1950 hospital maternity bill

[Rich Engelhardt]

Hello,

I suspect that once people got use to the idea of being able to seek health care when they were getting ill or injured, we would see a reduction in overall costs

My wife works for the county, so needless to say our coverage is both great and reasonable - compared to what the private sector has to suffer with.

My problem however has nothing to do with the actual cost and/or availability of services.
I'm in somewhat the same boat (or wagon if you prefer) as Steve.
I'm also one of those "pulling more than my share" of the loaded wagon, while others ride.
I simply can't afford to take time off to seek out treatment for anything short of a major "chest grabbing and flopping around like a fish out of water" type of thing.

My SIL's unemployed boyfriend? Oh yeah, every little twinge and he's off running to the ER. Same w/her two nephews, her niece who's on the .gov dole, all their kids....the list is a long one.

[Mitchell Andrus]

IMO, any health care system has to have incentives against utilization. That is, it should cost the user something to use the system. If there's no incentives against utilization, the utilization just goes off the chart.

Mike

All-you-can-eat restaurants come to mind. If the patrons over eat, the restaurant goes belly-up.
.

[Rod Sheridan]

Rod, I don't want to get political, I'm just curious how the health care system is funded up there? I just read that some folks will be taxed at 55% in the States if the health care bill goes through here. How does that compare to Canada?

Hi Steve, the per capita cost of healthcare in Canada is aproximately 60% of that in the USA, for universal coverage.

(Healthcare is based upon residency in the province. If you live in the province for 3 months, you're covered. If you move from one province to another, you're covered by your previous province for the 3 months that you don't have coverage in your new province.)

This means that if you retire and move to Canada, you have health coverage, even though you're not a Canadian citizen.

Universal healthcare was fought against by many doctors, with claims that you wouldn't be able to pick your doctor, that it was communist etc.

The Canadian system doesn't involve the government (except for paying), you pick your doctor, vist them as required, no government "approval" required etc.

Almost all the services are privately delivered, my doctor is self employed, labs are private enterprises, as are hospitals, clinics etc.

Wait times are far shorter than the occasional sensationalised news story, my family experiences have been extremely positive.

Canada as you know, has a greater land mass, with maybe 10% of the population of the USA, which increases costs due to lower density.

I would expect that the USA could come up with a good system that would save you substantial money, and deliver a premium product.

Regards, Rod.

[Orion Henderson]

Our priorities are skewed when we treat newborns as a drain on medical resources.

Well said.

[Brian Kent]

The top federal tax rate is 35% for income over $372,950. The number being considered in some of the many proposals going around is a 1/2% to 1% surtax on income over $350,000. This is not the rate on the whole amount, but on the part of the income that is over $372,950 or $350,000. Not all of the many bills being put forward have this tax increase proposed.

[Brent Leonard]

Honestly, I don't want to get political, but I'm seriously considering doing something else for a living that requires paying way less taxes. I doubt I'm the only one, then who is going to pay? I hear the "rich". I'm not rich, not even close, but every now and then everything works, and the IRS gets a big check from me. What is the reward anymore? Why should I stick my neck out for a society that gives nothing back to me?

wow.........

[Jeff Wright]

IMO, any health care system has to have incentives against utilization. That is, it should cost the user something to use the system. If there's no incentives against utilization, the utilization just goes off the chart.

The cost to the user can be modest, just big enough to make them think before using the system, but small enough that they can use it when they judge it's necessary. For major issues, catastrophic coverage would kick in to avoid bankrupting the user.

Mike

I would add that there should be a cost penalty for electing NOT to live a healthy life. My wife and I spend at least an hour and a half each day exercising. I don't always like doing it, but it's what it takes (for us) to keep our weight in the recommended zone. Hopefully it will reduce our chances of getting diabetes and minimize heart issues. What I find upsetting is my paying (in my insurance premium) a component towards those unwilling to make the effort and dedicate some time each day to stay healthy. We are both in our 60s and believe living a healthy life is part of our financial planning. If we can minimize our personal healthcare costs, we can live a "wealthier" life AND a healthier life.

I still recall as a six-year-old going to the family physician for a shot when sick and my mother taking out a five or ten dollar bill to pay for the visit. No insurance hassles or complications . . . for us OR the doctor. Why can't we go back to people paying cash for their normal visits and buying only catastrophic coverage?

[Greg Peterson]

We are already paying for 'deadbeats' using the emergency room as their primary care provider. It is less expensive to provide a system of care accessible to all.

There are a couple of cultural biases at play. One, that we don't have or can not afford the time to see a doctor unless we are in severe distress. This is both foolish and costly.

A co-worker complained of having a rash for over a week. Finally at the urging of several of his peers he went to his doctor. Turns out he had a staph infection. Aggressive antibiotics were prescribed and the symptoms of the infection abated. It can take up to a year for the infection to completely go away and even now he still has soreness in his back. Shortly after being diagnosed with the staph infection his infant grandson (that is on kidney dialysis) and daughter moved in. Had he not be diagnosed and begun treatment one has to wonder would could have happened.

This co-worker 'did not have time' to go see a doctor.

I have plenty of my own stories of avoiding the doctor. One of which resulted in a serious illness that impacted me for a year. Had I gone to the doctor early on, I could have avoided the physical pain and damage my body suffered. I 'did not have time' to see the doctor though.

The second bias is 'I got mine, you get yours'. We all know people that do not contribute to the system (i.e. pay their fair share). My effective tax rate is right around 33%. I do not have the luxury of tax loopholes, writing something off as a business expense or investing money elsewhere for the sole purpose of tax avoidance.

I have a problem with a tax system that penalizes people that get up and go to work everyday and rewards those that make their fortunes moving money. Warren Buffet has famously said that his secretary pays a higher percentage of her income in taxes than he does.

Is it so wrong to ask the same level of health care our government workers are provided?

There are so many health care models in the world these days, surely we can take the best of the best and develop a template that fits our needs.

There is nothing wrong with a profit motive in health care. It is necessary. But what is wrong with private insurance is the grossly over compensated executives. Nearly 20% of premium payments go towards overhead. Medicare is roughly 3%. I'm not particularly interested in providing the corporate elite with private jets and gold plated china.

Rod - I have indeed heard horror stories ( as most of us have) about long lines and waiting lists for health care abroad. I've seen absolutely zero evidence of this being common or standard practice in any universal system. If I want to see my doctor it takes several weeks to months to get in. And when I do go the appointment, I plan on waiting one to two hours past my appointment time before he comes into the exam room.

Our health care is already severely rationed. And should someone be so unfortunate as to contract a major disease or chronic ailment, good luck finding a policy that will cover that should one ever be required to change insurance plans.

If someone is ill or in need of treatment, why should they have to be troubled with the emotional drain of fighting the insurance company over denied claims?

[Glenn Clabo]

Rod,
Thank you for posting this. I can't tell you how much propaganda flying around the internets hurts the efforts to get through real facts here in the states.

My parents are getting up there in age and as someone who is married to a Canadian who's parents are near their end of life I constantly see the differences in real terms. I've also had first hand experience with the US system as I lost my first wife to cancer while going more than $250,000.00 in debt. People who make claims of wanting to deal with their own problems really can't understand how horrible it is to see a loved one being treated based on cost as you go into debt trying to keep them alive. It simply doesn't happen in other civilized countries...like yours.

[Ken Fitzgerald]

GLenn,

Talk about rumors flying around the internet and wanting to get the facts out.

Got to FWW. There a Canadian first name Stu.

Check out a couple of threads he started recently. One concering his cousin in BC and getting medical attention. One thread concerning Stu's wife getting medical attention. Both in "universal or socialized medical systems" in two different countries.

Nobody can make a statement that covers every instance, every case.

Don't take my word for it......check out Stu's threads.

[Greg Peterson]

I am impressed with the fact that the mods have not had to issue any warnings.

Perhaps this issues reputation for divisivness is unwarranted?

[Ken Fitzgerald]

I am impressed with the fact that the mods have not had to issue any warnings.

Perhaps this issues reputation for divisivness is unwarranted?

We are too busy disagreeing and being at each other's throats to do anythng else!

[Jeff Wright]

The Canadian system doesn't involve the government (except for paying), you pick your doctor, vist them as required, no government "approval" required etc.

Rod, by saying the government is not involved other than paying for services do you mean that the government is the one who ADMINISTERS the program? If so, I think our great fear is the potential for our government to drop the ball in the administration end of things.

[Glenn Clabo]

Ken,
Remember Ken...My wife is a nurse who has worked in both the Canadian and US systems. She doesn't base her opinion on hearsay...she bases it on facts and factual evidence. One of her most requested presentations involves the comparisons of the US system vs. other countries...based on facts...not feelings. The facts are hard for people to swallow but everyone walks away from those presentations with a different view.

I read those posts from Stu...and all I can say is what you are reading is one case that comes second/third hand from a family member who doesn't understand what speed of treatment has to do with outcomes...only that they know a loved one is sick and everything must happen yesterday...which is very understandable...But in fact that’s not realistic nor does it result in better outcomes... it only costs more. The fact that someone can pay to get something done quicker has no relationship to successful outcomes. In fact...Canada has one of the highest successful outcome rates in the world and the US is much lower even though we in the U.S. spend much more on health care than Canada, both on a per-capita basis and as a percentage of GDP. In 2006, per-capita spending for health care in the U.S. was US$6,714; in Canada, US$3,678.

His wife’s situation and their health care "system" have no relationship. It's about her doctor and their relationship. Someone once said that there really is a "worst doctor in the world...and the scary part of that is...someone has an appointment with him/her." While counseling men who are dealing with spouse’s health issues I find that most of them tend to blame the system vs. taking on the responsibility to confront the doctor or his boss. Most wouldn't tolerate a mechanic treating their spouses badly...but just bitch about how a doctor is without doing anything.

Remember also...I lost my first wife to cancer. At the time I was very ignorant about most things medical. I was one of those spouses who thought nothing happened fast enough...or whatever was being done wasn't enough. I have to live with the fact that what was demanded by us may actually have ended her life earlier than if we had taken our time and listened.

Besides ALL that...I'm very close to the proposals being worked right now...nobody is proposing ""universal or socialized medical systems"...only the availability of insurance.

[Greg Peterson]

Ken - I see very little disagreement.

Jeff - I would not opposed to crediting those of us who are proactive in their health. I do not know by what standard you would measure and monitor such a program, but alas people do need to take personal responsibility for their health. Plenty of illnesses, injuries, conditions are the result of people not taking care of themselves and the rest of us in the insurance pool are required to pay for their irresponsibility.

Going to the gym isn't always the easiest thing to do, especially when you know what's in store (I loathe the long and boring cardio workout). There are two kinds of autonomy. The kind money buys and the other money can not buy. We each are able to ensure that we have ample autonomy when it comes to our health. Money, well that's a whole other matter.

While the Canadian government administers the payment of medical bills, I took Glenn's comment to mean that the doctors decide the best course of treatment. In other words the government does not have a list of disallowed procedures, unlike many if not most of our private plans.

The quality of care and results in Canada's system are high and the cost is low. And they do not have a pre-existing condition exemption.