a nurse visits her once per day, and she has a personal support worker that visits to do housekeeping, laundry, meal prep etc. Out of pocket is zip.

You have probably heard of the H1N1 vaccinations, if I remember correctly we've had about 6 or 7 million doses for a population of 33 million, prioritised for those most at risk. Being a healthy adult, it will probably be another week or two until I'm able to be vaccinated. Cost zip.

I'm sure you've heard horror stories because we've seen some of the negative advertising items you have seen regarding Canada, in the USA. If it wasn't so inaccurate, we would laugh harder.

Our system isn't perfect, any system could be better. There are the occasional screw ups, anytime you have people involved, there will be failures, however there are almost no Canadians who would trade systems with our American friends.

Our outcomes are better, our life expectancy higher, and our medical costs substantially lower than yours.

I guess that once you take the profit out of the system, things get less expensive, in addition, their isn't a bias to deny coverage, since the medical benefits are well defined by the Federal government. The provinces and Territories then decide how to implement it at the local level.

I hope this helps..............Rod.

[Tim Morton]

So Rod, if you take a procedure like child birth that may run $15,000 here in the US..and you pay $30 out of your pocket...who pays the rest of the money?

[Rod Sheridan]

So Rod, if you take a procedure like child birth that may run $15,000 here in the US..and you pay $30 out of your pocket...who pays the rest of the money?

Hi Tim, funding for health care comes from the Federal government, who provide the money to the Province or Territory.

It's paid for through our taxes obviously, it's a lot less expensive than your insurance costs are in the US.

I can only surmise that the not for profit model results in lower costs....Regards, Rod.

P.S. the link below provides some info on a very complex issue.

http://en.wikipedia.org/wiki/Health_care_in_Canada

[Jon Grider]

Thanks Rod for your first hand account. You answered my questions thoughtfully and clearly.

[Rod Sheridan]

Thanks Rod for your first hand account. You answered my questions thoughtfully and clearly.

You're welcome, something I forgot to mention is that prescriptions are covered by the government for seniors, many people have additional coverage through their employers. My Mom is a senior, and the last time I picked up prescriptions for her I had to pay $2 or $3 dollars, maybe it's a dispensing fee from the pharmacy.

I have additional coverage through my employer for prescriptions, glasses, and some other items.

Prescription drugs are far less expensive in Canada, many Americans purchase them here. I have no idea why that is, some of the pharmaceutical companies are American, so you would think they would favour Americans over foreigners.

Drugs used in hospitals are covered as part of your hospital coverage, so there's no charges there that I'm aware of.

Regards, Rod.

[Eric Larsen]

Does Vancouver need another brew master?

:D

[Scott Shepherd]

Rod, what do you see up there from the aspect of the system going broke? I can't find a single government run system that isn't trending towards going broke. Canada, most European countries, etc. If you look at any trend lines, they are all trending in unsustainable paces, which actually, isn't much different that what's happening with our health care costs now. From the outside, it looks like it's the same problem, just different management. Same problem, trend of cost is going the wrong way.

Do you see reports of that up there? Is that all unfounded?

Not arguing, just curious.

[paul cottingham]

Another example:

I have a massive growth in my brain that was discovered when I was 40. It has been in my head since birth. Cost for the 3 complex operations that have allowed me to live a relatively normal life: zip.

With private insurance, I am sure I would have been denied coverage as it is a pre-existing condition.

When my daughter was born, LOML got septicemia and damn near died. she was in the hospital for two weeks. Cost to us: zip.

I am very glad I live in Canada.

As for the govt. going broke because of this, certain elements have been screaming about that since the Canada health act was enacted. Hasn't happened yet. In fact, I believe the cost of health care goes up at about the same rate as inflation in Canada.

[Ken Fitzgerald]

I will suggest that everyone read the Lewiston, Idaho ....Lewiston Morning Tribune article "Taking Canada's Pulse" published on Sunday 9/27/2009. In that article a physician practicing across the Snake River in Clarkston, WA.....he,Dr. Don Greggain, a native of Saskatchewan....educated there...practiced medicine in Ft. McMurray. He claims he left after having 8 patients die of things they didn't need to die of ....because they couldn't get the tests and procedures they needed.

In the article he states that the provincial government decided they needed to cut their medical expenses by 40% because it wasn't financially sustainable even in this oil rich province.

Initially elected boards controlled the decisions effecting the provinces medical system. Then the politicians got involved and the boards became appointed rather than elected and medical professionals weren't allowed to serve on the boards.

"They were literally rolling people out of the hospital onto the sidewalks and telling their families ""I hope you can take care of them at home, because we're going from 200 beds to 60 beds and can't afford to keep them' ". Greggain said.

Later even with increased spending his paitents faced higher waiting periods, delayed medical care and with the predictable impact on his patients, he moved on.

I'm sure there will be those who will say "it isn't so". I suggest that based on this article, each province runs/controls it's own medical system and therefore there might be differences.

[Rod Sheridan]

Hi Scott, the information I've been able to find suggests that spending is going up in step with inflation and/or our GDP.

It's still about half the cost of the American system per capita, if I remember correctly.

As another Canadian said, we've been claiming that it's been going broke for decades, however it obviously isn't.

Regards, Rod.

[Don Kondra]

As has been mentioned, health care is free but there may be a waiting period for non life threatening conditions and/or testing.

I've recently had two experiences, one good and one bad :rolleyes:

One morning I woke up and couldn't move my hand without extreme pain. It was a week or so before my doctor could see me and a trip to the emergency clinic was an hours long waste of time.

From doctor visit to appointment for testing to confirm carpal tunnel to meeting with the surgeon to operation was a year and half. Perhaps this would have been shorter if I lived in a larger center but nobody I talked to was impressed that I made my living with my hands or offered an alternative.

Ironically it seems a half time spraying contract is what put my hand over the top but paid the bills while I couldn't work in my shop.

100% recovery by the way :D

My second major experience was with a thrombosed where the sun don't shine condition :eek:

Hours in the emergency clinic and then the doc's in training sent me home and told me to come back if it didn't get better, sigh..

Next day I returned, after another two hour wait and examination they called the head doctor in on a Sunday and I was on the operating table in half an hour.

An overnight stay and I escaped the next day, cost zip.

As to pills, I'm type 2 diabetic with high blood pressure, cost ~ $50/month.

Also my 85 year old mother required a three month stay in hospital last year. Cost zip. She is at home now with a privately paid live in nurse and doing just fine. A health care nurse visits once a week to examine her and give her a shot for kidney disease, cost again zip.

I have nothing but high praise for our health care workers but sometimes the wait for tests, etc. may seem long.

Cheers, Don

[Josh Reet]

I'm not canadian, but I live 15 minutes from the border and used to work for a canadian magazine shooting extreme sports photos. It was always funny to hear the comparisons between the Canadian athletes and the US ones. These guys don't make much money overall, and nobody offers them employer insurance. So very few of the US guys had their own insurance. The canadian guys would just head to the doctor any time they broke something or had a bad crash. Sure, they might have had to wait a bit for an ACL operation or some such thing, but it always got done. And in an emergency they never hesitated to head to the ER. In contrast, the US riders would put off going to the doctor as long as possible. As a result, a guy I know ended up being in the ER due to getting flesh eating disease from a dirty skatepark crash. Another guy got a nasty infection in a gash on his leg that ended up with a long hospital stay. If he had just headed to the ER when it happened and gotten some stitches, it wouldn't have been an issue. But he was afraid of the ER bill and wouldn't go. And so on and so on. At the end of the day, the US guys either got saddled with a huge bill that followed them for years. Or they just stiffed the hospital under whatever "unable to pay" provisions existed. Which, of course, shifted the cost back on the taxpayers and/or other customers in the health care system. Like I said, sure some of the canadian guys had to gimp around on crutches for a few months before their non-life threatening ACL surgery could be performed. But in the US the guys limped around on crutches for months until they could figure out a way to pay for the surgery. So the net result for this group of people ended up being the same in the oft-mentioned "you have to wait forever for non life threatening surgery" department.

Another example would have been the birth of our first child. My former editor at the canadian magazine had a baby shortly after we did, so he and I have spent time comparing notes. He, obviously has govt funded health care. I have good insurance for my family through my job. I'm very lucky in that regard. When I was hired, they told me "we don't have a retirement or 401k matching plan. Instead we decided to offer really good health coverage to our employees and their families". Works for me.

I had a $500 deductable for the birth itself (reasonable uncomplicated) and $20 copays for every visit during the pregnancy. The pregnancy itself was a bit complicated and we probably had 30 visits plus a pile of prescriptions to fill ($15/ea). So figure around $1200-1300. Not bad all in my mind. However, keep in mind that I have VERY good insurance that would cost me close to $1000 a month (this is a lowball guess) if I had to pay myself. Few of my peers have insurance at this level and because of that I have watched a few of them end up with $10,000 in bills after a tough birth when coverage ran out. In comparison, my canadian buddy and his wife had more or less the same sort of pregnancy/birth as we did in terms of office visits and problems (or lack thereof). At the end of everything, he had little to nothing out of pocket (a few prescription filling fees, as mentioned earlier) and still got benefits that we never did such as a infant care nurse who made two house calls after the birth to make sure they had their "new baby" questions answered, the baby was being cared for, and that feeding/etc was going well. We got to watch a video about not leaving your baby out in the rain and they made us promise that we had a car seat before we left the hospital. Nobody gave two sticks about us after that unless we made the effort to get hooked up with a pediatrician.

Anyway, the canadian system isn't perfect. I'm sure plenty of the horror stories are true. But from my experience, the horror stories aren't the daily reality for most canadians. Just like the horror stories of insurance companies denying transplants or other expensive care in the US isn't the norm for most of us. Both things happen both places, and people die from it. But day to day for the average person is what we should be focusing on, not the rare events that make the news or get turned into movies.

[Neal Clayton]

"They were literally rolling people out of the hospital onto the sidewalks and telling their families ""I hope you can take care of them at home, because we're going from 200 beds to 60 beds and can't afford to keep them' ". Greggain said.

Later even with increased spending his paitents faced higher waiting periods, delayed medical care and with the predictable impact on his patients, he moved on.

I'm sure there will be those who will say "it isn't so". I suggest that based on this article, each province runs/controls it's own medical system and therefore there might be differences.

yeah, all of those things happen here in the US already.

a friend of my grandmother's has live in help. kinda a drifter, guy showed up lookin for work and there was none, so this old lady put him up in the garage apartment, in exchange for cutting grass, fixing leaks, and what not. he had a ruptured appendix about a year ago, and the hospital sent him home to die, because he couldn't pay for the surgery. if he hadn't had someone to bring him to the university hospital three counties away, he would be dead.

so why am i to fear the non-profit health care for the things that the for profit health care does already?

[Rich Stewart]

What I am curious about is how does Canada treat illegals in the country? If I go over the border and show up in a hospital will they treat me? Also I am curious about how much is taken out of the Canadian paycheck. I have heard the income tax is in the neighborhood of 50%.

While I am on the subject, in Europe where they say health care is free, gas costs 9 dollars a gallon. Is that a way to fund health care?

[Denny Rice]

I can drive a Zamboni.......I wonder if I can trade the American way of "trickle down" sub-standard healthcare for the Canadian way of life? I also have friends that live in Canada, I was amazed when they told me crime was almost nothing, they don't lock the doors to their home when they leave or go to bed at night. I thought that in itself was amazing.

[Josh Reet]

Also I am curious about how much is taken out of the Canadian paycheck. I have heard the income tax is in the neighborhood of 50%.

Income tax in Canada, as far as I know, is nowhere near 50%. The only places that touch 50% for personal income tax in the world, according to the wikipedia chart below, are Germany, France, and Belgium. Now, wikipedia is worth what you pay for it. But that roughly jives with other stats I have found on the net. But take it with a grain of salt I suppose. Particularly because reducing the income tax variations across a country's income levels to one average number is bound to be inaccurate in some fashion. If we were really having an accurate conversation ,we would be picking a specific income level and comparing tax rates for that level in different countries.

http://en.wikipedia.org/wiki/File:Income_Taxes_By_Country.svg

According to that chart and other info I have seen (and anecdotal evidence from friends), Canada's income tax is roughly the same as ours in the USA. Some places show it higher on average, some show it lower for a given tax bracket. I'm not enough of a tax expert to know for sure, but I think we can safely say that it isn't a huge amount different. Now, they do have a national sales tax in Canada, so you would have to factor that in there as well.

Probably the most relevant point I could make about income and tax in Canada is that my peers up there (meaning people my age and in the same general place on a career path) live much the same as my peers in the USA. Some have bought houses, some are saving still. Some have brand new cars, some are driving older ones for a few years longer. Etc etc. If there is an income tax difference, it isn't enough to make a visible difference in the standard of living, at least between my peers in BC and my peers in WA.

[Brian Ashton]

I've been on three systems:

Canadian, US (illegal immigrant insurance) and Australian.

My take all three

Canada's is the best by far as an overall civilized none discriminatory system. It has faults and is suffering from over spending. Sadly those faults could be easily fixed if people were forced to stop going to the doctors for every little thing or at least made to pay for them. I think people in Canada are too soft and are taking for granted what they have and as a result are running it into the ground.

US system for me was a good system. I was covered for everything with a yearly maximum expenditure of $2500 for medical services. All up it cost me around $350/month for my wife and I. One things for sure if you are sick or injured the best place on the planet to be is in the US. No other country can come close to the advanced medical treatment that is coming out of the US.

Australia is a two teared convoluted system of public and private. It appears that Australia tried to do a best of both worlds but somehow royally screwed it up. And if that weren't enough if I add up my tax contribution and my monthly private coverage costs I pay more and get half the service of what I got in the US. To me it's more like a survival of the fittest type system.

I think if you could hybridize the US and Canadian systems, but do it right! you'd have the best by far on the planet. You need the social and civil aspects to look after the populous, along with the capitalistic drive that brings medical advancement.

[David Freed]

....Sadly those faults could be easily fixed if people were forced to stop going to the doctors for every little thing or at least made to pay for them

That is a big reason insurance costs in the US have gone through the roof. So many people think that insurance should pay for everything, so the insurance companies create policies that do and then people complain because it costs so much. Insurance is supposed to be for emergencies/catastrophes, not a hangnail. If little Johnny or Suzy gets a runny nose, instead of making them blow it and buy a bottle of cough medicine or even go to a family doctor, they want run to a specialist. An insurance policy that doesn't cover all of that isn't bad, just sensible. It doesn't cost nearly as much either.

I read an article recently that concerned childrens weakened immune systems because people are demanding antibiotics for every little thing and using antibacterial wipes all the time. People should let their children and themselves live their life without worrying about germs all the time.

I will admit that I am a little bit on the other extreme. I have patched myself up on several occasions where if I had gone to a doctor, he/she would have put stitches in. When I ran my fingers through the tablesaw, I went to the house and cleaned it up. Only when I saw the bone in one of my fingers did I decide I had better go to the hospital. The doctor in the emergency room wanted to call a specialist because it had cut the tendons in the end of my ring finger. I told him if he could sew it up, get busy sewing and let me go home. He did.

[Rod Sheridan]

I can drive a Zamboni.......I wonder if I can trade the American way of "trickle down" sub-standard healthcare for the Canadian way of life? I also have friends that live in Canada, I was amazed when they told me crime was almost nothing, they don't lock the doors to their home when they leave or go to bed at night. I thought that in itself was amazing.

Denny, that Zamboni comment cracked me up, you made my day.:D

Unfortunately crime isn't non existent in Canada. I live in the largest city in Canada, and we have approximately one murder per week.

I wouldn't call that non existent.

Regards, Rod.

[Rod Sheridan]

What I am curious about is how does Canada treat illegals in the country? If I go over the border and show up in a hospital will they treat me? Also I am curious about how much is taken out of the Canadian paycheck. I have heard the income tax is in the neighborhood of 50%.

While I am on the subject, in Europe where they say health care is free, gas costs 9 dollars a gallon. Is that a way to fund health care?

Hi Rich, I believe the requirement for medical coverage is permanent residency of 3 months or more.

Income tax is graduated by income, so it is possible to pay 50%, it's also possible to pay nothing depending upon which end of the pay scale you're at.

I believe the average income tax is similar to the US value.

Regards, Rod.

[dennis thompson]

Rod
The reason that drugs are less expensive in Canada is that :
1-the Canadian govt controls the prices while the U.S. govt does not
2-most research & development spending is funded through the U.S.
Dennis

[Wayne Watling]

My Experience; snapped an ankle when I slipped on the ice a few years ago. Got taken to the emergency in ambulance and the next morning had an operation to place the pins. Stayed in a private bed for 2 nights, cost: $150, and it would have been $0 if I had taken the standard plaster cast, I took a more flexible type which costs more.

My opinion is that the medical area is one area of a society that you cant leave 100% in the hands of the private sector, the profits just eat and eat into the cost until its so expensive you have to sell your home to pay your medical costs, they start turning away less well off folks in favor of the wealthy and society starts to crumble. A publicly funded system is the only way to go if its managed reasonable well.

Regards,
Wayne

ps. The problem with medical insurance companies is that they keep redefining who can get what treatments and at what premium, all to lessen their risk (increase profit), if it were left totally up to them they probably wouldn't insure the elderly. This kind of works for car insurance but has very bad consequences when it comes to medical care for humans, when it comes to non elective medical care all should be treated equally.

[Rob Robinson VT]

Probably the most relevant point I could make about income and tax in Canada is that my peers up there (meaning people my age and in the same general place on a career path) live much the same as my peers in the USA. Some have bought houses, some are saving still. Some have brand new cars, some are driving older ones for a few years longer. Etc etc. If there is an income tax difference, it isn't enough to make a visible difference in the standard of living, at least between my peers in BC and my peers in WA.
I have a former business partner in Canada whom I've know for over 20 years. We've always been in the same profession, earning about the same income. You're right, from what I can see things are pretty much equal on both sides of the border in terms of standard of living with one exception: health care. He pays next to nothing and gets excellent care, including free orthoscopic knee surgery last year and a free H1N1 flu shot last week. I pay nearly $300 per month for supplemental Medicare insurance (plus nearly $100/month to the guvmint for parts A & B) and also get excellent care, but that same knee surgery would cost me over $1,000 (my sister-in-law just had it last year and we're on the same insurance) and I'm not able to get an H1N1 flu shot as we've had to ration our supply!

[Ken Fitzgerald]

Uh Rob...

You can't quite do a direct comparison between Canada and the US as Canada has 1/10th the population.......Size matters and frankly complicates things in manners that aren't always good.

The rationing of H1N1 flu shot has everything to do with the fact the manufacturer can NOT produce the H1N1 flu shot in large enough quantities to allow everyone in the US to be vaccinated. It has absolutely nothing to do with the US healthcare industry!

[Wayne Watling]

You can't quite do a direct comparison between Canada and the US as Canada has 1/10th the population.......Size matters and frankly complicates things in manners that aren't always good.

I'm not sure I can agree with the above. What about economies of scale, based on that principle shouldn't health care in the US be less expensive. Look at the huge buying power over the drug companies and other medical equipment you guys have. I don't buy the story that the US is less organized because the population is larger.
There is big money at stake for the medical related organisations with the status quo, the inertia for change is immense with all that vestured interest.

[Rob Robinson VT]

Uh Rob...

You can't quite do a direct comparison between Canada and the US as the Canada has 1/10th the population.......Size matters and frankly complicates things in manners that aren't always good.

The rationing of H1N1 flu shot has everything to do with the fact the manufacturer can NOT produce the H1N1 flu shot in large enough quantities to allow everyone in the US to be vaccinated. It has absolutely nothing to do with the US healthcare industry!
While I'd agree that size may be a factor I'd be much more inclined to believe it so if we were comparing the U.S. to, say, Switzerland which has a population smaller than that of metro NY. I've spent a lot of time in Canada in the last 10 years or so and I certainly see much more that we have in common than things that differentiate us. While their systems are far from perfect, they do seem to have worked out some things better than we have, partially because they don't appear to overly complicate them as we have a tendency to do.

I fully realize that there is a worldwide shortage of H1N1 vaccine, what I don't understand is how Canada managed to get enough for patients not in the most susceptible groups while we couldn't.

[Belinda Barfield]

I would be interested to know the statistics on malpractice suits filed in Canada versus the US, and if there is a difference in the cost of malpractice insurance between the two countries.

[Ken Fitzgerald]

Wayne,

Explain logically how it should be cheaper to maintain a full sized bus over a Volkswagen van?

[Dan Friedrichs]

Wayne,

Explain logically how it should be cheaper to maintain a full sized bus over a Volkswagen van?


Per occupant, the bus is cheaper :D



One thing that I (being employed and having good heath insurance) appreciate about the US system is that my money can buy care that is probably the best in the world. I can certainly find cheaper, but if I'm willing to spend money on my care, I can find private physicians who will provide a higher quality of care, if I'm willing to pay for it. I'm curious, does the Canadian system provide similar opportunity? If I want to pay extra for elective/non-emergent care, can I do so and receive better/faster service?

(I see this factor as a "perk" to the US system, but clearly the system also fails many who cannot afford care, so I don't mean to imply that the US system is better/worse than anything else)

[Wayne Watling]

Wayne,

Explain logically how it should be cheaper to maintain a full sized bus over a Volkswagen van?

Its not any cheaper but there are many more people paying for the bus ride, so the over all price per person should be lower. The idea is that there are parts that have to be maintained and replaced no matter whether you have a small or large van, thats probably why they keep building larger and larger jet liners. This is just the simple economies of scale argument which applies in so many areas of the economy.
When we go shopping in the US I noticed that goods are so much cheaper there than in canada even with the exchange rate. I guess because they can buy in such large quantities they can demand better prices from suppliers.
One should be able to extrapolate that same principle to the medical industry but it doesn't seem to want to work. Is it being kept artificially high by all the vested interest?

[Rob Robinson VT]

One should be able to extrapolate that same principle to the medical industry but it doesn't seem to want to work. Is it being kept artificially high by all the vested interest?
Bingo!

Give that man a kewpie doll!

[Glenn Clabo]

As I have family in both countries...and in the healthcare systems...both as patients and healthcare professionals...I see both sides anecdotally and factually.

There are significant differences in the basic philosophy of each country toward the health of their people. Canada has a whole country approach toward healthcare while the US has an individual approach. Canada believes that it is in the best interest of their country to promote healthcare of everyone from conception…through birth…in life…until death. The US approaches it as it’s an individual responsibility.

My anecdotal input involves our parents. Our US parents are getting nowhere near the healthcare attention at a much higher individual cost than our Canada ones. Our US parents will eventually use all their life savings if they live much longer…while our Canada ones have no worry what so ever.

Unfortunately the results of the US philosophy have proven to have been extremely costly both in human life and money. The US infant mortality rates are appalling…old age brings loss of all that most work hard for…2/3’s of all bankruptcies in the US are because of healthcare costs…the US pays more per person…Vets are living on the streets…etc…etc…Nothing is free. But until a country stands up and says enough…individuals suffer while some make out. Do you know of anyone that has worked far longer than they planned because of healthcare costs in the US? How about Canada?

There are some common misconceptions that are spread throughout the internet…mostly based on political slant these days. For instance…Canada has socialized medicine…which is not true…they have single payer mandated insurance. The US has the best healthcare in the world...based on outcomes and cost...not true. Drugs cost less Canada…not true on a total cost basis. There will be no new drugs if we pay less for them....All pharmaceutical companies spend more on ads and exec pay than they do on research. The healthcare system in Canada is going broke…not true…the country demands will not let it. Doctors make less in Canada than the US…not true. Many doctors who come to the states return to Canada…because of the frustrations of dealing with insurance. The Healthcare admin costs in the US are about 31% versus 17% in Canada because they demand it...we call it Capitalism.

Is good healthcare expensive? Yes…but when a whole country stands up and says…healthcare is for everyone…not just the rich…costs come down. Why are the Canadian pharm companies selling flu vaccine to the US? Because Canada demands that they have a higher capacity. When a whole country says healthcare is a right for everyone…you have better outcomes while looking to lessen cost…which has proven to result in longer and more healthy lives. Because most of the people in the US have insurance believe that those who don’t can simple work for it…there may never be a US healthcare system that can come close to compare to Canada…let alone that compares to most of the industrialized world.

[Eddie Watkins]

Very informative thread, just a note,tho. The United States ranks #1 in the world in obesity. That probably has more to do with our life expectancy ranking 32nd, or whatever it is, than the quality of our healthcare. That we live as long as we do, speaks well of our healthcare program(s).
My daughter had a skin rash which required some medication. The medicine was $400+ here as a prescription drug. My wife oredered the exact same medication online, from Canada for about $10 as an over-the counter drug.

[Ken Fitzgerald]

Wayne,

The initial outlay for the larger jets and the buses I referenced are greater and the maintenance costs are greater. And....aren't all the airlines having financial difficulties?

[Paul Ryan]

The Healthcare admin costs in the US are about 31% versus 17% in Canada because they demand it...we call it Capitalism.

Is good healthcare expensive? Yes…but when a whole country stands up and says…healthcare is for everyone…not just the rich…costs come down.

Here lies IMHO the problem with our (US) health care system today. For some reason our country believes nothing should be free, or very little anyhow. Why is it that the right to the best heath care is only for people that have money. If you are employed in a lower end job you do not recieve heath insurance and cannot afford it. It costs more money to eat healthy. We have al sorts of choices at the supermarket but the cheaper foods are those that are bad for you. It all costs money too much money. The right to quailty FREE health care should, again IMHO, be in the Bill of Rights. But in our country it is only for people that can afford it. I don't know what the solution is, but until we can get over the fact the each of us are responsible for the type of care "we can afford" our system will not get fixed.

[Ken Fitzgerald]

Some 12-14 years ago while on a skiing trip, our youngest son came out of the shower with both ears swollen to a thickness greater than a slice of bread. His teenaged vanity woulddn't allow him to wear a ski hat that didn't match his ski outfit. He was treated for frostbite at a hospital near the Super 8 where we were staying and the rest of our skiing holiday was cancelled. The next morning I shaved, showered and dressed and took my current "read" to the lobby to drink coffee, read and allow my wife and son to continue sleeping.

A gentleman joined me and then struck a conversation. He was on a bus trip from Calgary to Las Vegas and he indicated on several of the previous trips they had to stop in Spokane for their ritual "heart attack" where Canadian citizens would have to be treated in Spokane for heart problems for which they were "wait listed" in the Canadian healthcare system. He wondered if they were to stop again this trip.

As far as the cost of drugs, executives of drug companies have been quoted that they must negotiate the cost of drugs sold in Canada. They indicated the higher costs of drugs in the US offset their research costs.

Drugs are just a small part of the equation.

There is greed in all businesses where capitalism is practiced. When have you ever heard anyone ask the question "What is a reasonable profit?" The healthcare industry isn't the only cuplrit just the politically popular one right now.

Glenn,

Explain the difference between "single payer mandated insurance" and "socialized medicine"......you can call a duck anything you want but in the end it is still a duck. Explain this "single payer mandated insurance" is paid for.......

Read the article I cited.

16 years ago this past September, my wife was diagnosed with a rare and deadly form of cancer. It was 10 days from the diagnosis to the surgical treatment at one of the most recognized medical centers and medical schools on the West Coast of the US. It was the longest 10 days of our lives. While we had insurance it was still terribly expensive but we managed to eventually pay for it.

In the past 2 weeks a dear friend was diagnosed with cancer. It's been less than 2 weeks from initial diagnosis, retesting, biopsy and she is undergoing surgery as I type. I've seen the emotional stress she and her husband have encountered these past 2 weeks. These retired folks pay $700/month for their health insurance. It won't seem as expensive as it previously did.

There is no doubt there is greed in the healthcare industry.

There is no denying there are waiting lists for diagnostic and treatments in the Canadian systems.

Somebody want to explain the rumored "private clinics and hospitals" in Canada and if they exist....why?

[Ken Fitzgerald]

Paul,

Explain how in a capitalistic society you'd pay the folks who work there Paul.

Would you work at a Chevy dealer for free?

[Wayne Watling]

Here are some Canadian figures released today:

http://www.canada.com/Health+spending+183B/2245523/story.html

So in 2009 it looks like each Canadain paid CAD$5452 for the health care system. Highest costs are the hospitals followed by the drug companies then the doctors.

[Chuck Wintle]

So Rod, if you take a procedure like child birth that may run $15,000 here in the US..and you pay $30 out of your pocket...who pays the rest of the money?

The government pays the shot and they take money in the form of taxes to pay the costs. Our health system is not free and experiences vary widely from province to province. But no one goes without health care....its there for all citizens. In the US you have maybe 30~40 million who have no insurance and therefore no access to care.

Personally I have experienced extremely long waits at clinics and hospital emergency rooms. Once I cut my thumb on the table saw and it took 8 hours to be seen. It should have been immediately and it caused me to curse out our system. No system is perfect. :D

[Ken Fitzgerald]

So Wayne...my friends who are paying $8400 locally annual insurance premiums would be paying $10, 904 in Canada?

[Eric Larsen]

I don't know what the solution is, but until we can get over the fact the each of us are responsible for the type of care "we can afford" our system will not get fixed.

My opinion is that nobody should view human suffering as a profit-generating enterprise. Our police and fire departments are publicly-funded. A part-time, low income worker can expect the fire department to respond promptly if his or her apartment catches fire. A multimillionaire can expect the same response if his or her mansion catches fire.

Very few people argue that police and fire departments should be private for-profit industries. Why we can't make the small logical leap to include health care is beyond me. Everyone should be able to expect some sort of baseline care. If the rich wish to augment their health care, they can hire concierge doctors, just like they do now. (And they can hire private security, just like they do now.)

[Ken Fitzgerald]

THey tried that in a few states Eric.

Which State has the 7th largest economy in the world and is on the brink of bankruptsy?........many businesses leaving on the run?

[Glenn Clabo]

Socialized medicine, in it's original meaning, was confined to systems in which the government operates health care facilities and employs health care professionals. Nowadays...it seems depending on ones politcal bent...it's defined as anything that has any government hands on it.
Single payer mandated insurance, like Canada has, does not control the interface between the doctor and the patient. You pick the doctor...the doctor tries to fix you as they can. The Government simply tells the Province that you have to provide healthcare...and pay for it...anyway you see fit.
No ducks or doctors were killed in this message.

[Ken Fitzgerald]

Who pays the bills Clabo?

Who appoints the councils that control what happens in say the Province of Alberta.

The doctor I cited was a member of one of the original elected councils. Then they went to political appointments with NO healthcare professionals on the council. Hmmmmmmm.

So while the government pays for the healthcare and politicians appoint who serves on the councils containing no healthcare professionals that determine the direction of healthcare within a province....it's not socialized.

QUACK!

If you have to wait for an extended period of time to see a doctor...isn't that kinda like getting between a patient and the doctor?

[Wayne Watling]

So Wayne...my friends who are paying $8400 locally annual insurance premiums would be paying $10, 904 in Canada?


Not exactly Ken, the $5K figure is just the total $ amount divided by the the total number of Canadians. Because heathcare is funded by the tax system, some folks would be paying more and others less, according to how much tax you pay. A single mum with 3 kinds would hardly pay anything for their healthcare (as it should be).
In my opinion this is a perfect system for healthcare, capitalism has no place here. Cosmetic and elective medicine is different of course and there is some debate on what constitutes elective surgery.

[Josh Reet]

This thread should just be axed under the "no political talk" clause. I have a feeling it has run it course. I'm going back to talking about tools.

EDIT: OP removed personal opinion. I edited him belittling himself.

[Heather Thompson]

My husband and I pay 978.00 per month for health care, 11,736.00 per year, when COBRA runs out my husband will be uninsurable, he has a tremor. He had an upper and lower GI a few months back, cost about a 1000,00 out of pocket, took about 25 minutes. The health care system in this country needs to change, I was raped as a small child, it hurt less than what is happening now.

Heather

[Eric Larsen]

Ken, it seems that "the bottom line" is always your biggest concern.

One of my favorite lines from any movie comes from Platoon: "Free your mind and your ass will follow."

If we all stood up and said, "This has gone far enough." I am 100% unequivocally certain that we're smart enough to work up a solution. We don't have a money problem. We have a willpower problem.

We both know that most of California's problems stem from the crushing effect illegal aliens have on their economy. Anything California does is going to have to be filtered though the lens of hundreds of thousands of undocumented aliens.

But does that mean the rest of the country should stagnate? That people should be denied treatment just because some middle manager needs to bring profits up 4 percent this quarter?

We are smart enough to fix this. The radical fringe yelling, "No! No change. Nothing at all. No. No. No. No." receives too much attention. We should dismiss them as dead weight and fix this problem without them. They're partof the problem, anyway.

[Ken Fitzgerald]

Josh,

You feel it should be axed because someone disagrees with you? What is you definition of a mellow thread? One where eveybody gets together and nods their heads in agreement? A lot of the problems arise because of that type of flock mentality.

Because someone dare ask questions?

Where did I flame anyone?

I simply asked questions and cited a newpaper article.

I can cite others who are Canadian friends who have brought family member to the US for treatment and diagnosis.

You cannot separate the cost of healthcare from the politics if you are going to use tax dollars to pay for it.

You cannot separate the number of malpractice cases (deserved and undeserved) from healthcare discussions.

You cannot separate the quality of healthcare from the cost of healthcare. You can say you need to make it more cost effective....more efficient...but nothing is free. Even in Canada, somebody is paying the bills.

I'll agree the healthcare system needs to change but to rush into it without a lot of forethought on how to pay for it is being financially irresponsible.

As much as proponents would like to oversimplify the subject it cannot be done. It's much more complex than that.

[Ken Fitzgerald]

So now we get personal Erik?

They are nearly bankrupt because of FINANCIAL IRRESPONSIBILITY.


It didn't work there and it eventually it won't work elsewhere?

[Eric Larsen]

I'll agree the healthcare system needs to change but to rush into it without a lot of forethought on how to pay for it is being financially irresponsible.


And how many decades would you like to study it? Or do we just wait until a government that is more in line with your ideology is in place?

We as a nation are about as useful as the Judean People's Front from Life of Brian:


http://desertlamp.files.wordpress.com/2009/06/front_3.jpg

We've talked long enough. A good plan put into place today is far better than a perfect plan put into place 10 years from now. And most of America agrees with that. (http://www.huffingtonpost.com/2009/08/20/new-poll-77-percent-suppo_n_264375.html)

[Greg Peterson]

What exactly is it that health insurance companies provide that a single payer system can not?

Or even more precisely, just what do health insurance companies bring to the table?

[Rob Robinson VT]

What exactly is it that health insurance companies provide that a single payer system can not?

Or even more precisely, just what do health insurance companies bring to the table?
Duh, both are really easy! Profit for their shareholders!

[Ken Fitzgerald]

Uh...Rob.....what's wrong with profit in a capitalistic society?

Does your employer pay you? ....maybe with profit?...... surely not with unpaid debt.....:rolleyes:

[Horton Brasses]

the rest of our skiing holiday was cancelled.

That's a shame.:confused:

Not minimize the rest of your points, I just picked that out.

[Belinda Barfield]

Because heathcare is funded by the tax system, some folks would be paying more and others less, according to how much tax you pay. A single mum with 3 kinds would hardly pay anything for their healthcare (as it should be).

Not to be argumentative, I'm just curious. Why should a single mum with three kids pay any less for health care that a single woman, or anyone else?

[Eric Larsen]

Uh...Rob.....what's wrong with profit in a capitalistic society?

Does your employer pay you? ....maybe with profit?...... surely not with unpaid debt.....

It strays over the line and becomes wrong the second the profit is on "human misery" and not goods and services.

Making a buck on chemotherapy is wrong. (Paying the doctors, nurses, and technicians a fair wage to ease suffering is quite proper. Nobody is arguing that. Giving a hospital administrator a seven-figure salary for keeping costs down and revenues up is wrong. That's what we're arguing.)

Charging a sick person 400% more for medicine to ease their pain is wrong.

Denying health care to someone who has a life threatening illness in the name of profit is wrong.

Forcing people to choose between food and health care is wrong.

Forcing people to go bankrupt over illness is wrong.

And it's all done because it's profitable to do so. That's not just wrong, it's evil.



Throughout history, there have always been the "status quo" side and the "try something else" side. Their names change, but there's always one side in favor of doing nothing (or the least amount possible). That side is NEVER right. They weren't right about breaking away from England. They weren't right about ending slavery. They weren't right about giving women the right to vote. They weren't right about civil rights. And they aren't right about health care, and a host of other issues.

[Anthony Scira]

It strays over the line and becomes wrong the second the profit is on "human misery" and not goods and services.

Making a buck on chemotherapy is wrong. (Paying the doctors, nurses, and technicians a fair wage to ease suffering is quite proper. Nobody is arguing that. Giving a hospital administrator a seven-figure salary for keeping costs down and revenues up is wrong. That's what we're arguing.)

Charging a sick person 400% more for medicine to ease their pain is wrong.

Denying health care to someone who has a life threatening illness in the name of profit is wrong.

Forcing people to choose between food and health care is wrong.

Forcing people to go bankrupt over illness is wrong.

And it's all done because it's profitable to do so. That's not just wrong, it's evil.



Throughout history, there have always been the "status quo" side and the "try something else" side. Their names change, but there's always one side in favor of doing nothing (or the least amount possible). That side is NEVER right. They weren't right about breaking away from England. They weren't right about ending slavery. They weren't right about giving women the right to vote. They weren't right about civil rights. And they aren't right about health care, and a host of other issues.

Well said.........:cool:

[Greg Peterson]

Uh...Rob.....what's wrong with profit in a capitalistic society?:

Capitalism is fine. But I think a myriad of examples exist from the recent past where government services were privatized and the costs went up and the service declined.

Certainly there are times when cost for treatment should have a seat at the table. But it should not by default be the primary factor in determining care.

It comes down to a moral decision. Do we value human life over profit? It really is that simple. Take the profit out our current health care delivery system it becomes vastly more available to everyone.

The CEO of United Health received $753 million for a five year compensation package. Not including the perks of limos, private corporate jet and so on.

Again it really boils down to whether we want to reward the corporate elite with lavish lifestyles or spend those resources providing care to our fellow Americans. And yes, it is that simple.

There's a lot of gnashing of teeth over the failure to enact meaningful tort reform, but tort reform would only affect the average persons ability to hold negligent doctors to account and not save any meaning full amount (less than 1% of a doctors overhead).

If we want to reduce expense in the current health delivery system lets look at the additional staffing and resources doctors have to expend to handle insurance claims. Estimates are that 25% of a private practice staffing and resources are used in insurance paperwork. The medical records field is growing by leaps and bounds. This American Life did an excellent story on the complexities of filing claims with the insurers. Each procedure has a code and no two insurers use the same exact code. And should you forget the suffix or otherwise not use the correct code, well there's a form for that too.

What the insurance companies do is immoral, unethical, evil and indefensible.

[Belinda Barfield]

It strays over the line and becomes wrong the second the profit is on "human misery" and not goods and services.


Where do you stand on profits for the funeral industry? How about profits that attorneys make on human misery? How about profits from sales of food? Food is a necessity afterall. Where to you draw the line and say this group can make a profit, but this group can't? Why would anyone sell or produce anything if there was no incentive to do so?

[Wayne Watling]

Not to be argumentative, I'm just curious. Why should a single mum with three kids pay any less for health care that a single woman, or anyone else?

So you would like to see a single non working mum/dad with 3 kids pay the same for health care as a working couple? How is this going to work in civilized society? It can't!

As a society we have to decide whether we want to give health care assistance to those who are not as well off for whatever reason. I personally think health care should be one of those services that should be, without question, given to everyone who is a citizen of the country in question. Given that, some people are obviously paying more and some less tax.

[Dan Lee]

The US infant mortality rates are appalling…

Boy this is one that gets me going. The US has the stricktest definition of what a live birth is. Exerpt from and article I read there are many articles out there that adddress this false statistic. Ive read some reoports that attempted to normalize the data and US is smoewhere around 3 or 4th


I am sure you have seen various rankings where the US falls way behind other western nations in terms of infant mortality. However, no one seems to bother to check the statistic itself . Statistics like this that are measured across nations are notoriously unreliable, as individual nations may have different definitions or methods for gathering the data.
The main factors affecting early infant survival are birth weight and prematurity. The way that these factors are reported — and how such babies are treated statistically — tells a different story than what the numbers reveal. Low birth weight infants are not counted against the “live birth” statistics for many countries reporting low infant mortality rates.

According to the way statistics are calculated in Canada, Germany, and Austria, a premature baby weighing less than 500 kg [sic; typo--read 500g] is not considered a living child.

But in the U.S., such very low birth weight babies are considered live births. The mortality rate of such babies — considered “unsalvageable” outside of the U.S. and therefore never alive — is extraordinarily high; up to 869 per 1,000 in the first month of life alone. This skews U.S. infant mortality statistics.Norway boasts one of the lowest infant mortality rates in the world. But when the main determinant of mortality — weight at birth — is factored in, Norway has no better survival rates than the United States....

In the United States, all infants who show signs of life at birth (take a breath, move voluntarily, have a heartbeat) are considered alive.

If a child in Hong Kong or Japan is born alive but dies within the first 24 hours of birth, he or she is reported as a “miscarriage” and does not affect the country’s reported infant mortality rates....

Efforts to salvage these tiny babies reflect this classification. Since 2000, 42 of the world’s 52 surviving babies weighing less than 400g (0.9 lbs.) were born in the United States.
Page 30 or so of this interesting kind of dated but addressing international differences is still http://www.cbo.gov/ftpdocs/62xx/doc6219/doc05b.pdf (http://www.cbo.gov/ftpdocs/62xx/doc6219/doc05b.pdf)

[Glenn Clabo]

Ken,
What's wrong with capitalism?

My first wife, who died from breast cancer, was denied healthcare by our insurance company. Although we fought it...it put us $250,000.00 in debt while we tried to keep her alive. That year the CEO of the insurance company made $27,000,000.00 in benefits...becasue his company made so much profit!

As far as who appoints or is on the boards? Who do you think is between you and your doctor now...some clerk who doesn't have a clue about the difference between a bone marrow transplant and a tooth cleaning. All they know is it's on the list...or not on the list of procedures paid for. Which... by way... is what happened to me and thousands of others.

[Belinda Barfield]

So you would like to see a single non working mum/dad with 3 kids pay the same for health care as a working couple? How is this going to work in civilized society? It can't!

As a society we have to decide whether we want to give health care assistance to those who are not as well off for whatever reason. I personally think health care should be one of those services that should be, without question, given to everyone who is a citizen of the country in question. Given that, some people are obviously paying more and some less tax.

No, I would like to see a single non working mum/dad with three kids pay the same as a single non working me, or a working mum/dad pay the same as a working me. I am not responsible for the fact that they have three kids, they are. If I wanted to pay for three kids I would have had three of my own.

I have to leave now to go to the funeral of a very dear friend, so I can't continue here. Y'all don't beat me up too bad.

By the way, I'm not arguing that insurance companies should make huge profits. I just don't understand why some think it's okay for veternarians to make a profit, but not M.D.s, or dentists, etc.

[Greg Peterson]

Why would anyone sell or produce anything if there was no incentive to do so?

Look at Japan's health delivery system. Aside from 50% of the hospitals currently operating at a loss, the systems serves every one well. And fixing the hospitals operating at a loss is a relatively small matter.

Every two years the government sits down and produces a price list for every procedure. I.E. - A doctor receives $4.90 to stitch up a cut less than 40MM in length.

Japan has the highest per capita use of MRI's. And while the cost of an MRI is minuscule, at least one Japanese company produces MRI machines (Toshiba). Innovation isn't stifled by low cost access.

[Greg Peterson]

Dan - good point on the infant mortality rate.

But how do explain our lower life expectancy? Or the quality of life in later years?

Our system is broken, pure and simple. Anytime someone is forced to become an indentured servant to an insurance company because they were unfortunate enough to become ill, I have to wonder just how much progress we as a nation have made.

Not much in this regard. The people flocking to the defense of those that would have no qualms destroying their lives if it meant they could get another dollar out of them fail to see the irony. It would indeed be funny were the results not so inhumane.

[Dan Lee]

Dan - good point on the infant mortality rate.

But how do explain our lower life expectancy? Or the quality of life in later years?

Our system is broken, pure and simple. Anytime someone is forced to become an indentured servant to an insurance company because they were unfortunate enough to become ill, I have to wonder just how much progress we as a nation have made.

Not much in this regard. The people flocking to the defense of those that would have no qualms destroying their lives if it meant they could get another dollar out of them fail to see the irony. It would indeed be funny were the results not so inhumane.

Lower life expantancy well I suppose the fact that we consider any baby that takes a breath a live birth will probably skew that statistic as well. What is the US like 78 years for a male vs 82 for some of the top rating countries?

How is quality of life (by definition a subjective title) calculated?
I guess my pont is that statistics get thrown around few people really research them.
I started trying to fact check IM stat some time ago cause it just didn't pass the smell test to me. Ive never seen anything that attempts to rebut articles like the one in my previous post.

[Greg Peterson]

What is the US like 78 years for a male vs 82 for some of the top rating countries?


I'd call four years difference significant.

As for health related quality of life (I left out the health related part originally), here is a quote from the CDC's page:

"In public health and in medicine, the concept of health-related quality of life refers to a person or group's perceived physical and mental health over time. Physicians have often used health-related quality of life (HRQOL) to measure the effects of chronic illness in their patients to better understand how an illness interferes with a person's day-to-day life. Similarly, public health professionals use health-related quality of life to measure the effects of numerous disorders, short- and long-term disabilities, and diseases in different populations. Tracking health-related quality of life in different populations can identify subgroups with poor physical or mental health and can help guide policies or interventions to improve their health."

You can Google health related quality of life.

HRQoL has always been around. Health care providers need this information, usually gathered in an informal manner. They simply ask their patient how they feel, how they have been feeling lately, has anything changed, anything been compromised or reduced, how do you feel about this in general.

There may be a combination of factors influencing our low position on the international HRQoL scale.

[Rob Robinson VT]

I don't think that anyone here is lobbying against health practitioners (doctors, nurses, technicians, labs, etc.) making a living and/or profit. And, quite frankly, that part of our health care system doesn't appear to be broken. What IS broken is how we pay for those services and, therefore, who has access to them. Going to a single payer system would NOT in and of itself change who provides the services, only who pays for them. It would standardize procedure codes and reimbursement rates, vastly reduce paperwork and administrative costs and eliminate profit from the system which pays for health care. Profit is not inherently bad, profit at the expense of the well-being of our citizens is not only bad, it's downright evil and immoral. Just my $.02 worth.

[Glenn Clabo]

http://www.youtube.com/watch?v=14A1zxaHpD8

The helping "men" become doctors indicates how old this is.

[Dan Lee]

Greg-
Got this quick blurb from Wiki about LE(OK you get what you pay for:o, don't have time right now to look into what factors influence LE calculations). Anyway IM stats are not comparably calculated and they effect the LE, so who knows the real LE stats are

"Also note that in countries with high infant mortality (http://www.sawmillcreek.org/wiki/Infant_mortality) rates, the life expectancy at birth will be lower and may not reflect the life expectancy a person who has survived his/her first year of life would have."


BTW
The numbers I cited were for overall M and F not just Male as I stated

[John Pratt]

Where do you stand on profits for the funeral industry? How about profits that attorneys make on human misery? How about profits from sales of food? Food is a necessity afterall. Where to you draw the line and say this group can make a profit, but this group can't? Why would anyone sell or produce anything if there was no incentive to do so?

Well Said!!

[John Pratt]

I would really like to know about malpractice insurance and tort reform in Canada also.

I really can't complain about my health insurance, it is great. I pay $464.00 a year for a family of 6. YES, that's right, $464.00 a year. I did give up 24 years of my life to get that coverage though.

An earlier post said that the problem is that everone thinks nothing should be free or something to that effect. I disagree, I think the problem is that everyone thinks everything should be free. There is a cost to everything. Medical school, Malpractice insurance, employees, research, etc. If you told me I was going to pay $400,000 for medical school to make $40K a year as a doctor, then you probably wouldn't see me at medical school. I really feel for some individuals who cannot afford insurance, while others I have no sympathy for. Life is frought with tough choices and I think too many people are not willing to make those choices or decisions. I do think that the current system in the U.S. needs some changes, but a complete overhaul of the best medical system in the World (when you take away access) seems a bit drastic. Why cant we take it a couple of chunks at a time (preexisting conditions, Tort reform, etc) and see where we need to move from there. All the talk about money hungry insurance companies isn't entirely accurate either. Last I heard they were operating on about a 2-3% profit margin.

[Paul Ryan]

Paul,

Explain how in a capitalistic society you'd pay the folks who work there Paul.

Would you work at a Chevy dealer for free?


Ken,

I am a little confused as to what you are implying, or what your question is. I am not sure how it pertains to our health care system. My whole point is your care, my care, my neighbors heath care should not be determined by how much money each of us make. At this point in time it is. Many people that cannot afford insurance must pass up simple procedures that would make them heathier. And that is wrong. I have a close friend that lives in Brooklyn. He and his wife purchased a modest 800 sq foot apartment 3 years ago for the low low price of $480,000. They have 1 child that is 3. About 4 months ago his wife got laid of, her employer supplied a heath insurance option that they could afford. Since her lay off, they cannot afford the cobra payments, his employers insurance option runs $1700 per month. Private insurance for them for a basic policy with a high deductible runs $1100 per month. So at this point in time himself, his wife, and his 3 year old child are uninsured because they either pay for their dwelling, or their heath care insurance. So if that little girl comes down with flu like symptoms, they may for go the doctor visit an extra day or 2 days because they do not have insurace. Now if she comes down with very bad flu and double pneumonia. It may cost her, her life because they did not see the doctor as soon as some one with insurance. That is what is wrong. And that is capitalism at its best. To grow the economy and increase a countries wealth capiatalism is great. But to take care of us, wether it is through public saftey, elected officials, or heath care it is wrong and should be illegal. Insurance companies that are getting rich off of others heath is wrong. I have no problem with capitalism in insurance when it comes to property, and casualty, but not heath. It is not your right to determine what type of care a person should received by how much they can pay you. We need a system where everone receieves the same treatment regardless if they make 1 billion per year, or 1 dollar per year.

[Greg Peterson]

Last I heard they were operating on about a 2-3% profit margin.

Paying the CEO of United Health $753 million over five years is simply obscene. If he's getting that much, how much do the other executive bring in? How about the other big insurance companies?

Health insurance companies profits over the past ten years have skyrocketed, as well as have premiums.

Tort reform is a strawman argument. Malpractice accounts for such a small part of the pie (less than 1%), it isn't even worth going after. Besides, would you be willing to surrender your only avenue of recourse should you ever have the misfortune of crossing paths with a doctor that shouldn't be practicing in the first place.

If you want tort reform go after the ambulance chasers. Give 'em a three strikes your out rule. Three frivolous lawsuit filings and your out.

No one should have to surrender their freedom just because they got cancer or diabetes. People get locked into jobs they don't like or enjoy because they have a condition that would prevent them from getting a new policy elsewhere.

My brother is stuck at a job that is literally breaking his back. One day soon he will turn the wrong way and that's it, he won't be able to lift so much as a feather. His employer just won't give him a different job (and this company is an international company). He could take disability as it is with his other conditions, but he wants to work. I guess when the company finally breaks his back he'll have no other choice but to take disability. So much for the bottom line.

Praise the dollar and banish all else to the scrap heap. When did we start measuring worth by the god almighty dollar?

[Dan Lee]

Greg you said
"Tort reform is a strawman argument. Malpractice accounts for such a small part of the pie (less than 1%), it isn't even worth going after. "

Is that settled court case awards or does it include/exclude malpractice insurance the Drs have to pay.
In these cases good thing we have insurance companies that sell malpractice insurance and pay damages.

Greg you said
"If you want tort reform go after the ambulance chasers. Give 'em a three strikes your out rule. Three frivolous lawsuit filings and your out"

Now that sounds like a interesting and maybe good idea.Maybe 2 strikes

edit
Maybe take look at Texas medical tort reform. Varying opinions

[Wayne Watling]

No, I would like to see a single non working mum/dad with three kids pay the same as a single non working me, or a working mum/dad pay the same as a working me. I am not responsible for the fact that they have three kids, they are. If I wanted to pay for three kids I would have had three of my own.

If I'm reading you right Belinda you are advocating that everyone pay exactly the same rate no matter what their financial situation.

Lets leave childen out of the picture for a moment. Even in so called civilized western societies such as the US and Canada you get folks who are born into povety like circumstances, obviously not by choice. Under your system these folks would simply not get health care. This is but one example, there are many others where folks through no fault of their own would get no health care due to their financial position.
You can't have this going on if you want your country to stay civilized. The whole medical industry is a very different beast to other areas of a society in that it very directly relates to the raw necessity for humans to stay healthy and alive, we can't leave this to capitalism to sort out otherwise the whole things turns into an animalistic jungle.

[Neal Clayton]

Canada believes that it is in the best interest of their country to promote healthcare of everyone from conception…through birth…in life…until death. The US approaches it as it’s an individual responsibility.



whereas the US has the approach of "how can i make the most money from this".

i honestly don't pay much attention to the constant debate about this in the congress, and the news, etc.

because no one will stand in front of a camera in this country and plainly state that "there is no room for third party administrative profit in health care. this is now a public service, and as such, the profit motive is gone, hope you enjoyed it while it lasted"

and that's the bottom line. paying for it all is rather simple. you eliminate the insurance company overhead, use that to cover the care of the poor, and tell the insurance companies to get bent.

when you see that, come join me while i toss snowballs in hell ;).

[Greg Peterson]

Because no one will stand in front of a camera in this country and plainly state that "there is no room for third party administrative profit in health care. this is now a public service, and as such, the profit motive is gone, hope you enjoyed it while it lasted"


We worship at the altar of the all mighty dollar and quarterly reports. The United Kingdom has their royal family, and we have our corporate elite. Not much difference between the two.

In the most powerful nation the world has ever seen, and the envy of the world, that there is even a debate as to whether health care is a right or a privilege for the citizens of this country indicates to me that perhaps we still have some growing up to do as a nation. A lot of growing up to do.

[Greg Cuetara]

I think we have the best health care in the world...hands down. Why does everyone in the world come to this country for their treatment? Why do we have the highest survival rates when it comes to cancer?

There needs to be a break between health insurance and health care. If you can't afford it you go into an emergency room and you will be treated. Yes there are problems with the way in which insurance companies handle things but realistically do you think the gov't is going to handle them any better. The gov't this week came out with recommendations to postpone mamograms 10 years until woman are 50....how crazy is that when a lot of women get breast cancer in their 40's. Along with postponing the mamograms they are also recommending to not do self-exams hoping that woman won't go to the doctor. Is that a good gov't recommendation?

Do we need reform? Yes we do. Are there things we can do which will simplify everything and not have a single payer system? Yes.

Another item which has been broached here but is more important than health insurance is the cost of the actual treatments. Health insurance companys actually reduce the costs of all the treatments compared to what hospitals charge. Why shouldn't we be looking at the charges to begin with. Insurance companys just pay a bill. If you do not look at where the charges are coming from then there is no way to reduce the costs. Even if we have a single payer system the big evil hospital managment personel will still be making big profits.

[Rick Moyer]

And how many decades would you like to study it? Or do we just wait until a government that is more in line with your ideology is in place?

We as a nation are about as useful as the Judean People's Front from Life of Brian:


http://desertlamp.files.wordpress.com/2009/06/front_3.jpg

We've talked long enough. A good plan put into place today is far better than a perfect plan put into place 10 years from now. And most of America agrees with that. (http://www.huffingtonpost.com/2009/08/20/new-poll-77-percent-suppo_n_264375.html)

I had to quote your post Eric, just to bring up the pic of the Judean People's Front again. Thanks for the laugh!

On a more serious note, I am rather conservative idealogically and politically. However, I am in favor of major health care reform in this country, despite my misgivings about the government's ability to run anything better than the private sector. I fear the big government approach many others do, but "desperate times call for desperate measures". My wife and I are both self-employed. We work hard and pay our own health insurance. Our health insurance costs eat up a larger portion of my wife and my incomes than anything else, including mortgage, and we are healthy. I liked the analogy of the fire departments, etc. Shouldn't public health be as important as public safety? We pay a lot of taxes for things that are way less important to me than my health. I don't want much from my government, save for them to keep me safe. Shouldn't that include preventing my premature demise even though I could no longer afford to pay the high costs of insurance run health care?

I wonder how many on the side of capitalistic health care are paying the bulk of their own health care premiums.

[Mike Henderson]

I'm a big believer in capitalism, but I also have a lot (waaay too much) experience with the medical system.

For capitalism, consumers have to be able to compare prices, quality, and any other factors that are important to them (like how close the facility is to them). For many of those factors, that's rarely possible with health care. When you're sick, you are not in a position to make those kind of choices or shop for doctors or services, even if the quality and cost information was available to you (which it's not).

And private insurance is a serious problem. The insurance companies would like to make each person "a group of one", meaning that each person would pay for insurance based on their medical history and condition. But that eliminates the reason for health insurance. If you're going to to a "group of one", you'd just as well pay your own health costs.

One way to reform the health system is to require everyone to carry health insurance, and to allow them to change carriers without penalty for past health experiences. Even without a "single payer system" the insurance companies can figure out how to price under those rules. But the costs would be based on the entire group (all US citizens) and not some small group, or a "group of one".

I'm now on Medicare. Medicare is a WONDERFUL system for the patient - maybe too wonderful. Much better than any private policy I ever had. The only bad thing I have to say about Medicare is that if you have Medicare and a supplemental policy, you generally don't pay a penny, which is the wrong incentive.

For all health care, there should be some cost to the patient. We should probably limit the "out of pocket" cost in each year, but there has to be some disincentive for utilization. If you make health care completely free (not based on usage) people will use as much as possible. The co-pay should be based on a sliding scale but everyone, even the poorest, should pay something, even if it's only a dollar.

People will object because applying some cost will cause some people to delay or not seek care, but it's the only way to "ration" care that reasonable. At least the individual makes the decision - not some committee.

How would I do it? I'd reform Medicare to apply a cost to each doctor's visit, or test, or whatever, with an annual max out of pocket. Then, I'd start lowering the age for Medicare, until after some number of years, everyone would be covered by the equivalent of Medicare. Payment is still not decided (by me). Either some tax, or each person pays an annual fee for their "policy", or some other funding source. I'm not particular about the way we fund it.

Anyway, that's my $0.02

Mike

[Mike Henderson]

My husband and I pay 978.00 per month for health care, 11,736.00 per year, when COBRA runs out my husband will be uninsurable, he has a tremor. He had an upper and lower GI a few months back, cost about a 1000,00 out of pocket, took about 25 minutes. The health care system in this country needs to change, I was raped as a small child, it hurt less than what is happening now.

Heather
Look into what's called a HIPAA policy. They aren't cheap, but you can get a policy without any consideration of pre-existing conditions, as long as you get the policy within some time (60 days???) of the expiration of your COBRA policy.

Do some research on the web on HIPAA.

Mike

[Dan Lee]

This has been a very good discussion thread with out being over come by politics.

[Greg Peterson]

Mike - In the This American Life episode I recently listened to they spent the entire hour telling stories about the health insurance industry.

I guess EMT's could carry a price list of the various ER's and let the patient decide what they want.

As for using the ER as a primary care provider, that doesn't work to well if you have a chronic or long term disease that requires continuous care and medication (cancer, diabetes, high cholesterol, Parkinson's, MS....).


I find the way Japan manages their system to be very elegant. The fact that half of their hospitals are running at a deficit is a relatively minor problem compared to the matters we need to correct here.

[Dan Friedrichs]

I am not responsible for the fact that they have three kids, they are. If I wanted to pay for three kids I would have had three of my own.


+1.

Ultimately what we need is a system that spreads the risk of unforseen illness EQUALLY amongst everyone. Then we need some way to discourage people from visting the doctor everytime they cough, but not to the point that they don't seek attention in serious cases. Mike's analysis is right-on.

Also, I personally think there should be some financial penalties for doing things that hurt your health and cost the system (either private or public) more money. Smoke? Your premium should be 10x the normal premium. Think you need 23 children? You should be paying 23 premiums. Obese? Higher premium. I'll gladly share the unforseen risks with you, and frankly, even if you have a preexisting condition, I think it's my moral obligation to help relieve you of that burden. But if you're choosing to do things that cost the system more money - you should be the one paying for it.

[Darius Ferlas]

One thing that always gets me are meaningless slogans. One that almost always comes up in any health care debate is "socialized" medicine. What does it mean? Why is it even considered wrong, even derogatory. After all, aren't Americans proud of their "socialized" military? "Socialized" court system? How about the "socialized" national highways system? I'm not sure how the word became derogatory. It isn't and the way it is presented it is designed to scare people away.

Now a few thoughts on some responses in this very interesting and clearly civil thread.


Why should a single mum with three kids pay any less for health care that a single woman, or anyone else?

For the same reason that same woman pays less for police protection, fire protection and prevention, military defense and a host of other "socialized" services provided to all citizens. If that is not enough of the reason then it would logically follow that those who make more money (and therefore pay more in taxes) should have access to more effective policing or fire protection. In case of war the richer should be protected by the military while the poor should not.

Another reason is that Americans are a nation of people who are supportive of one another and full of compassion, aren't they?

While certainly not a an argument to be considered by all, but rather by those who profess certain beliefs and values, yet another reason to support "socialized" medicine could be summed up in the old adage: "what would Jesus do?". Some of us may remember He treated the poor (for free) and didn't have a whole lot of sympathy for the rich.


However, no one seems to bother to check the statistic itself . Statistics like this that are measured across nations are notoriously unreliable, as individual nations may have different definitions or methods for gathering the data.
The main factors affecting early infant survival are birth weight and prematurity. The way that these factors are reported — and how such babies are treated statistically — tells a different story than what the numbers reveal. Low birth weight infants are not counted against the “live birth” statistics for many countries reporting low infant mortality rates.

According to the way statistics are calculated in Canada, Germany, and Austria, a premature baby weighing less than 500 kg [sic; typo--read 500g] is not considered a living child.


So I checked the statistics and the document you link to. It turns out that some of the fundamental arguments in your statements are not true. Of The three countries named both in Germany and Austria ALL LIVE births are reported, regardless of the child's weight or term. (source (http://www.cdc.gov/nchs/data/databriefs/db23.pdf), page 2)
I have no relevant information for Canada, but from friend's personal experience I know that serious care takes place even before birth, including pre-natal surgeries. (a side note, just last year I didn't know they could do a heart surgery on an unborn baby)


But when the main determinant of mortality — weight at birth — is factored in, Norway has no better survival rates than the United States....
The same source, on the same pages states:

since no live births occur before 12 weeks of gestation, the requirement for Norway that all live births at 12 weeks of gestation or more be reported is substantially the same as for countries where all live births are required to be reported.

So Norway can still be considered as a country with better survival rates.


Efforts to salvage these tiny babies reflect this classification. Since 2000, 42 of the world’s 52 surviving babies weighing less than 400g (0.9 lbs.) were born in the United States.
Page 30 or so of this interesting kind of dated but addressing international differences is still http://www.cbo.gov/ftpdocs/62xx/doc6219/doc05b.pdf
Again, the same source (page 6) indicates that there is indeed better survival ratio in the US for children born prematurely (before 37 weeks), but much worse for children born after that. But then, the US seems to have a greater ratio for premature to full term births than any of the countries analyzed. That, I'd say, is a medical indicator too, and not such a good one for the US.

The conclusion in the source I quoted are (emphasis mine):

However, it appears unlikely that differences in reporting are the primary explanation for the United States’ relatively low international ranking. In 2005, 22 countries had infant mortality rates of 5.0 or below. One would have to assume that these countries did not report more than one-third of their infant deaths for their infant mortality rates to equal or exceed the U.S. rate. This level of underreporting appears unlikely for most developed countries.


Now, the report I am referring to is dated November 2009. The one you refer to is over 17 years older (dated February 1992. That report states that it was commissioned by Representative Willis D. Gradison Jr. (Rep.) A year after that report's purpose (whatever that purpose might have been we can only speculate) Mr Gradison took the position of ... SURPRIZE! SURPRIZE! - president of the Health Insurance Association of America! He held the position for 6 years. :)

But even if the Gradison report is seriously oudated (and perhaps biased?), it does reveal some interesting numbers where there can be no question about discrepancies in gathering and reporting data as all that data refers to the US.

Page 35 talks about Native American mothers, page 34 about Hispanic and page 33 about black ones. The conclusions are consistent with the numbers shown in Table1 (page 9, comparing IMR for white and black Americans) and they are also consistent with the material status of various ethnicities within the US. Given the current medical system in the US it would be hard to hide correlation between affordability of medical care and medical outcomes. I can't see how similar correlation would not be valid between the US and other developed countries where medical care is free and universally available.

There is no question that "socialized" health care system is less expensive to run. Yes, per capita a bus is much cheaper than a Golf. The rest of the debate is philosophical and political. In the US the wealthier and the luckier are given a better shot at obtaining medical care (although often at a risk of bankrupcy). In countries with "socialized" medical system every body is given a fair shot at surviving what God/Fate throws at them.


Your premium should be 10x the normal premium.
In Canada, taxes paid by smokers cover more than twice the cost of all cases deemed smoking related, whether they indeed are or not. The government needs the cigarette tax and I'd be surprised if the US was any different.

[Greg Peterson]

Darius - Well stated.

17 year old report being passed off as relevant data? Why do I not find this surprising? Sounds FOXy to me.

[Ken Fitzgerald]

Uh Darius,

I suggest before you call Dan's referenced document provided IIRC by the CBO....full of lies or errors, you research what the definitions of those countries was at the time of the research. His document was from 1992 and may have been perfectly accurate in 1992. Now in 17 years it's very possible some of the countries have changed their references. The document you referenced was from 2009.

Beyond that.....explain to me why if someone decides to have 10 children and it is a decision, I or anyone else should have to finance their obvious irresponsibility? If you can't afford 10 children, why continue to have them unless you are looking for some form of socialized financial support or don't have enough selfdiscipline to take measures to prevent the pregnancy. And then you want to lay a guilt trip on me for their failure to control themselves?

[Ken Fitzgerald]

That 17 year old document is a Congressional Budget Office document that resides at a US govenment site. I would suggest it was probably considered accurate for the time it was written but certainly is outdated and the one Darius cited is probably curently more accurate and appropriate.

To everyone in general and nobody in particular:

I will caution everyone from being uncivil....making wild personal accusations, insinuations or becoming political.

This thread is walking a very tight line of being political and at the first sign will be closed by myself or one of the other Moderators. Keep in mind that politics includes international politics.

I feel these type of subjects can be discussed but you have to keep emotions out of them. Too many mistakes are made today because everyone wants to surround themselves with a nodding mass when I believe dissenters can provide an interesting perspective and often point out mistakes in the subjects being discussed.

[Doug Mason]

As a society, I think it reprehensible that we ration healthcare based upon "ability-to-pay."

The healthcare debate in many respects mirrors the debate on the US tax structure--a debate in which one political party wants no capital gains tax (a tax on wealth), but rather wants a user-based tax system (sales tax, prop tax, user fees, tax on wages, etc). And you have these middle-class people who support this user-based tax structure despite the fact that it is going to raise their taxes and reduce the taxes of the wealthy--and they are too ignorant to see this!

So to is it with healthcare. One political party wants to maintain the "status quo" with our current system based on "ability to pay" and is going to extremes to avoid any change. And yet you have a large part of the middle class who concur with this--which to me is inexplicable!

No system is perfect; but health care should not be a "for-profit" industry.

[Ken Fitzgerald]

So how do we pay for it?

The last estimate I saw on the US national debt was nearly 12 trillion dollars. Other countries are already squeemish about continuing to lend the US money. Some countries are even suggesting the US dollar no longer be the accepted global monetary standard because of our financial woes.

If we are going to nationalize healthcare, how can we reasonably and RESPONSIBLY pay for it in a way that won't effect the entire financial system of this country?

Over a decade ago, political pressures were applied and financial institutions were "encouraged" to change the accepted lending standards of the time and make the American Dream more accessible to more people. Look at the current housing crisis and banking problems that have sucked money from the public treasury. This is in no way related to current politics.....it started over decade ago.

While it may seem morally superior, I think it's irrational and financially irresponsible to legislate a nationalized healthcare system without a well thought out, realistic and reasonable method to pay for it.

[Neal Clayton]

we covered that already.

take the profit out. there is no need for a hospital to turn a profit. there is no need for a middle man between patient and doctor. eliminate those and you'll find the system is "paid for" quite easily, by people paying less than they're paying now for health insurance toward a medicare-ish national health program.

that's how the other countries do it. that's how it works.

but like i said, wake me when congressmen who have been paid a million dollars each by the health insurance lobby are willing to stand in front of that podium and state to a camera and microphone that there's no room for profiteering in health insurance if we're serious about providing health insurance to all citizens.

[Mike Henderson]

So how do we pay for it?

The last estimate I saw on the US national debt was nearly 12 trillion dollars. Other countries are already squeemish about continuing to lend the US money. Some countries are even suggesting the US dollar no longer be the accepted global monetary standard because of our financial woes.

If we are going to nationalize healthcare, how can we reasonably and RESPONSIBLY pay for it in a way that won't effect the entire financial system of this country?

Over a decade ago, political pressures were applied and financial institutions were "encouraged" to change the accepted lending standards of the time and make the American Dream more accessible to more people. Look at the current housing crisis and banking problems that have sucked money from the public treasury. This is in no way related to current politics.....it started over decade ago.

While it may seem morally superior, I think it's irrational and financially irresponsible to legislate a nationalized healthcare system without a well thought out, realistic and reasonable method to pay for it.
Of course, we're paying for health care now, one way or the other. The problem most people see with the present system is the inequities in the system. If you lose your job, once you've exhausted your COBRA you're thrown on the private market which discriminates against people. People who have paid for health care all their lives now can't get a policy when they need it.

What people want is a fairer health care system that allows people to depend on having health care. I don't think anyone is looking for free health care, but a more just system.

But before we get into how to pay for it, we need to decide what we really want in a health care system for the United States. Then we have to decide if we can pay for it, and if so, how.

Mike

[Darius Ferlas]

Uh Darius,

I suggest before you call Dan's referenced document provided IIRC by the CBO....full of lies or errors, you research what the definitions of those countries was at the time of the research. His document was from 1992 and may have been perfectly accurate in 1992. Now in 17 years it's very possible some of the countries have changed their references. The document you referenced was from 2009.

Ken, first, I did not use the words lies. The definitions may have been indeed different at that time. I admit I don't know but the onus is not really on me to prove that. I do know though that the report was commissioned and presented over 17 years ago by someone who was clearly biased against "socialized" medicine.

The reason I reject the document referenced by Dan is that it creates an impression about status quo while in fact status quo is different. I'm writing about what IS, not what WAS 17 years ago.


Beyond that.....explain to me why if someone decides to have 10 children and it is a decision, I or anyone else should have to finance their obvious irresponsibility? If you can't afford 10 children, why continue to have them unless you are looking for some form of socialized financial support or don't have enough selfdiscipline to take measures to prevent the pregnancy. And then you want to lay a guilt trip on me for their failure to control themselves?

I presented (and hopefully justified) my doubts about the validity of the document used by Dan. I also proposed the reasons why the society as a whole might want to agree to help those who are unable to help themselves.

Also, I didn't write what I did to lay guilt on anyone anymore than those rejecting public funding exercise guilt trips towards those who cannot afford hospital stays, medical procedures and medication.

It simply boggles my mind that a country, where about 75% of population is identified as Christian, has such a huge issue with what should be really a no brainer to them - help the less fortunate.

And by help I don't mean a quarter tossed into the Salvation Army jar in front of Walmart once a year, or a Made in China magnetic ribbon of one color or another attached the a car's bumper.

As for parent(s) with 10 kids, yes, some of them are irresponsible but apparently natural growth in the US does not indicate this to be a prevailing trend. Some loopholes and inefficiencies in any system are to be expected in any system.

[Ken Fitzgerald]

Neal,

How have you covered it?

I fail to see how you have covered it. Someone quotes a figure from no particular source about how much an insurance executive made last year or over the past 5 years. Everyone immediately assumes that is enough to foot the bill for everybody's medical expenses. It won't begin to cover the medical expenses.

When you have a well thought out, financially responsible suggestion for a national healthcare system...call me...I'm in the phone book.....I'll back it in a flash.

[Rob Robinson VT]

I have been extremely fortunate in that the largest claim(s) I've ever made against any of the various health insurance policies under which I've been covered over the years have been for physical exams. I'm retired now and covered by Medicare but over the years the amounts spent by my employers and myself for medical insurance have to be well over a hundred thousand dollars, so there is no doubt that the health insurance industry has made something like a 90+% profit margin on me in the nearly 40 years since I got out of the military.

I'm not complaining about this as having insurance is the price we pay for the peace of mind gained by knowing that one illness or one accident won't wipe us out financially. It's that peace of mind that I strongly believe is the right of every American citizen and why I believe we need some serious reform of our health insurance situation. I don't propose to know what the "right" or "best" answer is but I think it's probably going to be some hybrid of what we have now and what the rest of the developed nations of the world have settled upon. I don't think that it's going to take legislation of nearly 2,000 pages to accomplish this or that it should result in any reduction in the quality of our health care.

[Ken Fitzgerald]

Darius,

I quote your previous post.... So I checked the statistics and the document you link to. It turns out that some of the fundamental arguments in your statements are not true.

The document he linked and referenced is an official US government document from the Congressional Budget Office located at an official US government site and while the information might be incorrect, I suspect it was thought to be accurate at the time.

I agree that the document you referenced is probably more accurate, timely and appropriate.

Don't think I am hard hearted. I have supported myself since age 15 when I started working on oil rigs for my father. I was drafted in '68...met and married a young divorcee....adopted her two children from previous marriage and we had one more. My father never lived to see our youngest as he died on a rig floor 3 months before our youngest son's birth. My mother remarried 5 years after my fathers death and I help support my Mom and her husband today as they find it difficult to make ends meet on just social security. I just believe people need to be responsible for their actions. Anything less, encourages people to continue to be irresponsible.

My 3 kids...one is a local deputy sheriff a former 9 year Army veteran...my daughter...very beautiful and petite....a mother of 3 ...grandmother of 3......a college degree in automotive mechanics..she's worked for a sheriff's department and patroled as a police officer...currently she's working for a US airline company ...youngest son...college graduate...currently a 11 year Navy veteran.... a 3rd year dental student on Navy scholarship....

3 wonderful, responsible young adults. I am blessed.

I'm not really hard hearted...I just don't feel obligated to pay for other peoples' mistakes....if you buy a house that you can't afford...that is your problem....not mine.

Ask my daughter what happened when as a 16 year old HS junior, somebody passed her a beer and she took a drink from it with two uniformed police officers sitting in a marked car 30' away. One officer called me at home. As I drove her home my daughter said "Daddy...I'll get a job and pay for the lawyer." I said "Don't worry XXXXXXX. You don't need a lawyer to plead guilty...and if two cops say you're guilty...Lady you are guilty." She later set at the defense table by her lonesome. When the judge asked her how she pleaded she replied guilty. The judge stated they'd done a background check and this was her first and only offense (illegal consumption by a minor) and he was fining her $13.50 with $36.50 court costs..she could pay the bailiff now or go to jail until she could pay. "Can you pay now?". When her head snapped around to look at her mother and I sitting at the back of the court room, laughter erupted within the court and I thought the judge was going to fall off the bench. I,of course, nodded yes. She learned a valuable lesson that day...all 3 of my kids did. And I have 3 young responsible adult children. They are extremely generous too!

[Ken Fitzgerald]

Folks,

Something needs to be done...take Heather's case....there should be someway for someone to carry insurance even if they change jobs.....

It really is complex......

Take catastophic coverage....so we pass a bill that covers catastrophic coverage...who decides what is covered. Suppose it's me and my family loves me so much that even though I've had a massive stroke and the sugeon says he can do surgery...relieve pressure on the brain but I will always be in a vegetative state...never again to interact as a human being as we know it. Who decides what medical treatment....how long it will continue.....whether or not it will be discontinued......Who will decide?
We actually had that decision stare us in the face 4 years ago when my FIL had a massive stroke. I pray my family will have the same strength to make the same tough decision in the event I fall victim to the same predicament. And we allow someone to remain on ventilators and other machines forever?...who decides?

It's not black and white....it's really complex.....

That is just one of many complex problems that need to be considered prior to passing national healthcare legislation.....

[Eric Larsen]

Folks,

Something needs to be done...take Heather's case....there should be someway for someone to carry insurance even if they change jobs.....


And that's why we need to do something right freakin' now. There are a lot of people who simply cannot wait while our legislative branch wrings its hands and counts beans.

There is a human cost to this debate. That cost outweighs any financial cost. Who among us has the gall to tell someone who needs a transplant that they should not receive it because a hospital administrator needs to buy a Lear? This is ridiculous. Let's fix it.

How will we pay for all of this?

1) Tax the hell out of junk food -- soda, potato chips, Big Macs, Hot Pockets, and all the rest of the crap that is making the US the most obese nation on the planet. Alcohol and tobacco are already heavily taxed. Pepsi and Coca Cola are lobbying-up big time because they know where this is heading. Taxing the hell out of junk food will reduce obesity, and therefore heart disease, diabetes, and cancer (study the link between obesity and cancer -- it ain't pretty.)

2) Remove profit from the health care equation. It's not working. It hasn't worked for decades. Too many good people have died for want of treatment. That is unacceptable. The first-person stories shared here only reinforce my opinion that making a profit on human suffering isn't just wrong. It's evil.

3) Reallocate expenditures. We've spent more money trying to make Iraq and Afghanistan "free" (and they don't seem to want us there, so why bother) than we would on fixing health care. That money would better be spent at home, taking care of our own.

Everyone should have the right to some sort of baseline of health care. The wealthy can spend extra for nose jobs and private physicians. They're doing that now, so no big deal.

Any taxpayers reading this? Great! All taxpayers are already paying for indigent health care -- every time an indigent person shows up at the emergency room at the county hospital, we're paying for it through our property taxes. We're spending the money ANYWAY, so let's create a better system.

Our first line of attack should be beefing up the urgent care centers -- that way families that have a child running a high fever have someplace to go other than the emergency room. ER visits cost a BUNCH more than urgent care visits. Everyone knows that. So let's make urgent care the first responder. Every dollar we spend on this will save at least three.

Next we need to get the pharmaceuticals in line. It is ridiculous that people buy medicine in Canada and Mexico because it's one-tenth the price it is here. Fix this.

Most importantly, we need a change of attitude. Suggest that we cut medicare and all the seniors will scream bloody murder -- even though medicare is socialized medicine. These same seniors scream bloody murder when we suggest that we give everyone the same plan that they already enjoy. Unacceptable. And frankly it's hypocritical beyond belief.

[Anthony Scira]

Where do you stand on profits for the funeral industry? How about profits that attorneys make on human misery? How about profits from sales of food? Food is a necessity afterall. Where to you draw the line and say this group can make a profit, but this group can't? Why would anyone sell or produce anything if there was no incentive to do so?

Funeral industry ??? Really ??? Well that is an optional expense. If I want to be buried in a Kiss Casket that's up to me.

Food is already highly regulated, try opening a restaurant.

As far as the mother of 3 goes, well you just have to show some compassion for the kids. They were born into the situation and to deny them coverage is not "American"

It is in our best interest to care for our fellow citizens.

Its sad to see how we have become a Nation of "what do I get out of it?"

And I guess if the "Reform" passes when asked "what did I get out of it?" I can say we live in a Country that will not turn its back on each other in out REAL time of need.

Will people abuse the system ? Sure. Someone always does. But that should not be a reason to not do something. ;)

[Mike Henderson]

I'll just add a comment about children, in response to Belinda's earlier comment. Children don't have any say about who their parents are. Unless you're willing to punish the children for the sins of the parents, we (as a country) need to do our best to see that children get health care even if their parents can't afford to pay for it.

If you want to advocate for responsibility in choosing how many children to have, or making sure the parents can afford the children, please do so. But once the child is born, we should not deny that child health care because the parents didn't listen to you.

Mike

[Ken Fitzgerald]

And now the politics begin and this thread is just about 1/2 second from closing...

once again Erik you want to tax...tax...tax.....and the businesses and the people go BYE......BYE.....BYE. You wanted to raise taxes for the environment...now free medical.....raise taxes......

Now Eric, how would you feel about a national compassionate home program where we provide at no cost homes to every American. Of course, we won't need realtors and the building contractors will be expect to incurr and not get paid for their services or expenses but still provide their services. Hogwash!

First I don't have a clue where you get the idea MY property taxes are paying for indigent health care. That may be true where you live but....here hospitals eat that expense inititially, write some of it off on taxes and pass the difference on as higher fees to me and my insurance company.

Some folks like to "tout" Medicare as a great financial model for healthcare. Let me tell you a FACT...in some cases, Medicare doesn't even pay the cost that the hospital incurs when they perform a diagnostic exam.....I'm not talking about cutting into any perceived profit...What Medicare pays doesn't cover the cost incurred to perform the exam....and what does the hospital do....those $3 boxes of Kleenex with 4 sheets in them you and your insurance company get charged for...it helps make up for what Medicare doesn't pay.....

Don't drag Iraq and Afghanistan into this argument. That will make it political and get this thread closed. They are short term problems and nationalized healthcare is something that if legislated needs a long term financial solution that our own Congress can't meddle with as they have so underhandedly done with social security for more than 40 years.

Anthony....In my America, people are responsible for their actions. Let the lady get a job. Let's don't make it too easy or people will flock there by the millions to enjoy the rewards. I can suggest a current failed model for such financial irresponsibilities if you'd like.

[Mike Henderson]

Some folks like to "tout" Medicare as a great financial model for healthcare. Let me tell you a FACT...in some cases, Medicare doesn't even pay the cost that the hospital incurs when they perform a diagnostic exam.....I'm not talking about cutting into any perceived profit...What Medicare pays doesn't cover the cost incurred to perform the exam....and what does the hospital do....those $3 boxes of Kleenex with 4 sheets in them you and your insurance company get charged for...it helps make up for what Medicare doesn't pay.....

Medicare is not as generous as private insurance in paying for certain medical procedures. The reason hospitals continue to take Medicare patients (they do have the option to opt out) is that they generally get other government subsidies. In fact, one condition of the hospital taking the subsidies is that they continue to accept Medicare patients on a non-discriminatory basis.

As soon as the hospitals feel they aren't getting a good deal on Medicare, they'll reject the subsidies and stop taking Medicare patients. No one is forcing them to accept Medicare.

Medicare demonstrates that a single payer system can work and work well.

Mike

[Belinda Barfield]

First, I never suggested we deny health care for anyone. Medicaid is alive and well in this country, and Peachcare is alive and well in Georgia. Yes, there are folks who fall into the range of being unable to afford insurance but not being eligible for Medicaid. Children should not suffer for the mistakes of their parents, I agree 100%.

As for the single mom paying the same as me, yes I believe she should. Why should the fact that she has three children make HER insurance premium any less. If someone has diabetes, for example, I don't believe they should pay a higher premium. No one should be penalized for being ill, nor should they be penalized for not being ill.

I also agree that is it time for people to take responsibility for their own actions and their own health. Obesity, hypertension, heart disease, kidney disease - all a big drain on our health care system.

Since there seems to be a great deal of concern over the coverage for children why not propose coverage for all uninsured children? Just don't expect me to pay for health care for the non working (note I did not say unemployed - there is a difference), smoking, drinking, drug abusing, self destructive parents at the same time. Those same parents who have 10 children. This is not a blanket statement covering all noninsured children, just many in my particular area.

[Belinda Barfield]

Funeral industry ??? Really ??? Well that is an optional expense. If I want to be buried in a Kiss Casket that's up to me.

I asked about the funeral industry in response to a comment about making profit off of human misery. So yes, really. :)

Bingo Anthony! That is an optional expense. If you want to be buried in a Kiss casket that is most assuredly your choice (suject to change without notice:rolleyes:). Health insurance should be an optional expense if my neighbor Joe decides he wants to put his money in a health savings account rather than pay the salary of the CEO of an insurance company, or hospital administrator, or your devil of choice.

[Ken Fitzgerald]

Mike,

You explain to me how not paying the cost of something is a good model.

We aren't talking about the difference between costs expended to perform a procedure and profit. We are talking the actual expense incurred to perform a procedure isn't fully covered.

If the hospital has to raise the costs to me and my insurance company to recover the costs it expended on you as a Medicare covered patient, then Medicare is just passing on a financial responsibility to someone else and shouldn't be used as an example " how a single payer system can work and work well".

Other examples of absurditities of Medicare:

Two hospitals.....2 towns..one hospital in each town.....separated by a state line and a river. You cross the river on one of two bridges and a US highway.

Both hospitals offer the same services.....surgery...day surgery.....a lot of the physicians practice at both hospitals.........ICU.....ER.....Radiology...

Medicare pays at one rate at one hospital...a different rate at the other hospital......:confused:

[Mike Henderson]

Health insurance should be an optional expense if my neighbor Joe decides he wants to put his money in a health savings account rather than pay the salary of the CEO of an insurance company, or hospital administrator, or your devil of choice.
Sure, as long as your neighbor, Joe, can show that he can pay for his medical care, no matter what happens.

The reality is that Joe saves his money and can pay for all his usual and ordinary medical expenses but he's in a terrible automobile accident and runs up over $100,000 in medical expenses - and he doesn't have the money.

That's why we have insurance. So I'd modify your statement to say that if Joe wants to buy a catastrophic policy but pay for his ordinary and usual medical expenses by himself, good for him.

But without that, it's likely that you and I will pay for Joe's treatment.

Mike

[Mike Henderson]

Mike,

You explain to me how not paying the cost of something is a good model.

We aren't talking about the difference between costs expended to perform a procedure and profit. We are talking the actual expense incurred to perform a procedure isn't fully covered.

If the hospital has to raise the costs to me and my insurance company to recover the costs it expended on you as a Medicare covered patient, then Medicare is just passing on a financial responsibility to someone else and shouldn't be used as an example " how a single payer system can work and work well".

Other examples of absurditities of Medicare:

Two hospitals.....2 towns..one hospital in each town.....separated by a state line and a river. You cross the river on one of two bridges and a US highway.

Both hospitals offer the same services.....surgery...day surgery.....a lot of the physicians practice at both hospitals.........ICU.....ER.....Radiology...

Medicare pays at one rate at one hospital...a different rate at the other hospital......:confused:
If you don't like the way Medicare treatments are paid for at hospitals, you should lobby for changes. That is, if you feel that payments should only be made for the actual procedures, and there shouldn't be a base amount (the subsidy) and then lower payments for each procedure, lobby for a per procedure charge, only. But the hospitals are obviously satisfied or they wouldn't continue to accept Medicare. The subsidy gives them a guaranteed amount each year no matter how many Medicare patents they treat. It also lowers the incentive for them to do excess procedures.

And I'm sure you understand the reason for the differences in reimbursements so I won't go into that. If not, I'll explain to the best of my ability in a PM. But I'm not a Medicare expert, just a very satisfied customer.

Mike

P.S. There's no truth that Hospitals raise their cost to insurance companies to compensate for Medicare treatments. The rates are negotiated with the insurance companies who are not willing to pay any extra. If one hospital tried to negotiate higher rates, the insurance companies would simply not do a contract with that hospital.

The difference is that the insurance companies do not provide any subsidies to the hospitals so the fees have to be higher to reflect the actual cost.

[Eric Larsen]

I asked about the funeral industry in response to a comment about making profit off of human misery. So yes, really. :)



When morticians are making $25 million a year, I'll start thinking about ways to improve the funeral industry. Funeral expenses are optional. They don't do a bit of good for the deceased. They're only for the friends and relatives of the deceased.

In the meantime, I'll quote the Mayflower Coffee and Doughnut shop:

"As you ramble on through life, brother,
Whatever be your goal,
Keep your eye upon the doughnut
And not upon the hole."

The doughnut here is a decent national healthcare plan. The "hole" is the "no no no no no no" people who don't seem to give a hoot that people are suffering and dying for want of a doctor, a nurse and some medicine.

Another quote for anyone who visited 59th and Fifth more than 35 years ago:

"'Twixt optimist and pessimist
The difference is droll;
The optimist the doughnut sees -
The pessimist the hole."

[Belinda Barfield]

Sure, as long as your neighbor, Joe, can show that he can pay for his medical care, no matter what happens.

The reality is that Joe saves his money and can pay for all his usual and ordinary medical expenses but he's in a terrible automobile accident and runs up over $100,000 in medical expenses - and he doesn't have the money.

That's why we have insurance. So I'd modify your statement to say that if Joe wants to buy a catastrophic policy but pay for his ordinary and usual medical expenses by himself, good for him.

But without that, it's likely that you and I will pay for Joe's treatment.

Mike

I agree wtih you Mike, and should have addressed the need for a catastrophic policy in my post.

For the record, I cannot currently afford health insurance. I am still paying medical bills for testing performed last November because my insurance plan at that time had a high deductible. I am also about to incur significant additional medical expenses. The hospitals and physicians were more than happy to set up a payment plan for me. No one in any office pressured me to pay a specific amount. In each instance they asked what I could comfortably pay. As long as I make those payments everyone is happy.

[Belinda Barfield]

When morticians are making $25 million a year, I'll start thinking about ways to improve the funeral industry. Funeral expenses are optional. They don't do a bit of good for the deceased. They're only for the friends and relatives of the deceased.

In the meantime, I'll quote the Mayflower Coffee and Doughnut shop:

"As you ramble on through life, brother,
Whatever be your goal,
Keep your eye upon the doughnut
And not upon the hole."

The doughnut here is a decent national healthcare plan. The "hole" is the "no no no no no no" people who don't seem to give a hoot that people are suffering and dying for want of a doctor, a nurse and some medicine.

Another quote for anyone who visited 59th and Fifth more than 35 years ago:

"'Twixt optimist and pessimist
The difference is droll;
The optimist the doughnut sees -
The pessimist the hole."

Really people, I don't care what morticians make. With that question I was merely asking someone to explain to me where we draw the line regarding who should and who should not make a profit. Yes people are suffering any dying for want of medical care ALL OVER THE WORLD. And yes sir, I most certainly give a damn, but it happens. Do you propose worldwide health care? Maybe we should feed every starving child while we're at it. For a great majority of people life is just plain miserable and I can't fix it for everyone. Charity begins at home. I try to help everyone that I can, but I would prefer not to do it through a heavy burden of taxation.

Yes, we need a change. I haven't argued that point with you Eric. I'm not saying no, no, no. I'm just saying please don't make me pay a huge penalty because I can't afford to insure myself. Increasing my taxes isn't going to make insurance any more affordable for me, that's for darn sure.

[Ken Fitzgerald]

Look,

You want to be compassionate? Fine.

Show me a reasonable, realistic, longterm method of paying for nationalized healthcare.

I can show you an example of a place where compassionate people in a rush, without much forethought, passed legislation without a reasonable method of paying for it. They made it easy. People rushed to take advantage. The same place is teetering on the brink of bankruptcy today. That is a beautiful example of financial irresponsibility.

There are no free rides. Eventually you have to pay the fiddler.

A national debt of nearly $12 trillion dollars. How are we going to finance it without effecting the current financial situation? For the first time in decades other countries are starting to be skeptical about the financial stability of the US.......talks of the US dollar no longer the accepted international standard.....think about it folks.......

I'm all for compassion. I am a compassionate man. Show me the realistic, reasonable long-term plan to pay for this pie in the sky. I will then take up and beat the drum for you.

And now my gutters need cleaning before the predicted "more" rain comes this afternoon. It's in the high 30's or low 40's. Boy this is a loved annual event.

When you can show me the payment plan....I'll consider looking at your donut...okay?:rolleyes:

[Jon Grider]

Wow, what a thread, thanks Ken for letting the interesting discussion continue. I think as was alluded to earlier, a bit of politics is inevitable on this topic, but so far I think everyone has been civil.
Someone mentioned that they shouldn't be responsible for the irresponsibility of their neighbor deciding to have 10 children. Or for increased costs that smokers, drug abusers, alcoholics would add to public provided health care.
I do agree with that. Personal responsibility for health has to be a huge part of the equation. However, I don't think that those examples have to eliminate what I consider the right of all Americans to affordable health care. Those that have 10 kids or use heroin or abuse alcohol or smoke tobacco or take their kids to the doctor for colds should have to ante up more than those who wouldn't abuse the system and try to live responsibly and healthily.

For our Canadian friends that his thread was started for, how does the Canadian government deal with these situations. I know tobacco is heavily and properly [imo] taxed, but how are other abuses of the system handled?

[Mike Henderson]

Look,

You want to be compassionate? Fine.

Show me a reasonable, realistic, longterm method of paying for nationalized healthcare.

I can show you an example of a place where compassionate people in a rush, without much forethought, passed legislation without a reasonable method of paying for it. They made it easy. People rushed to take advantage. The same place is teetering on the brink of bankruptcy today. That is a beautiful example of financial irresponsibility.

There are no free rides. Eventually you have to pay the fiddler.

A national debt of nearly $12 trillion dollars. How are we going to finance it without effecting the current financial situation? For the first time in decades other countries are starting to be skeptical about the financial stability of the US.......talks of the US dollar no longer the accepted international standard.....think about it folks.......

I'm all for compassion. I am a compassionate man. Show me the realistic, reasonable long-term plan to pay for this pie in the sky. I will then take up and beat the drum for you.

And now my gutters need cleaning before the predicted "more" rain comes this afternoon. It's in the high 30's or low 40's. Boy this is a loved annual event.

When you can show me the payment plan....I'll consider looking at your donut...okay?:rolleyes:
I don't think anyone is looking for some way to pay for health care for everyone. By that, I mean that people pay for health care today, both directly and indirectly through taxes.

What is being discussed is how to pay for health care for those who cannot afford it today.

I don't have the answer but there's a bunch of ways of doing it, but all of them affect certain groups more than others. And those people will scream bloody murder. As Russell Long said, "Don't tax you, don't tax me. Tax that fellow behind the tree."

Again, I think our priorities are to first decide what kind of health care system we want in the United States, then decide how we're going to pay for it (and if we can pay for it).

Mike

[Anthony Scira]

And now the politics begin and this thread is just about 1/2 second from closing...

once again Erik you want to tax...tax...tax.....and the businesses and the people go BYE......BYE.....BYE. You wanted to raise taxes for the environment...now free medical.....raise taxes......

Now Eric, how would you feel about a national compassionate home program where we provide at no cost homes to every American. Of course, we won't need realtors and the building contractors will be expect to incurr and not get paid for their services or expenses but still provide their services. Hogwash!

First I don't have a clue where you get the idea MY property taxes are paying for indigent health care. That may be true where you live but....here hospitals eat that expense inititially, write some of it off on taxes and pass the difference on as higher fees to me and my insurance company.

Some folks like to "tout" Medicare as a great financial model for healthcare. Let me tell you a FACT...in some cases, Medicare doesn't even pay the cost that the hospital incurs when they perform a diagnostic exam.....I'm not talking about cutting into any perceived profit...What Medicare pays doesn't cover the cost incurred to perform the exam....and what does the hospital do....those $3 boxes of Kleenex with 4 sheets in them you and your insurance company get charged for...it helps make up for what Medicare doesn't pay.....

Don't drag Iraq and Afghanistan into this argument. That will make it political and get this thread closed. They are short term problems and nationalized healthcare is something that if legislated needs a long term financial solution that our own Congress can't meddle with as they have so underhandedly done with social security for more than 40 years.

Anthony....In my America, people are responsible for their actions. Let the lady get a job. Let's don't make it too easy or people will flock there by the millions to enjoy the rewards. I can suggest a current failed model for such financial irresponsibilities if you'd like.

Health care reform is health care reform. Trying to mix other topics that do not relate make no sense. The whole socialized home thing is silly. And technically we do have it in the form of Low Income housing.

The "lady" in a lot of cases has 2 jobs and no health-care. That there in is the problem. And this is not FREE health care. If your working your paying for it. That is upsetting to hear the mis information that is being thrown around. Even my uncles keep chiming in "where is my free health care?" At that point the discussion is lost and there are just bad name calling's coming my way. (socialist, communist etc....)

And the Medicare thing is not true. My wife is a PT and their reimbursement is high. The have to follow a lot of rules though and if you skimp on the treatment you risk losing the ability to accept Medicare. That is something that would not be good for the Practice my wife works at.

And the whole "My America" thing is another part of the problem. To me it has always been "Our America".

[Caspar Hauser]

Yes people are suffering any dying for want of medical care ALL OVER THE WORLD. And yes sir, I most certainly give a damn, but it happens. Do you propose worldwide health care? Maybe we should feed every starving child while we're at it.

We can only hope.

[Eric Larsen]

Health care reform is health care reform. Trying to mix other topics that do not relate make no sense. The whole socialized home thing is silly. And technically we do have it in the form of Low Income housing.
.
.
.
And the whole "My America" thing is another part of the problem. To me it has always been "Our America".

In my mind, it's all connected. We spend money on frivolous boondoggles, which makes the important things hard to pay for.

Healthcare falls under a "need" as far as I'm concerned, along with "breathable atmosphere," "potable water," "nutritious food," "decent shelter," and "clothing."

Everything else is optional. Fun, but optional.

By virtue of being born a human being, the above things should be the minimum birthright for everyone. We can make that so by reallocation -- the numbers have been out there for anyone who cares to look at them since Kennedy.

I have no time for people who choose willful ignorance. We're already paying for universal health care. It's just that it's not universal. We can make it universal for the same -- or less -- than we currently pay. The federal outlay will go up. The municipal and state outlay will go down. It's all connected.

The only difference will be that hospital owners and insurance CEOs will not be able to buy five Learjets each year with the money they're currently making on the backs of the sick and dying. Pharmaceutical CEOs won't be able to afford private islands in the Caribbean. (They already own most of Puerto Rico.)




And pencil me into the "our America" crowd. Well said.

[Greg Peterson]

Stephen Hemsley owns $744 million in unexercised stock options. In 2008, United Health Group had $75 billion in revenues and $4.6 billion in profits. It ranked No. 21 on Fortune's list of largest corporations.

What service does a health insurance company provide that a single payer system could not provide?

We are all currently paying for a broken system, and every year the cost goes up. We are paying almost twice of that of the next most expensive nation yet our outcomes are nowhere near as good.

In short, we are not getting a good return on our investment. We have no problem defending the excesses of the corporate class living lavish lifestyles by destroying families that have the audacity to contract a serious illness or injury.

And since I don't have any kids, why should I pay taxes to subsidize the public education system? If you want kids, fine. You pay for their education.

Actually, I don't have a problem with public education because I see the value in having an educated nation. Imagine trying to hire employees that can't read, write or do simple math.

For this same reason I also see the value in a healthy workforce.

I'm convinced that I am on the correct side of this debate. The moral and just thing to do would be to never deny health care to anyone (ER visits do not count as health care, that is trauma care).

Darius did a nice job of combing through the report that was previous cited as evidence that the US is not doing as poorly as some would say. Whether or not the poster intentionally omitted the obvious antiquity of this report or not is for someone else to determine. The fact remains that the original posters fundamental argument was not correct because it was outdated information. If this qualifies as an attack then I'm afraid we've entered into a whole new level of being politically correct.

[Ken Garlock]

After browsing the 8 pages of posts, I feel that this discussion has only landed a glancing blow at the real problem in medical care and that is absurd malpractice settlements. Texas has addressed the problem of limiting the max payout to the victims, but did nothing to limit the greed of the the lawyers. (http://www.mcandl.com/texas.html#VIII)I my opinion, the lawyers should be limited to not more the 10% of the victims settlement.
Why? I saw a panel of 60 MDs on "Foxy"(apparently someone doesn't like both sides of a story). A young lady just starting her practice was paying $200,000 per year in malpractice insurance. Let us not forget her bills from 8+ years of school, a number that could as well get into the 6 digit area. How would you like to be saddled with a 200K bill every January one? Oh yes, only 7 medical students of the group of 60 thought government run mediical care was acceptable.

Another thought.... The Cleveland Clinic in Cleveland Ohio ranks as one of the best hospitals in the world. Every doctor, nurse, and staff are employed by the clinic: they are on a salary and only work at the Cleveland Clinic. It is run as a business! Does it make a profit, I don't know, but do know that people from allover the world come to Cleveland for medical care. And yes they do treat the 'down and out.'

Last thought.... I know it is not popular to read or know history. But, if one would look at the history of governments, you would find that Socialism has never worked. Just name a program from Washington that has not cost more than promised and has not been grossly mismanaged.

Those are my opinions, take'm or leave them.

[Mike Henderson]

I've never read anything that makes a good case that malpractice awards are a major cost in the medical system. However, a number of locations have limited malpractice awards for pain and suffering. Here in CA, it's limited to $250,000.

The claim I've always heard is not that the malpractice awards are a drain on the system, but that doctors order excessive tests so that they can better defend themselves in case of a suit, and this leads to excess costs.

Maybe someone has better information.

And I don't think anyone seriously mentioned socialism when describing health care.

Mike

[Anthony Scira]

I've never read anything that makes a good case that malpractice awards are a major cost in the medical system. However, a number of locations have limited malpractice awards for pain and suffering. Here in CA, it's limited to $250,000.

The claim I've always heard is not that the malpractice awards are a drain on the system, but that doctors order excessive tests so that they can better defend themselves in case of a suit, and this leads to excess costs.

Maybe someone has better information.

And I don't think anyone seriously mentioned socialism when describing health care.

Mike

Mike,

People have been using Socialism, and that is some of the nicer language being used by some to describe Universal Health Care.

[Greg Peterson]

Why? I saw a panel of 60 MDs on "Foxy"(apparently someone doesn't like both sides of a story).

I find some so called news outlets quite entertaining. One is so over the top that it rivals The Onion in absurdit

We are all paying for health care now. My employer use to cover 100% of my premium. In the past ten years I've had to contribute to the premiums to the point that what I pay now is greater than what my premiums were fifteen years ago and there is no end in sight. My employer still picks up the vast majority of the premium but at what point will my employers share equal my share?

[Ken Fitzgerald]

I suggest it is just as immorale to spend more than you recieve and to pass on one generations debt another generation.

Approximately 12 trillion dollars of national debt and other countries losing faith.

You can say it's just a nickel ...it is just a diime but in the end, regardless of how you get there, it adds up to nearly 12 trillion dollars.

Financial responsibility.

[Belinda Barfield]

I've never read anything that makes a good case that malpractice awards are a major cost in the medical system. However, a number of locations have limited malpractice awards for pain and suffering. Here in CA, it's limited to $250,000.

The claim I've always heard is not that the malpractice awards are a drain on the system, but that doctors order excessive tests so that they can better defend themselves in case of a suit, and this leads to excess costs.

Maybe someone has better information.

And I don't think anyone seriously mentioned socialism when describing health care.

Mike

Many doctors do order more testing than they feel necessary in order to cover themselves in the event of a suit.

One poster made a comment along the lines that if a physician had a suit filed against him/her he should no longer be allowed to practice but, sadly, mistakes are made in the field of medicine just like they are everywhere else. It isn't always negligence. Here'e something else to think about. If a physician instructs his nurse to give you an injectable medication, and the nurse gives you the wrong medication, guess who gets sued . . . nope, not the nurse, the physician. Same with nurse practioners and physician's assistants, the supervising physician is ultimately responsible. I've raised this question before and never got an answer, so I'll ask it again. If the the government is the single payer, what happens with lawsuits. As best I recall you can't sue the federal goverment if a mistake is made by a physician at a VA hospital - another single payer government funded health care system that I can't believe no one else has mentioned. I'm fairly certain some of you are familiar with medical care provided through the VA.

[Greg Peterson]

I suggest it is just as immorale to spend more than you recieve and to pass on one generations debt another generation.

Approximately 12 trillion dollars of national debt and other countries losing faith.

You can say it's just a nickel ...it is just a diime but in the end, regardless of how you get there, it adds up to nearly 12 trillion dollars.

Financial responsibility.

Little late in the game to be calling for fiscal responsibility. And who rung up this deficit?

[Brian William]

Well all Ican say is that my wife was diagnosed with a heart problem and had many many tests done. The end result was her having a stent put in. Then there was the medication after all this. The medical proceedure cost was absolutely nothing to us. The medication was fully funded by my company medical coverage. We initially had to pay for the meds,but every pennny was refunded to us in 8 days. Ultimately the complete proceedure cost us nothing. This is paid for by the Gov't. This is why we pay provincial sales tax ,and a general sales tax,which combined comes to something like 12%. So that isn't bad.

[Belinda Barfield]

Little late in the game to be calling for fiscal responsibility. And who rung up this deficit?

Regardless of who rung it up, we don't have to continue. If I'm drowning I'm going to swim toward the surface, and I'm certainly not going to wait until I reach the seafloor to start.

[Art Mulder]

Hmmm, not seeing too many Canadians in this thread for the last 4-5 pages of posts... :p

Just to answer the original poster... Well, actually I think Rod Sheridan did a great job of that back in post #3 or #4.

Count me as another Canadian who is basically satisfied with the system here. I can see my family doctor within 3-5 days usually for non-urgent care. I can get an Ultrasound or X-Ray within a week, again for non-urgent. I've had a CT scan on two different occasions within 3-4 days. (And on BOTH those occasions I saw urgent care people getting bumped to the front of the line, as I think it should be)

Are there delays? Yeah there are. My son has bad eczema, and we've tried all kinds of cremes and we finally have an appointment for a pediatric skin specialist (I forget the exact title), and it's probably going to take about 4-5 months before we get to see them. Do I like that? No I don't. But again, this really is not urgent/critical care, this is mild discomfort.

Are there problems in the system? Sure, it's created by fallible humans after all.


So Rod, if you take a procedure like child birth that may run $15,000 here in the US..and you pay $30 out of your pocket...who pays the rest of the money?

Tim, I'd ask the question as to why it costs $15,000. And I'd be interested to know if if costs the province here the same or not. I suspect that it's lower, but I don't really know.



I would be interested to know the statistics on malpractice suits filed in Canada versus the US, and if there is a difference in the cost of malpractice insurance between the two countries.

Me too.

But I'd be more interested to see some hard statistics on what the gov't pays per-capita for health care in Canada vs the US. My brother-in-law attended a talk by a rather prominent former US politician who claimed that the US gov't already pays more per capita on healthcare than Canada does.

If that is true, then to me that is a huge huge deal for my US friends.



I can cite others who are Canadian friends who have brought family member to the US for treatment and diagnosis.

Anecdotes, Ken. Just like my story above is an anecdote. Stories are important, but they aren't statistics. :rolleyes: I'm more interested to know if the vast majority of Canadians are getting good care.


No, I would like to see a single non working mum/dad with three kids pay the same as a single non working me, or a working mum/dad pay the same as a working me. I am not responsible for the fact that they have three kids, they are. If I wanted to pay for three kids I would have had three of my own.

I have to leave now to go to the funeral of a very dear friend, so I can't continue here. Y'all don't beat me up too bad.

Hope this isn't beating up, I've just come late to the thread, so I've got lots of things to think about all at once!!! :p

I see it like this, Belinda. As a society, I think that we (that is, Canada) have decided that we want healthy, educated, safe kids/families. So we have taxes that help fund schools, and Universities, and Hospitals, and Fire departments. So hopefully these kids grow up into the kind of adults that Ken has raised ;) Who then take over and help run a good society for themselves and for the next generation. AND of course, so that they help look after me and you when we're a bit older and need a helping hand.


who decides what is covered. Suppose it's me and my family loves me so much that even though I've had a massive stroke and the sugeon says he can do surgery...relieve pressure on the brain but I will always be in a vegetative state...never again to interact as a human being as we know it. Who decides what medical treatment....how long it will continue.....whether or not it will be discontinued......Who will decide?

Ken, as far as I know, that decision is handled here in Canada the same as there in the US. It's up to the family. Or rather, it's up to you, if you've already made your wishes known in a living will (or some other legal document, whatever you call it). The doctors here take the same hippocratic oath that doctors there and elsewhere take. So the ethical conundrums are the same under our system as yours, I think.



...art

[Ken Fitzgerald]

Greg,

Belinda is right. It doesnt' matter. We as a country have to accept responsibility for it. And we live in a world this expects us to rightfully pay it.

Folks,

This discussion has reached the point where I am cosidering closing the thread. I may defer to other Mods if I do.

Further religious or political comments may cause this thread to be closed.

[Greg Peterson]

I'd trade my 35% tax burden for a 12% tax burden that provides health care for all, no questions asked.

"As a society, I think that we (that is, Canada) have decided that we want healthy, educated, safe kids/families. So we have taxes that help fund schools, and Universities, and Hospitals, and Fire departments. So hopefully these kids grow up into the kind of adults that Ken has raised Who then take over and help run a good society for themselves and for the next generation. AND of course, so that they help look after me and you when we're a bit older and need a helping hand."

Bingo.

[Belinda Barfield]

I see it like this, Belinda. As a society, I think that we (that is, Canada) have decided that we want healthy, educated, safe kids/families. So we have taxes that help fund schools, and Universities, and Hospitals, and Fire departments. So hopefully these kids grow up into the kind of adults that Ken has raised ;) Who then take over and help run a good society for themselves and for the next generation. AND of course, so that they help look after me and you when we're a bit older and need a helping hand.
...art

I understand this Art. I would like to have this as well. Let me ask you this one question as it pertains to my major issue with what is on the table now. Do the taxes you pay for health care also pay for other things? Things like a bridge in a particular state, or building a new building in another?

[Wayne Watling]

As for the single mom paying the same as me, yes I believe she should. Why should the fact that she has three children make HER insurance premium any less.

You have misinterpreted the argument. That was just one of many examples I could have put forward. I could have just as easily said that you (as a non working low tax paying person) were entitled to very low payments. You missed the point and the point being that here in Canada we pay for health care according to our ability to pay (via taxes). Little or no tax payers pay very little and higher tax payers pay much more.

Judging people by the number of children they happen to have has no place in this discussion, that is another topic altogether. Basically as a society we have to find a way to provide basic heath care for all citizens no matter what their circumstances, their title or history.

Something we have to consider is that health care is vastly different to anything else, its not like schools or roadworks or parades or any other social service, its the number 1 thing we have to provide for citizens because without our health we are nothing.

[Dennis Peacock]

While this is a very good thread and I commend each of you for handling things and stating things very well, we are nearing an end for

this thread to be closed.

Please expect this thread to be closed by no later than Sunday evening as no matter how much we discuss it, we aren't going to solve the U.S. budget issues nor the health care issues.

[Dan Lee]

Darius
Good post.
So as I interpret the report most European countries now follow the same guidelines for reporting. They chose not to address the other 15-20 countries ranked ahead of the US

Also kind of curious the report says:

“Using direct standardization (10), we applied the U.S. gestational-age specific infant mortality rates to Sweden’s distribution of births by gestational age. If the United States had Sweden’s distribution of births by gestational age, the U.S. infant mortality rate (excluding births at less than 22 weeks of gestation) would go from 5.8 to 3.9 infant deaths per 1,000 live births—a decline of 33%.”

“The United States compares favorably with Europe in the survival of infants born preterm. Infant mortality rates for preterm infants are lower in the United States than in most European countries. However, infant mortality rates for infants born at 37 weeks of gestation or more are generally higher in the United States than in European countries.”

As I read it on one hand if US had lower preterm rates IM would drop significantly but the second paragraph implies our problem is with full term births.

I suppose I could dispute the report cited based on its timing relative to current events and that CDC director is a direct report to the HHS secretary as of June of this year.
Sort of like questioning the CBO report based on who requested it. But I won’t

[Glen Gunderson]

What many Americans don't seem to realize is that they are already paying as much in taxes for government health care as Canadians are. Per capita, residents in both countries pay about $3,000 USD a year in taxes at all levels of government for health care. So it's not a case of Canada having higher taxes to fund health care, but the overall cost just being a lot lower.

There a bunch of reasons for that, and with some changes the US could lower the cost of health care. Some of the changes wouldn't be that difficult to implement (managerial efficiency, tort reform), and some would be very difficult to change (demographics, nutrition and fitness, violent crime).

[paul cottingham]

Also, in BC we pay insurance premium of 100 per person per month, as well as user fees for many services. This amount is indexed, so poor people don't pay any premiums at all. Our taxes pay for the remainder, and consume about 20% of our GDP. For this, everyone is covered, regardless of pre-existing conditions, and regardless of ability to pay.

[Paul Ryan]

17 trillion dollars of national debt and other countries losing faith.

You can say it's just a nickel ...it is just a diime but in the end, regardless of how you get there, it adds up to 17 trillion dollars.

Financial responsibility.

Ken,

I would like to see your sources for the 17 trillion in debt. I have heard around 4.5 which is still ridiculous but a far cry of 17 trillion. Is the 17 total for the next 10 years or current. I don't believe it is current, I believe my number to be much closer. 17 trillion is only 4 times higher than what I have heard. No matter how you look at it, the heath care plan needs to be funded. I don't mind paying more in taxes if my cost of insurance will go down. I firmly believe if we can get a plan together that provides equal insurance regardless of income levels. In the long run costs will go down. Or atleast say at todays levels.

I think we all know the reason insurance is so high is because what the heath care facitlities charge is so high. My wife works in the Mayo Health system. Which is many times sited as being a facility that has it right. Here is a perfect example of waste. My wife recently gave birth to our 2nd child. During the delivery the doctor thought he may need the "mity vac" a vacuum device that attaches to the babies head to help remove the baby. He opend the package the "mity vac" was in tested it and set it on the table behind him. He never needed it. So after the delivery while nurses were cleaning up, they pickup up the "mity vac" and put it with the rest of the garbage. I asked what was going to happen with it, the nurses said it would be tossed out. I asked why, it had never been used. I was told since it was in a patients room regardless if it was used or not it is thrown out. Well I kept it then. Works great for vacuum tests on emission systems and bleeding brakes. Our insurance was charged for a $450 vacuum pump that was never used and was esentially thrown out. That same vacuum pump can be purchased from napa, or a tool guy for about $50 and used for years. Now I have 2 pumps, they are both a little different but accompish the same thing. If these cost go down so will our insurance rates.

I will never believe that malpractice suits contribute to such high priced insurance. Sure doctors have to pay rediculous high premiums to protect them from greedly lawyers. But those costs are minor compared to $450 vacuum pumps, $25 asprin, so on a so forth. I think the malpractice adjustments need to be an after thought, not a priority.

[Art Mulder]

I understand this Art. I would like to have this as well. Let me ask you this one question as it pertains to my major issue with what is on the table now. Do the taxes you pay for health care also pay for other things? Things like a bridge in a particular state, or building a new building in another?

:confused: Bridges? Buildings? I don't follow.

I just pay tax, Belinda, it's not subdivided into building tax, road tax, or health care tax. There is no specific "health tax" here.

Of course, I'm not a tax expert. But you could read the wikipedia entry on Canadian Taxation (http://en.wikipedia.org/wiki/Taxation_in_Canada), and that'll give you a capsule summary of our system I guess.

[Ken Fitzgerald]

Ken,

I would like to see your sources for the 17 trillion in debt.


Paul,


I am not sure where I got the 17 trillion dollar figure. I stand corrected and thanks for causing me to search. I just did a search and came up with 3 sites showing 11.9 trillion and 3 sites indicating 12.1 trillion.

Where did you get your 4 trillion figure and do you think we could get our creditors to accept that?

The main point is that in the last two weeks, countries loaning us money have cooled off doing so because they are getting squeemish about our financial woes. Some countries were even discussing finding an alternative to the US dollar as the accepted economic standard. That is scarey.

Thanks for pointing out my error. I will go back and edit each of my posts so they are correct.

[Rob Robinson VT]

But I'd be more interested to see some hard statistics on what the gov't pays per-capita for health care in Canada vs the US. My brother-in-law attended a talk by a rather prominent former US politician who claimed that the US gov't already pays more per capita on healthcare than Canada does.

If that is true, then to me that is a huge huge deal for my US friends.
According to this (http://www.infoplease.com/ipa/A0934556.html) website, here are the United Nations figures for per capita health care costs by country for 2007 (in U.S. dollars):

U.S. $6,096
Luxembourg $5,178
Norway $4,080
Switzerland $4,011
Austria $3,418
Iceland $3,294
Canada $3,173
Germany $3,171
Belgium $3,133
Australia $3,123
Netherlands $3,092
France $3,040
Sweden $2,828
Denmark $2,780
Ireland $2,618
United Kingdom $2,560
Italy $2,414
Japan $2,293
Finland $2,203
Greece $2,179
Spain $2,099
New Zealand $2,081
Israel $1,972
Portugal $1,897

[Paul Ryan]

[QUOTE=Paul Ryan;1265362]Ken,

I would like to see your sources for the 17 trillion in debt.
QUOTE]

Paul,


I am not sure where I got the 17 trillion dollar figure. I stand corrected and thanks for causing me to search. I just did a search and came up with 3 sites showing 11.9 trillion and 3 sites indicating 12.1 trillion.

Where did you get your 4 trillion figure and do you think we could get our creditors to accept that?

The main point is that in the last two weeks, countries loaning us money have cooled off doing so because they are getting squeemish about our financial woes. Some countries were even discussing finding an alternative to the US dollar as the accepted economic standard. That is scarey.

Thanks for pointing out my error. I will go back and edit each of my posts so they are correct.

Ken,

I really dont have any sources other than what I hear on the evening news or read in the newpaper, and we all know how accurate that can be. I knew my numbers wouldn't be right on but I still didn't think the deficit was that high. But no harm no foul, no need to edit your posts, it is just a friendly discussion, as my father and I would like to call it.

It is too bad that we have racked up such a debt since 1995. It is truly scary that the US dollar may not be enough to secure a loan any more. How long do we continue going into debt. I can go into how I think the heath care plan should be paid for, but my views get aweful political. Some of my previous post I had typed them, but erased them before submiting realizing they could be viewed as political. I believe there are all sorts of ways to start fixing our problem but something that will take decades to perfect. But we need to start some where, we cannot afford to do nothing. And it seems that there are to many that are afraid of change. Unfortunatly I believe this problem is not one that little baby steps can over come. We need to make a splash and start fixing from there.

[Denny Rice]

Denny, that Zamboni comment cracked me up, you made my day.:D

Unfortunately crime isn't non existent in Canada. I live in the largest city in Canada, and we have approximately one murder per week.

I wouldn't call that non existent.

Regards, Rod.

Rod,

Thanks...I know any murder is bad, but it seems here murder is a DAILY thing in the tri-state area. If it only happened once a week here the police force would be much smaller and I belive this country would be a much better place to live. I have been to Canada 4 times and I am amazed how friendly people there are. Are you sure there aren't any Zamboni openings?

[Dan Lee]

Greg said:
Stephen Hemsley owns $744 million in unexercised stock options.

You realize that depending on his strike price for these options they could be worthless.
Yeah he has 13,000,000 unexercised shares but if the strike price is $30 or $50 dollars per share (based on market 3 years ago) and the current Friday close market per share is $25 well ....

[Darius Ferlas]

Darius
Good post.
So as I interpret the report most European countries now follow the same guidelines for reporting. They chose not to address the other 15-20 countries ranked ahead of the US

Also kind of curious the report says:

“Using direct standardization (10), we applied the U.S. gestational-age specific infant mortality rates to Sweden’s distribution of births by gestational age. If the United States had Sweden’s distribution of births by gestational age, the U.S. infant mortality rate (excluding births at less than 22 weeks of gestation) would go from 5.8 to 3.9 infant deaths per 1,000 live births—a decline of 33%.”

“The United States compares favorably with Europe in the survival of infants born preterm. Infant mortality rates for preterm infants are lower in the United States than in most European countries. However, infant mortality rates for infants born at 37 weeks of gestation or more are generally higher in the United States than in European countries.”

As I read it on one hand if US had lower preterm rates IM would drop significantly but the second paragraph implies our problem is with full term births.

Hi Dan,

I noticed the differences between dependent on whether the birth is pre-term, but perhaps I didn't show clearly that this also might be problematic. Preterm births are, well premature and thus aberrant (no undertones). That in itself indicates medical issues that manifest themselves the most within the US population, i.e. in other countries compared in the studies more women (per capita) have proper pregnancies than in the US. Would free pre-natal care change help in the US?


I suppose I could dispute the report cited based on its timing relative to current events and that CDC director is a direct report to the HHS secretary as of June of this year. Sort of like questioning the CBO report based on who requested it. But I won’t
Agreed.
Timing, authors and whoever commissions the report should certainly be considered in any analysis of data that is debated. All these factors tend to skew the results and/or conclusions.

I have no idea who the authors are (politically) and I'm pretty sure the report has been commissioned by the current administration. As for the validity and timing of the data (in regards to rules in some EU countries) it comes from a 2008 European report that can be read here (http://www.europeristat.com/bm.doc/european-perinatal-health-report.pdf). That report, while obviously used by the current White House administration, has nothing to do with it. It was commissioned by an EU agency a year before the last US elections.

The American report (Nov. 2009) also seems consistent with the general assessment of health care in the US. While there is sufficient anecdotal material suggesting the health system is good the way it is, it is also obvious that health care in America is a huge personal and corporate burden (one of the reason GM ans such like Canada is that they do not have to pay insane rates for their employees health insurance). A large portion of the population either lacks access to medical care, or faces bankruptcy in the face of medical misfortunes.

In the area of finances I have no answers as I am not an economist, but I can see the differences between the per capita cost in various countries. In the US that cost is the highest. The US also has the highest percentage of GDP spent o medical care, and yet so many have no access to health care.

I have a feeling that, given a chance, some bright minds could not only restructure the system so that it would not cost more, but they might be even able to find ways to lessen the burden on the tax payer.

Bottom line is that the system is broken and "socialized" medicine has not been tried in the US. Looking at the experience of other developed countries it turns out that socialized health care won't make things any worse than they are, but it could make them better. Heck, socialized banking system and socialized automakers are another point in case. Just a couple of days ago GM reported a five fold decrease in their losses. If they did not have to pay health insurance premiums they might have even cranked out some profit last month.

[Anthony Scira]

Greg said:
Stephen Hemsley owns $744 million in unexercised stock options.

You realize that depending on his strike price for these options they could be worthless.
Yeah he has 13,000,000 unexercised shares but if the strike price is $30 or $50 dollars per share (based on market 3 years ago) and the current Friday close market per share is $25 well ....

I would love to sell 13,000,000 of anything for 25 bucks a share. I would even settle for 5.

But I am easy !

:D

[mreza Salav]

Very interesting,
As a Canadian I am happy to live in this system.

Going through all the pages and posts I try to address some of the questions raised. I think Rod did a good job of listing things.

My wife and I are expecting our first child in a few months and have started dealing with the health care system more often. So far, we have been able to see our family doctor whenever we wanted, have had our annual check ups routinely, and paid nil for any of these (including a few visits to emergency rooms). My wife has regular appointments with the specialist (routing ultra sounds) we are even offered prenatal classes etc, and the cost of delivery and hospital will be nil.

All of these are paid through taxes. I used to think we pay a lot more than in US but after comparing what I pay with some of my friends in the same income bracket the difference wasn't much (would say we both pay around 35%).

Is the health care system perfect here? not at all, but I think it is far better than what my relatives/friends have it in the US.

I find the examples Ken has pointed out to very rare (a family with 20 children etc). In any system you'll have some outliers but the vast majority of public behave close to an average person.

And remember, the cost of health care system even with all the in-efficiencies of a government run system shouldn't be more than what you are already paying for through insurance companies. Here, we just don't have to pay for the profit of those companies (and the bonuses of their CEO's).

[Eric Larsen]

And remember, the cost of health care system even with all the in-efficiencies of a government run system shouldn't be more than what you are already paying for through insurance companies. Here, we just don't have to pay for the profit of those companies (and the bonuses of their CEO's).

And that is hitting the nail squarely on the head. As has been brought up time and again, Americans are already paying for a universal health care system. But we are not getting the benefits of a universal health care system. We are paying more for less. That is fiscally ridiculous, morally corrupt, and inefficient beyond belief.

The current system being bandied about by the US Congress isn't adequate for me. But it's a start. Changing our collective mindset is the first step. Once that is accomplished, the pieces will fall into place. That is inevitable. America is capable of creating a health care system that is fair, honest, decent and compassionate. This current bill isn't it. But it's a start.

The "Let's Do Nothing" crowd has had it's way for 80 years (England started putting their system into place in the 1930s.) Anything we do is going to be better than what we're doing now. This is a no-brainer in my opinion.

If JFK hadn't been shot in 1963, I think we would already have universal health care. If Bobby hadn't been shot in 1968, I think we would already have universal health care. If Bill Clinton didn't put Hillary in charge in 1993, I think we would already have universal health care.

This bill isn't universal, and it has a lot of shortcomings. But it's a start. And it's still a no-brainer.

Yesterday, at work, I talked about this with a man who escaped from Bulgaria during the Cold War. His take on the situation was that America spent so long fighting communism, that we lost sight of the fact that occasionally the socialists got it right. Health care is one of those things. Cuba has a better system than we do. Are we as a nation really satisfied with that?

I just hope we can wrap this up quickly and focus on all the rest of the mind-bogglingly important problems facing us. I hope the next things on our government's docket are jobs, jobs, and jobs. Eisenhower's Highway Investment Plan stopped a post-war recession in it's tracks. And we've been enjoying the benefits for 60 years. With luck, we can do it again. (Something to ponder on Monday's commute, if nothing else.)

[Anthony Scira]

Thanks for the Canadian point of view. System does not sound bad at all. They keep telling us you guys are dying in line over there and are trying to jump our borders to give us your hard earned money !

:cool:

[Glen Gunderson]

Also, in BC we pay insurance premium of 100 per person per month, as well as user fees for many services. This amount is indexed, so poor people don't pay any premiums at all. Our taxes pay for the remainder, and consume about 20% of our GDP. For this, everyone is covered, regardless of pre-existing conditions, and regardless of ability to pay.

I think you're getting the family rate mixed up with the per person rate. BC's MSP premiums are:

1 person: $54
2 person family: $96
3 or more persons family: $108

Although, those are all going up by a few dollars on January 1st, 2010.

[Dan Mages]

From my own experience with Canada's medical system. I lived Whitby, Ontario, in the Toronto Metropolitan area in 90-92. My brother, a friend of ours, and I decided to go do a little night time sledding. Yeah, not the smartest move. My brother broke his arm and was rushed to the hospital in Whitby. Because it was a compound fracture, they had to send him to another hospital in Oshawa to be treated because they did not have a doctor on staff that could treat him. It was another day or two before he had surgery to have it set correctly and a pin inserted. It still gives him trouble to this day.

Someone mentioned the income taxes in Canada. That is only half the story. When I was living there, the sales tax on many goods was 15%.

Someone mentioned Japan's healthcare. Japan also has 860 trillion yen in national debt. That is bordering on, if not exceeding 200% of their GDP.

Another person mentioned that the rich get the best healtchare. Yeah, and quite often because they work their tushes off to get where they are. I have known my wife for 5 years now. Since the day we met, she has worked full time, gone to law school at night, and excels at both. She hopes to finish law school next spring. She is compensated very, very well for her efforts. Will someone please explain why we should pay more in taxes to pay for the government benefits of a person who is lazy, does nothing to enrich themsleves, works in a minimum wage job, and expects the government to take care of them?

If you think I am being critical, I have seen it first hand. When I was in culinary school, there was a girl who was there on a state funded program. She decided to go to culinary school to continue to welfare payments that were about to run out for her and her illegitimate child. She made no effort to excel in the class and barely made it through the program. At the end of the program, she was happy to mention that she was pregnant with her second illegitimate child and will be able to collect welfare for 18 months to 2 years. She had no desire to work in the profession. She was just there to game the system and collect welfare checks.

Dan

Dan

[Gord Pat]

:confused: Bridges? Buildings? I don't follow.

I just pay tax, Belinda, it's not subdivided into building tax, road tax, or health care tax. There is no specific "health tax" here.

Of course, I'm not a tax expert. But you could read the wikipedia entry on Canadian Taxation (http://en.wikipedia.org/wiki/Taxation_in_Canada), and that'll give you a capsule summary of our system I guess.

Hmmm Art, I guess you subscribe to Mr McGuinty's way of thinking.:)
According to him the "Health surcharge" as he calls it is not a tax , to me it is a tax , it's collected when you file your yearly tax return and is based on your income. Unfortunately the tax monies received under the health surcharge are just dumped into general revenues and not allocated specifically for the Health Budget.
I just mention this hoping it gives a clearer answer to Belinda's question.
BTW it is mentioned in the capsule summary you pointed too.
No malice meant no flame intended.

[Jim King]

This has been very interesting to see the opinions from different perspectives. Here in Iquitos, Peru we have health care for the general population that is about the same as the 60´s in the States. It is very economical and many times free. This is a very poor country by US and Canadian standards and there is health care for all.

We have several general hospitals owned by the government. A medical doctor here is paid the same as any other trained profession and normally work in at least two hospitals to make ends meet. We also have privately owned hospitals which are a about 20 years behind you up there but very good. Intensive care is about $100 a day.

For my employees I paid about $30 a month for full coverage which included the family menbers. We still have house calls for the people who dont like to go to the hospital. We have no blood bank but there are about 800 young well fed soilders which are on hand with a call to the base commander. I give blood every three months to the son of our secretary and having it done in the house with a nurse for several hours and a doctor for a couple of hours and the needles, blood bag etc the total cost is $80.

Malaria and Denge are treated free to encourage people to get treatment quickly. I have had Malaria 26 times and Denge 3 times and no charge for the treatment. Birth control is free but the church is fighting it.

The dental care and cosmetic surgery are world class and have created a medical tourist industry because of the extremly low costs. Below is a photo of our doctor at our house giving me an IV for Denge.

We do have a couple of drawbacks, one is that it is not a good idea to get sick on Sunday as most doctors are recovering from Saturday night at the disco.

I have not heard of anyone addicted to seeing a doctor as many seem to be in the States. I have never heard of a doctor or a medical facility here being sued for anything. Doctors do not need or have insurance. Another perspective.

[Greg Peterson]

Will someone please explain why we should pay more in taxes to pay for the government benefits of a person who is lazy, does nothing to enrich themsleves, works in a minimum wage job, and expects the government to take care of them?

Not everyone working a minimum wage job is lazy and expects government handouts.

Our America decided that providing an education for everyone was an important if we wanted our nation to prosper. Our America decided that providing a dignified life for our elderly was reasonable, just and within our means. Our America decided that our elderly should not suffer needlessly at the hands of illness and disease. I'll wager that many retirees over age 75 have likely withdrawn more from the system than they paid in. But our America doesn't limit their access based on what they contributed.

An educated and healthy workforce is critical to our ability to compete on an international stage.

Jim - The hypochondriac argument is just a knee jerk argument without any bases in fact. Are there people that go to the doctor at the first sign of a sniffle? Sure. Does everyone go to the doctor at the first sign of a sniffle? No. Likely we all know someone that we may consider a hypochondriac but A) technically is not, and B) these so called hypochondriacs are far and few between. If you know 100 people and one or two would fit this loose description of being a hypochondriac, is this condition really that significant?

[Eric Larsen]

When I was in culinary school, there was a girl who was there on a state funded program. She decided to go to culinary school to continue to welfare payments that were about to run out for her and her illegitimate child. She made no effort to excel in the class and barely made it through the program. At the end of the program, she was happy to mention that she was pregnant with her second illegitimate child and will be able to collect welfare for 18 months to 2 years. She had no desire to work in the profession. She was just there to game the system and collect welfare checks.


And you, and I, and everyone who pays taxes are paying for her lifestyle now. Some people are going to milk the system. Poor people are going to milk the system. Average people are going to milk the system. Rich people are going to milk the system.

We can't change that. We can change the system.

[Neal Clayton]

Neal,

How have you covered it?

I fail to see how you have covered it. Someone quotes a figure from no particular source about how much an insurance executive made last year or over the past 5 years. Everyone immediately assumes that is enough to foot the bill for everybody's medical expenses. It won't begin to cover the medical expenses.

When you have a well thought out, financially responsible suggestion for a national healthcare system...call me...I'm in the phone book.....I'll back it in a flash.

http://abcnews.go.com/Business/health-insurance-profits-worth-outrage/story?id=9036632

if we're spending 2.5 trillion on health care, and insurance companies are showing profit margins of 5% on average, that's 500 billion a year. if there are 50 million uninsured, @ 100 dollars a month (what the average 30-something person pays for health insurance) to medicare, that's enough money right there?

and this isn't even considering hospital profits.

note that profits do not count salaries. doctors, administrators, etc. can make the same amount of money they make now, even more possibly. just talking about removing profit from the equation.

[paul cottingham]

I think you're getting the family rate mixed up with the per person rate. BC's MSP premiums are:

1 person: $54
2 person family: $96
3 or more persons family: $108

Although, those are all going up by a few dollars on January 1st, 2010.

You are quite right, I meant per family. Should have been clearer.

[Dale Hemm]

Rod has provided a lot of great detail about our system; more information than I've ever really thought about. Essentially, we're looked after from cradle-to-grave, with funding coming out of our taxes and some augmenting by medical plans through employment.

Wait times can sometimes be a pain, but overall the triage systems will always get priority cases to the front; and I've never heard of anyone not getting the essential care they required because of an inability to pay.

As for the doctor who claims to have left Canada because he felt some patients died as a result of not getting the tests they required in a timely manner, who knows; people die in hospitals every day. If I was cynical, I would suspect his decision probably had more to do with differences in compensation than it did with differences in heath care systems.

Be well.

[Jim Becker]

I would love to sell 13,000,000 of anything for 25 bucks a share. I would even settle for 5.

But I am easy !



FYI, if the "strike price" is $35 and the market is $25, that would mean you'd be buying the option shares at $35 and turning around and selling them at a $10 loss per share. They are "under water" and for all intensive purposes, worthless. Options are "options to buy at a particular price" not shares granted outright.
----

Interesting read, folks, but I too believe this one's gonna get closed real soon now.... ;)

Jim
SMC Moderator

[Ken Fitzgerald]

Jim,

Don't confuse anybody with financial details.

[dan grant]

i can give a for instance, first daughter was a premie, spent 89 days in intensive care, had vision problems on release (retna detatched), there was a chance of saving some vision but had to have a specialist do it who practised in houston tx.(funny thing is the specialist was from regina, which is a 150 miles from me, but went to the states for the money) the next day she was on her way, total price for this was well over 100K which the govt picked up, my total cost was the airfare for which my local union paid half, operation didnt help but there was no thought of that, this is my opinion only but i think some people attach the socialist name to health care where really it should be people helping people, not im ok ####you jack

[Jon Grider]

Interesting read alright, but as the OP, I agree that it may be time for this thread to end. I am a bit surprised at the sarcasm and ruffled feathers or should I say from where the sarcasm came from here. Too bad the opinions of the Canadians was not the main bent of this thread as I originally intended.
My bad for starting this thread, I really didn't want this to become a divisive issue amongst us USA Creekers, I really did just want to see how Canadians liked their health care, as I don't have any contact with Canadians other than this internet forum.I thought it relevant as we seem to be stepping in that direction, like it or not.

Well, hope everyone enjoys the rest of the weekend. I'm going to go to the shop and make some sawdust.

[Ken Fitzgerald]

Closed at the OPs request.