So how about that crack Canadian "free health care" system you guys have going?

[CheffoJeffo]

About all (yeah, right!) I'll say about this debate is that it fails as most online debates do because people take anecdotal evidence as representative. For every horrendous ER experience, there are countless experiences that aren't terrible. I've been to the ER, either for myself, my wife, my brother or my kids a couple of dozen times and never had an experience like ChadTower describes, although I don't doubt his description.

My uncle had a pair of strokes recently and his care has been exemplarary and covered, including both short and long term rehab. My mother-in-law started suffering from what appeared to be heart-related trouble. Within a week she had an angiogram, followed by angioplasty the next day. But even these are only anecdotal in nature ... and if they had appeared in some article somewhere, then this discussion would have started very differently (DK wouldn't have even bothered).

One of the problems that we do have, which is also a key reason why we have to have "universal" (?) health care is that Canada is so damned big and some parts of the country are significantly less affluent than others. Without universal health care, there would be NO health care in large geographic regions. Providing services in many areas is VERY expensive (a friend of mine was an air ambulance pilot in Northern Manitoba), which drives costs up and puts a financial strain on other areas.

Comparing the health care systems in the US and Canada in the rather simplistic manner that the press and politicians do is rather counterproductive -- we have some very fundamental differences in terms of population size, distribution and density. We have different needs and different problems.

Cheers.

[paigeoliver]

Maybe it's me, but I'd rather have RELIEF from the pain of needing a hip replacement NOW, and have to pay my insurance, or out of pocket.....

Thats great for you now, because you can afford it. What if you couldn't? What if you didn't have the money to pay for insurance, or out of pocket. Ask Paige, who just wrecked his moped. He could have been screwed over hardcore.

Its funny how those with money don't give an f about those without.

When I wrecked my scooter I REALLY needed to go to the hospital, BADLY.  I had lost several square feet of skin, deeply in some places, and had what appeared to be a broken hand.

I had to make the decision, I could call the ambulance and trade my life's savings (and likely most of my possessions), for one emergency room visit, or I could take my chances and not get treated.

I had to take my chances. My last time I saw a doctor outside of the emergency room was in 1987 (aside from my army physical. Last hospital visit was in 1990.

The situation is really bad for the working lower class in America, not only do we not get insurance, we also don't get sick days either. I was at work all week this week, despite the fact that it is really painful to stand up for more than 30 seconds, and that I am having some trouble walking. I have been to work with every illness you could imagine in the last 7 years or so.

Some lower class employers are even worse, as they not only don't provide health insurance, they also require a note from a doctor for any medical absense.

I am actually pretty good with my money, I COULD get health insurance, I could afford it, the only problem is that would take EVERYTHING. I would go from having a nice healthy surplus of income vs expenses to living right on the edge. Even then I STILL wouldn't be able to afford to actually go to the doctor, as a deductible, co-pay, or anything like that would be beyond my reach if I was paying for insurance.

The medical establishment charges people without insurance 3 times as much as it charges the insurance companies.

Insurance costs double if you have to get it on your own.

So if your employer doesn't offer it then you are basically stuck. Most lower class employers have already dropped it, and jumping from lower class to middle class is EXTREMELY difficult to do.

[Zakk]

It bothers me to hear of my fellow BYOAC'ers struggling financially.

[HaRuMaN]

Is that anything like the crack Canadian Navy?

 

[ChadTower]

Paige, how much is basic ER style coverage for an individual your age?  I know I could insure just myself for a couple hundred a month, independently with decent low end coverage.  It's when you have to add dependents that it really adds up (I pay something like $1250/month for health insurance for my family).

[Edgedamage]

The most problems with ER's in toronto is they are flooded with people showing up with simple things like splinters in their fingers or bumps and bruises. And weekend nights the ER's are filled with idiot drunks who hurt themselves doing stupid things. Last year my wife had gal stones which were blocked. In the ER sunday night and was out of hospital by the next wed night after surgery. And that ER was the one of Toronto's top five over crowded ER's.

[Zakk]

Is that anything like the crack Canadian Navy?

 

You can TELL that's a fake picture...  We don't have guns like that. 

[shmokes]

Paige, how much is basic ER style coverage for an individual your age?  I know I could insure just myself for a couple hundred a month, independently with decent low end coverage.  It's when you have to add dependents that it really adds up (I pay something like $1250/month for health insurance for my family).

For somebody working full-time at $8/hr, which is hardly a living wage by itself, a couple hundred bucks a month is going to be nearly a quarter of your net income.  That's no answer.  And that's almost $3/hr more than minimum wage.

[ChadTower]

It is, yes, but most single adults have no business making minimum wage.  Even the least educated, reliable single adult should be able to hold a pick and pull warehouse job for twice minimum wage to start.

[KenToad]

Are you playing Devil's Advocate or what, Chad?  "Pick and Pull" warehouse jobs are not exactly a happy career choice.  A little higher rate, but no retirement or benefits ... usually not even a legitimate living wage.  They're highly dependent upon a well-functioning set of limbs.  There's a reason that jobs like that pay more.  They have a high turnover rate.  Speaking of minimum wage.  Other countries laugh at our minimum.  Minimum wage in the U.S. doesn't even come close to keeping up with the rate of inflation.

Good jobs are possible, just not available for most college graduates.  I don't think anyone doubts that.  Many industrial jobs have left or are leaving the country, for example.  Even the tech guys are going to get outsourced sooner or later.  Right now, self-insurance rates are through the roof, with huge deductibles that make them impractical. 

Without research, we're lost in the woods.  Who's ready to point us to some interesting articles?  Drew? 

Bueller? 

Bueller?

Cheers,
KenToad

[jbox]

Without research, we're lost in the woods.  Who's ready to point us to some interesting articles?

Because *facts* have ever actually won anyone an argument? The article on wiki isn't as funny as the amount people are complaining about it. Seems pretty parallel, right down to cherry-picking the most specific metric one can conjure up. Mmmm, p. avium's....

[ChadTower]

Are you playing Devil's Advocate or what, Chad?  "Pick and Pull" warehouse jobs are not exactly a happy career choice. 

So you're saying people should have lower paying jobs that can't support them because the job is an unhappy choice?  What kind of work ethic is that?  If they hate that job so much, they should get the job, go to night school, and acquire the skills needed to get a happier job.  Why should others have to help support someone when the only reason they can't support themselves is that they don't like the available jobs that pay enough?

Life isn't always about what is the most enjoyable.  Work is about supporting oneself (and dependents, if applicable) first, and enjoying the work second.

[paigeoliver]

Are you playing Devil's Advocate or what, Chad?  "Pick and Pull" warehouse jobs are not exactly a happy career choice. 

So you're saying people should have lower paying jobs that can't support them because the job is an unhappy choice?  What kind of work ethic is that?  If they hate that job so much, they should get the job, go to night school, and acquire the skills needed to get a happier job.  Why should others have to help support someone when the only reason they can't support themselves is that they don't like the available jobs that pay enough?

Life isn't always about what is the most enjoyable.  Work is about supporting oneself (and dependents, if applicable) first, and enjoying the work second.

You can acquire all the skills you want, that doesn't create a NEED for the skilled worker. We already have a surplus of those.

I make $11.xx an hour ($11.35, but I am due for one of those generous 50 cent annual raises). I bring home about $1500 a month. $200 or $300 a month out of that for health insurance is nuts.

[ChadTower]

You may consider it nuts, and that's your decision.  I, on the other hand, don't consider it nuts, I consider it essential.  That's $2500/year insurance against the thousands of things that could happen to you and cost you 6 figures in medical costs.  It's the same as car insurance or renter/homeowner insurance.

Maybe you'll come out behind, but the first time you have a real accident, the $25,000 in medical costs will be more than made up for by the $10,000 you paid over the last four years.

It works out even better if you actually USE your insurance for regular checkups, eye exams... you know, the things any person should do regularly but you probably skip because you don't want to pay out of pocket for them.  Say that would have been $750 for those checkups, well there is 3-4 months of your premium used right there.  I know I don't want to find out the hard way that I have terminal colon cancer that any checkup within the last 8 years would have found in time.

[Jabba]

Where the Heck is Drew in all of this. Checked his profile, I think he's gone to Canada for some of that "free" heath care we're talking about...

[ChadTower]

Maybe he got a life for a few days.  Let's applaud it.

[CheffoJeffo]

You may consider it nuts, and that's your decision.  I, on the other hand, don't consider it nuts, I consider it essential. .

Just 'cause I'm tired am feel like trolling ...

So, it's OK for lower-income folks to pay 15-20% of their income for health care in the US, but horrible for higher-income folks to pay 10% in Canada ?

Cheers.

EDIT: Hope I get this in in time ... this REALLY is just a troll ... quality of care for those prices is also a big issue ...

[ChadTower]

So, it's OK for lower-income folks to pay 15-20% of their income for health care in the US, but horrible for higher-income folks to pay 10% in Canada ?

The primary difference:  Those people are paying for themselves, supporting themselves, rather than forcing everyone else to do it for them. 

When did it become reasonable to ask everyone around you to pay to support you, whether they even know you or not?

[CheffoJeffo]

When did it become reasonable to ask everyone around you to pay to support you, whether they even know you or not?

Are you trolling me back ??

 

Cheers.

[Dartful Dodger]

The most problems with ER's in toronto is they are flooded with people showing up with simple things like splinters in their fingers or bumps and bruises.

It's like that here in the states too.  The hospitals do not throw people who have no money out on the streets, they take care of them, and they send them a bill, even though they wont get paided.  The people that have no money know what to say and they know how to fake a serious ailment to get the hospital to put some peroxide and a band aide on their boo boo.  If the hospital didn't, these people also know what to tell a lawyer, and a lawyer, doesn't care how much money they have, as long as they said and did the right things in the hospital.

While the people who have money and are concerned about their credit ratings end up dieing because they decided to wait a day to see if the swelling and/or pain would go away.

I try not to get sick or hurt anywhere, ever.

[KenToad]

So, it's OK for lower-income folks to pay 15-20% of their income for health care in the US, but horrible for higher-income folks to pay 10% in Canada ?

The primary difference:  Those people are paying for themselves, supporting themselves, rather than forcing everyone else to do it for them. 

When did it become reasonable to ask everyone around you to pay to support you, whether they even know you or not?

Some things in life are better shared.  Education costs, for example.  Every kid and every kid's neighbor has a right to a decent education.  We can't vote with dollars.  The rich naturally would get more votes. 

Just think, Chad, you have to hire your own vigilante police force, contract your own fire brigade.  Nothing is free, remember?  Imagine that every single organization you have to personally pay for just wants to make a buck.  Be thankful our government isn't selling its services to the people through several thousand middle men that also just want to make a buck.  Private industry has its place.  It has no place driving markets that we all need to live a happy and fruitful existence.

If you lived in California during the water crisis last decade, then you might have a different opinion about making public services private.

Cheers,
KenToad

[ChadTower]

Right, so we want public health care that is so underfunded that no one gets care?  The police put their lives on the line every day and get paid very little, fighting a hopeless battle to put your teenager in a cell because he has a $10 bag of weed.  Firemen get paid less than you can make at Walmart.  Public education is such a joke that half the people I went to high school with barely qualify as literate even ten years later.

The publicly funded system just doesn't work very well.  Why throw another necessary service under the bus?

[KenToad]

Our publicly funded system doesn't work very well, because, yes, just like you point out, most of the programs don't get the support they deserve.  The problems you're pointing to are caused by the movement to privatize, not the lack of privatization.  Again, the wealthiest nations in the world will bear me out.  Literacy is low in the U.S. because of unjust funding based primarily on property values in the district. 

We have the same concerns.

Cheers,
KenToad

[ChadTower]

Actually, much of the problem is waste.  At least in the educational system, you'll have most of the budget tied up in special education.  Where it costs $4k-5k to educate a single child for a year, it will cost $75k to educate a special needs child that will never get beyond a third grade intelligence.

Sure, that kid deserves an education too, but should we spend as much on that one kid as on fifteen nonhandicapped kids?  It's a hard question.  And that's only one area that needs questioning.

[Grasshopper]

Actually, much of the problem is waste.  At least in the educational system, you'll have most of the budget tied up in special education.  Where it costs $4k-5k to educate a single child for a year, it will cost $75k to educate a special needs child that will never get beyond a third grade intelligence.

Sure, that kid deserves an education too, but should we spend as much on that one kid as on fifteen nonhandicapped kids?  It's a hard question.  And that's only one area that needs questioning.

Chad, I wonder if you'd feel the same way if you had a child that was born handicapped.

[ChadTower]

That's the issue... I don't know I would want the town paying $75,000 a year to educate my child, money that is way out of scale with the average child.  I would possibly opt to do it myself, or perhaps privately, but I don't know I would think it all that fair to make the town bear that type of cost for one child.  Like I said, it's a hard question.

[ClubNinja]

That's the issue... I don't know I would want the town paying $75,000 a year to educate my child, money that is way out of scale with the average child.

[DrewKaree]

So evidently no one has an ideal solution yet, but "someone else" seems to do it better.....or so we've been told.  Interesting also, the preconceived notions percieved in others but not ourselves.

Back with more soon.

[menace]

After living both in the US and Canada it comes down to this--if you have a job with benefits, the US system is better with respect to prompt service and individual attention--I never had the need for major surgery so i can't comment on that.  If you don't have a job or can't afford care, canada is better--you will get your basic needs looked after free of charge and any major operations will also be performed without banrupting you (although the wait for some operations may be lengthy)

I have known people requiring major surgery and emergency services in canada and they received it--in fact 4 of my friends were involved in a serious car accident and all received treatment immediately

[ChadTower]

you will get your basic needs looked after free of charge and any major operations will also be performed without banrupting you (although the wait for some operations may be lengthy)

It's not free of charge!  That's the concept people need to understand.  It isn't free, and it's not less expensive.  It is PREPAID BY GOVERNMENT WITHHOLDING.

[CheffoJeffo]

you will get your basic needs looked after free of charge and any major operations will also be performed without banrupting you (although the wait for some operations may be lengthy)

It's not free of charge!  That's the concept people need to understand.  It isn't free, and it's not less expensive.  It is PREPAID BY GOVERNMENT WITHHOLDING.

While certainly not free, it *is* less expensive (US has higest health care costs in the world) and the user is not out of pocket for co-pays or deductibles, which I think is what menace was getting at.

Cheers.

[ChadTower]

Not on average, I would bet... I pay what is considered a LOT out of pocket for health insurance, probably $15,000 a year.  Most people who have insurance pay far, far, far less than that, in the $4000 range.  One incident, one broken limb or small car accident, and you've broken even.

At some point the balance is going to have to be found between inexpensive care and quality care, and that balance point will never be low enough for every single person to be fully covered.

[CheffoJeffo]

Not on average, I would bet... I pay what is considered a LOT out of pocket for health insurance, probably $15,000 a year.  Most people who have insurance pay far, far, far less than that, in the $4000 range.  One incident, one broken limb or small car accident, and you've broken even.

I'll take that bet ... I finally decided to dig up the WHO statistical annexes (I was an actuary in a previous life) so that I could provide the numbers, which hopefully will illustrate the point that schmokes was trying to make earlier in the thread.

For the year 2002, here are the per capita breakdowns of health care spending:

Australia
Government Spending US$1354
Total Spending US$1995

Canada
Government Spending US$1552
Total Spending US$2222

USA
Government Spending US$2368
Total Spending US$5274

Disclaimer: There are a number of ways that these figures could be presented and these were designed (EDIT: by the WHO, NOT me) for comparability between nations and use an average conversion rate. I have also not performed an exhaustive analysis of the underlying techniques -- anybody who wants to should go to the WHO website and download the World Reports and annexes.

Kinda turns the whole "subsidizing others through higer taxes" argument on its ear, doesn't it ??

None of this is as simple as people think ... some very smart folks, with specific training in medicine, finance and risk theory have been trying to solve these problems for a very long time ...

Cheers.

[ChadTower]

Kinda turns the whole "subsidizing others through higer taxes" argument on its ear, doesn't it ??

It doesn't, actually, unless you correllate that data against something indicating quality of care.  It's been consensus here that the US has better advanced care, less waiting time, and more availability of care (whether it gets paid or not) than Canada.  A flat dollar comparison that does not take that into account is incomplete.

[CheffoJeffo]

Kinda turns the whole "subsidizing others through higer taxes" argument on its ear, doesn't it ??

It doesn't, actually, unless you correllate that data against something indicating quality of care.  It's been consensus here that the US has better advanced care, less waiting time, and more availability of care (whether it gets paid or not) than Canada.  A flat dollar comparison that does not take that into account is incomplete.

Sorry, should have been clearer -- the argument is often made that the Canadian system is not free and, indeed, costs more than the US system because we pay higher taxes to fund it. That argument is fallacious because US government spending (and hence taxation for health care funding) is higher.

I make no argument about the quality of care in the US (have lived in both countries and my parents and brother both live in the US), nor try to pick one system as superior (as I have said, we are very different countries with very different needs), only that people are busy debating issues that aren't real.

Cheers.

[shmokes]

It doesn't, actually, unless you correllate that data against something indicating quality of care.  It's been consensus here that the US has better advanced care, less waiting time, and more availability of care (whether it gets paid or not) than Canada.  A flat dollar comparison that does not take that into account is incomplete.

I don't know whatchoo talking about, "consensus," but I think you better look that word up in the dictionary.  Sure ain't no consensus here.  And here are some correllating data indicating quality of care.  These aren't cherry picked numbers.  There are even a few here that the U.S. wins on, but the trend leans heavily in favor of Canada:



Babies born with low Birthweight:  U.S.=7.8%   Canada=5.6%

Doctors per 1000 people:  U.S.=2.8   Canada=2.1  (U.S. actually wins this one)

Child mortality per 1,000:   U.S.=16   Canada=11

Life Expectancy (in years):   U.S.=77.14   Canada=79.83

Life Expectancy (Healthy Years):  U.S.=67.6   Canada=69.9

Probability of not living to 60:    U.S.=12.8%   Canada=9.5%

Annual Plastic Surgery Proceedures     :    U.S.= 90,992     Canada= 11,102

All the following numbers indicate deaths, by cause, per 200,000 people, year 2000 (most recent data)

Infectious and parasitic diseases:   U.S.=42   Canada=20.2

HIV:  U.S.=10.4   Canada=3.3

Malignant neoplasms (cancer):   U.S.=393.4   Canada=407.4

Diabetes:  U.S.=49.2   Canada=43.6

Malnutrition:  U.S.=2.7  Canada=1.1

Diseases of the Circulatory System:  U.S.=668.5   Canada=496.5

Pneumonia:  U.S.=45.1   Canada=28.5

Influenza:   U.S.=1.3   Canada=3.7

Bronchitis:  U.S.=86.1   Canada=62.9

Appendicitis:  U.S.=0.3  Canada=0.2  (Exlusive E.R. territory)

Chronic Liver Disease:  U.S.=21.2   Canada=15.1

Motor Vehicle Traffic Accidents:  U.S.=30.1   Canada=16.2

Accidents caused by firearm missile:  U.S.=0.6   Canada=0.1

Homicide and injury purposely inflicted by other persons:   U.S.=11.9   Canada=3 

All Causes:  U.S. =1708    Canada=1469.9


And we pay over twice what our Canadian neighbors pay for health care.  At the very least it seams that we could outlay $2222 per capita to exactly duplicate their system and then use the $3000 per capita above and beyond that, which we are already paying, to make our system better than theirs.

[ChadTower]

Okay, now factor in the amount of people the US who are horridly obese by their own choice.  Factor in the amount of people who immigrate to the US and need immediate medical care.  Factor in the amount of people flown to the US from all over the world specifically to get US care.  Canada has none of those issues (the obesity is far, far less rampant there, anyway).

The US has more per capita medical problems because people come to the US to have medical problems treated.  It also seems that as time goes on, the averages in terms of lifestyle related disease such as heart disease, liver disease, etc become more and more common here.  A LOT of the cost of medical care in the US is because too many people here just don't take care of themselves. 

It's a chicken and egg thing, here.  People complain about the cost of medical care, insurance, etc... and then let themselves become 280lb with a cardiovascular system that is one flight of stairs away from failure, running up thousands of dollars in treatment and driving up insurance rates.

I contend that the cost of insurance in the US is really a combination of waste in the system combined with a growing health problem as a whole.  That same rising tide mentioned in economic threads applies to medical costs as well.

[CheffoJeffo]

Okay, now factor in the amount of people the US who are horridly obese by their own choice.  Factor in the amount of people who immigrate to the US and need immediate medical care.  Factor in the amount of people flown to the US from all over the world specifically to get US care.  Canada has none of those issues (the obesity is far, far less rampant there, anyway).

Huh ?

Not sure where you come up with your information about Canadian immigration (after all, hasn't the US been complaining about Canada's immigration levels and the resultant imminent threat to the USA???) and people flying in to Canada for medical care (happens fairly regularly) ... so, where did you come up with those ?

And we have plenty of obese people here ... the morning double-double and maple glaze seems to be the main culprit ..

Cheers.

[ChadTower]

Huh ?

Not sure where you come up with your information about Canadian immigration (after all, hasn't the US been complaining about Canada's immigration levels and the resultant imminent threat to the USA???) and people flying in to Canada for medical care (happens fairly regularly) ... so, where did you come up with those ?

And we have plenty of obese people here ... the morning double-double and maple glaze seems to be the main culprit ..

Cheers.

No, Canada's immigration laws are MUCH tougher than the US'  laws.  I've been through them.  They actually require you to at least pretend you have some way to support yourself and contribute to society.  The US lets anyone in for any reason.  And I think you've misread what I said about people flying into Canada specifically for specialized care:  I said they don't do it, but they do go to the US for that reason, skewing those stats.

[shmokes]

Obesity in the U.S. is significantly higher than Canada (30% vs. 15% about), but all the numbers show a trend toward equal/better healthcare in Canada.  How does obesity factor into infant or child mortality?  HIV?  Malnutrition?  Apendicitus?  I'll accept it for cardiovascular, and maybe even respiratory diseases (though that's questionable), but it doesn't away the numbers as a whole.  What it especially doesn't do is point to anything besides your gut instinct that suggests that the U.S. has a better system.  You're really good at saying, "Nope, I don't buy your evidence.  The U.S. must have a better system."  Why don't you give us a chance to refute your evidence? 

The US has more per capita medical problems because people come to the US to have medical problems treated.

That sounds beyond flimsy.  I suspect that the percentage of people treated for any of the given causes of death above are so miniscule that they register somewhere in the neighborhood of 0%.  C'mon, give us some numbers.  That sounds beyond flimsy.  Back this stuff up.  If you want me to be your fact checker you're gonna have to pay me.  If you're not going to pay me, do your own fact checking.  Until then, a claim like that just sounds absurd.