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

[ChadTower]

Canadians pay less in taxes to support health care than Americans pay in taxes to support health care. [I think we should be spending more and have access to private supplemental insurance, but these are the facts of the tax matter.]

That is because Canada's hospitals will turn nonCitizens away if they cannot pay.  I've seen it happen.  They do not pay for health care for millions upon millions of illegal aliens on a daily basis the way the US does.  If they did that, Canadians would be paying more than the US does.

There is no way in hell any politician here would ever speak out against treating illegal aliens, so that problem will never go away.  Thus, we do provide socialized health care, but we provide it to millions of people who don't pay ANY taxes.

[CheffoJeffo]

I've heard that both ways.  I'd like to see the facts on that.

See my post earlier in the thread ... per capita GOVT spending on health care is higher in the US than in Canada. Stats available readily from the WHO.

What do Canadians pay in taxes?  I talk to them and they say that they pay more?

Oh, we do ... and people here like to THINK that it is for health care so that we can feel good about it and can taunt those heartless 'mericuns. Truth be told, I'm not sure where the heck it all goes (although we tend to do stupid things like blow over a billion dollar on a gun registry program that doesn't even work).

I know they pay an income tax that's less than the US / State taxes, but dont they also pay a 17% sales tax on top of that?

Sales tax depends on jurisdiction and ranges from 7% to 16% (although maybe there is a 17% jurisdiction)... but that's a whole other story.

Cheers.

[fredster]

What do Canadians pay in taxes?  Not just one tax, I'm talking about the final amount they pay. 

We have federal, state, local income taxes here.  We also have property taxes, sales taxes, car taxes, etc.

What do Canadians actually pay?

[ChadTower]

Having lived in both places, I'd say Canadians pay 10-15% more in taxes than we do here in the states. 

That figure is a percentage of gross income, not of taxes.  So, say that you make $10,000.  In the US you'll probably pay, in various taxes, what, 40% of that, meaning $4,000.  In Canada you'd get taxed something like $5,500.

I know the "sales tax" in NS is actually two separate taxes.  There is the regular sales tax of 10% and a goods and services tax of 7%, or at least that's how it was when I left.

[CheffoJeffo]

We have pretty much the same types of taxes.

Income taxes vary wildly at the lower end of the income range, depending on tax credit situation (e.g. my wife was earning 40K a year and ended up paying very little tax because she claimed 21K in child care costs as well as 8K basic personal credit).

At the higher end (say 80K and up), you are looking at basically 45-50% combined federal and provincial income tax.

[EDIT: Should have mentionned that the 45-50% is actually a marginal rate that applies to the income over a threshold]

http://www.taxtips.ca/tax_rates.htm#FederalTaxRates

Property taxes can vary wildly by location and year. Here in Toronto, taxes are based on a "Market" Value assessment that can jump rapidly (mine has increased 50% in the five years I've owned this house).

Cheers.

[ChadTower]

See, that's pretty much most people, though.  CAN$80,000 is considered high end?  That's like $45,000, which really is barely average here in MA.  A person making $45,000 in eastern MA cannot own a house unless they are single with zero debts.  A person making $45k with kids, they can barely afford rent, nevermind a home.

[CheffoJeffo]

See, that's pretty much most people, though.  CAN$80,000 is considered high end?  That's like $45,000, which really is barely average here in MA.  A person making $45,000 in eastern MA cannot own a house unless they are single with zero debts.  A person making $45k with kids, they can barely afford rent, nevermind a home.

It certainly is most homeowners in metropolitan centres.

I picked 80K because it seemed representative of where the marginal rates started crossing over to the higher ranges.

C$80K is actually about US$65K, but is still not a killer income (if I earned that, there would be no way that we could live now that my wife isn't working). There are parts of the country, however, where that is actually a good living.

I should note (not in defense of our tax system, mind you) that the tax brackets are designed to determine when you should make a "full" contribution to the system and reflect the fact that having additional, higher brackets for high earnings doesn't typically improve the tax revenue situation for the government.

Cheers.

[Zakk]

Chad, these are Canadian dollars, not pesos.

[ChadTower]

Wow, a lot of reading crap into my crap that wasn't crapped. 

I'd love to live in the Maritimes again, but there aren't any jobs.  People don't make money there because there is no money to be made.  You're a lobsterman or you work in a store or restaurant.  That's it.  And you can't just go out and become a lobsterman without paying half a million dollars for a lobster license, something that never gets sold.  Lobster licenses get handed down from father to son.

Sure, someone where I lived could live like a king on $70k, but there isn't $70k to be made.

[CheffoJeffo]

I'd love to live in the Maritimes again, but there aren't any jobs.  People don't make money there because there is no money to be made.  You're a lobsterman or you work in a store or restaurant.  That's it.  And you can't just go out and become a lobsterman without paying half a million dollars for a lobster license, something that never gets sold.  Lobster licenses get handed down from father to son.

Sure, someone where I lived could live like a king on $70k, but there isn't $70k to be made.

Don't be so sure ... they put a lot of $$$ into infrastructure (it still ticks me off that there are folks out there who get double the DSL speed I do here in Toronto) and wooed some big call centres ... dunno exactly what the job situation is, but my understanding is that it has changed.

[fredster]

That's what I'm saying.  There is no apples to apples comparison of taxes or health care from the US to Canada.

I don't know what to make of it.

I am not opposed to having such a national healthcare system if I knew I could expect good service.

It's a huge problem in the US for hardworking, taxpaying, responsible people.  One screw up like cancer or an "emergency" triple by pass and you have lost everything you ever had.

People here are working way beyond what they should simply to have the health care.  They need perscriptions, they need the security, and there is no way people of average income can "just get their own"

Cobra extension of healthcare at my employer is $729 a month for the 80/20 plan.  Wow. If you needed it to cover say a new baby or some major issue that's comming up right after you leave it's a bargain.  But that's a house payment for most people.

I know of at least two people who have health problems and have fake ID's.  They just go to emergency rooms and get it and leave.  That' not right. I don't blame them for finding a way to survive.  Illegals get better treatment here than the citizens is my big pain.  It puts us all at risk when health care centers go under because of the strain.

My fear is that we would put this plan in place and then find that we stopped people from being doctors 10 years down the road by fixing their income. 

I get this from just some people I talk to, but Canada is so screwed up they don't know what language to speak.  As I understand it's harder to find an english speaking doctor because all of them move here to make a decent living.  The French speaking doctors stay.  English speaking people have a tough time up there.

I don't know if that's the way it is because I don't live there.  But I have heard from "non" political people that Chad is right.  They are having trouble getting ontime/ondemand care when they need it.  That's scary for a lot of us.  I don't want the government to tell me I don't need this or that, or even when I can get it.  That's a sticky point.

[ChadTower]

Don't be so sure ... they put a lot of $$$ into infrastructure (it still ticks me off that there are folks out there who get double the DSL speed I do here in Toronto) and wooed some big call centres ... dunno exactly what the job situation is, but my understanding is that it has changed.

I used to write applications for call centers.  That is one of the worst jobs ever.  They get paid minimum wage, are given quotas that are literally impossible to fill and their pay is often partially contingent on meeting those quotas.  They get yelled at all day by people who didn't want to be called.  Turnover at call centers is like 400% a year and the average length of employment is less than 3 months.

[CheffoJeffo]

Don't be so sure ... they put a lot of $$$ into infrastructure (it still ticks me off that there are folks out there who get double the DSL speed I do here in Toronto) and wooed some big call centres ... dunno exactly what the job situation is, but my understanding is that it has changed.

I used to write applications for call centers.  That is one of the worst jobs ever.  They get paid minimum wage, are given quotas that are literally impossible to fill and their pay is often partially contingent on meeting those quotas.  They get yelled at all day by people who didn't want to be called.  Turnover at call centers is like 400% a year and the average length of employment is less than 3 months.

Sorry ... wasn't suggesting that the frontline folks would be making bigger salaries, but having run a call centre in a previous life, I know that *I* made a reasonable salary.

Cheers.

[fredster]

what's a "call center" ?

[ChadTower]

Telemarketers, phone support, customer service, etc.  A place where you have a large amount of employees making and/or receiving phone calls.

[DrewKaree]

Drew, how is it that you can write something eloquent and on-target, then come up with this ??

It's a gift, really.  I'm like a savant or something.

Where'd I put my helmet?

[daywane]

heck yes! I will pay more in tax dollars for health care.
lets see here.
insurance cost $75.00 a week
just paid $100.00 for 2 bottles of pills ( copay) also need to refill 3x
dentist cost $200.00 a visit for 4 visits per person ( 4 people in my house)
doctor copay of $25.00
I think my tax difference would be less

long waits in ER? try the VA here in KY! I bring a book,GBA, and a small DVD player. Not once has my father in law got out of there in less than 8 hrs
we go 2 times a week. blood work,and trying to get this leg cut off. VA canceled operation 2x because of potassium level to high
(hay! a new record for me only 2 misspellings) ( could not do that again if I tried) 

[ChadTower]

It's funny how people will regularly drop hundreds to keep their car running, or to fix something on their home, or to maintain some possession... yet won't even consider spending the same to maintain their health.  I don't understand that. 

[DrewKaree]

heck yes! I will pay more in tax dollars for health care.
lets see here.
insurance cost $75.00 a week
just paid $100.00 for 2 bottles of pills ( copay) also need to refill 3x
dentist cost $200.00 a visit for 4 visits per person ( 4 people in my house)
doctor copay of $25.00
I think my tax difference would be less

long waits in ER? try the VA here in KY! I bring a book,GBA, and a small DVD player. Not once has my father in law got out of there in less than 8 hrs
we go 2 times a week. blood work,and trying to get this leg cut off. VA canceled operation 2x because of potassium level to high
(hay! a new record for me only 2 misspellings) ( could not do that again if I tried) 

It's almost as if you didn't read this thread!  Dental care hasn't even been discussed other than some folks telling us that's not a Canadian item, IIRC.  You'd drop the payment of $75/week for your insurance to pay higher taxes for government health care which I'm guessing would add up to somewhere in the $75/week range.  You'd pay that to get health care similar to, if not IDENTICAL to the care your father-in-law already recieves, which sounds EXACTLY like the Canadian system that's being discussed.  To top it all off, when describing what GOVERNMENT-RUN health care is like, you don't speak of it in glowing terms, it sounds as if you're describing some awful chore you would gladly pawn off on someone else or push off until another day.

Dawayne, I wonder if it's dawned on you that the people currently in charge of the sucky service you already are aware of are the SAME people who would be in charge of ensuring that the higher tax dollars you're willing to jump at go to pay for the SAME type of sucky service.

And again, my point is made by someone else without them even realizing they're describing the problems I'm talking about.  Someone who's aware of how a crack government health care system IS NOT the answer, but doesn't realize many are asking for more of the same.

[daywane]

It's funny how people will regularly drop hundreds to keep their car running, or to fix something on their home, or to maintain some possession... yet won't even consider spending the same to maintain their health.

[ChadTower]

So you're paying $75/week and it doesn't cover prescriptions?  I bet you can find better insurance than that.

[CheffoJeffo]

Not to beat a dead horse, but the following article was referred to me concerning the cost differentials between the US and Canadian health care systems. It is a little dated (1989), but raises some interesting points.

In 1985, insurance and prepayment administrative overhead (managing the flow of paperwork and money) cost Americans $95 each and Canadians $21 each (in Canadian dollars). In fact, Canadians spent less per capita to administer their universal comprehensive coverage than Americans spent just to administer Medicare and Medicaid (approximately $26 per capita).

http://www.findarticles.com/p/articles/mi_m3225/is_n5_v39/ai_7621819

Thought some of you might find it interesting.

Cheers.

[ChadTower]

Yep.  It makes sense that inferior care costs less per capita.

[shmokes]

Chad, you sound ridiculous.  You just make claim after claim with absolutely no corroborating evidence.  Do you honestly believe that the entire Canadian healthcare system is inferior to Medicaid and Medicare?  I mean, it's one thing to claim that Canada's system is worse than the U.S. healthcare system as a whole.  You'd still be wrong, but it's at least one thing...   But to just stick to your guns like a damn broken record even when it's narrowed down to speak only of Medicare and Medicaid, and then say, "uh....I'm not here to convince anyone," when asked where you get your information is just lame.

[CheffoJeffo]

CT -- c'mon you can do better than that ...

The interesting part is the difference in ADMINISTRATIVE costs -- if costs less per capita to ADMINISTER the entire Canadian health care system than it costs to ADMINISTER Medicare and Medicaid -- that's without considering quality of care (even then, if you make the argument that Medicaid and Medicare are better than the whole Canadian system, then I want to know what they're prescribing you so I can get some).

Personally I find it amazing that anybody is less efficient that the Canadian government (and the provincial governments) ... I always thought we were number 1 in that department!

Cheers.

[fredster]

Medicare and Medicade get ripped off pretty good in the US.  Fraud is rampant, but they try and keep it to a minimum.

Medicare is for the disabled and retired.  Medicade is for the very poor and the very old in nursing homes.

Medicare doesn't pay for a lot of stuff.  Medicade stiffs doctors pretty good.

My question on this has always been what would happen to the medical community in the US if the government became the main healthcare insurance provider?  Just how much would they pay and what would be restricted?

Here in TN they have tried a universal healthcare program called TennCare.  It's really enhanced medicade.  Hospitals here decided they wouldn't take TennCare patients.  They had the administration of the program priviatized, and one of the two companies that administered it screwed it up totally.  The program is failing because people from every bordering state were cashing in on it.

They get people here all the time on TennCare fraud of perscriptions.  Lortabs and oxyconten.  They get on Tenncare then sell pain killers.

Not good, but par for the course in Government administration of a program.  Local hospitals were getting really stiffed.  Big writeups and editorials on how local small hospitals were in the red due to the non-payment or refusal of payment from the program.

HMOs can be sued.  I don't know if the government can.  They do have ways to appeal decisions, but when the chips are down, you have to wait months to do that.  Would that really help?

Plus, how would it politicise the program? Would a universal healthcare program paid for by tax dollars have to exclude catholic and baptist hospitals?  Would people begin to object and pull any reproductive work?  Do we have to pay for sex changes?

Lots of questions we haven't explored yet.  Would the program ballon and cost like 3X what it was supposed to?  What government program doesn't grow so large we can't handle it?  Iraq, the Big Dig, Highway funding, urban housing, etc.  What would be different here?

[ChadTower]

Yes, I would have to say that numbers, charts, and studies are more important than hands on experience.

Wait, they are not.

[DrewKaree]

Not to beat a dead horse,

I'd have never thought that there truly WAS a smiley for everything, but from this point forth, I shall never doubt the power of the smiley, no matter how obscure!  I don't think this discussion is a "dead horse", and think others still find it worth discussing, but CJ, I can't resist the urge to pass this along to you based on your comment - use it freely whenever

I present:

[CheffoJeffo]

CJ, I can't resist the urge to pass this along to you based on your comment - use it freely whenever

Thank you, kind sir ...

 

Cheers.

[DrewKaree]

"The Vancouver, British Columbia-based Fraser Institute keeps track of Canadian waiting times for various medical procedures. According to the Fraser Institute's 14th annual edition of "Waiting Your Turn: Hospital Waiting Lists in Canada (2004)," total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, rose from 17.7 weeks in 2003 to 17.9 weeks in 2004. For example, depending on which Canadian province, an MRI requires a wait between 7 and 33 weeks. Orthopaedic surgery might require a wait of 14 weeks for a referral from a general practitioner to the specialist and then another 24 weeks from the specialist to treatment."

http://www.fraserinstitute.ca/shared/readmore.asp?sNav=pb&id=705

And the link from CJ demonstrates yet again why a move to give the U.S. GOVERNMENT the reigns for health care isn't the answer.  The "administrative costs" never seem to define whether costs such as malpractice or legal fees are factored into the equation.  Again I point back to the Canadian government and the "limits" on compensation should their doctors screw something up.  CONVINCE me that when Johnny or Susie Angelface loses a limb or has some infection/disease go nuts due to waits even CLOSE to the Candian system that their parents won't want to sue the pants off Aunt & Uncle Sam, and anyone else they can throw a lawyer at.

Lawsuits the size awarded in America wouldn't simply be dropped for the "good" of everyone who'd be in the system.  It's either accept a system that can demonstrably show a drop in comparable service or reduce the costs of lawsuits (among other things) to help with total costs. When people can "win the lottery" after spilling a cup of coffee in their laps (and there surely are examples for medical cases of stupid judgements like this), the cost isn't simply eaten by the loser of the suit.  Does it stand to reason that costs not only will increase for THAT case, they'll increase for FUTURE cases that are CERTAIN to arise?  Does it stand to reason that insurance for hospitals and doctors increase yearly, maybe even monthly, and in hefty quantities?  If you had a claim a month on your car insurance, is it reasonable for you to expect that your costs WON'T go up?  Does it stand to reason that if the GOVERNMENT gets to run your health care, the costs of the lawsuits (that, GUARANTEED, will continue to happen) won't be passed on?

The entire arguments on costs AND services are well and good on paper, but as Chad points out, it's the experience.  It's not going to wash with Americans - when they wait for weeks on end, the "solution" that lies north of our borders IS NOT the solution when anyone can see that we Americans can take something like that and increase the costs faster than you can blink.

Susie Angelface will be on the nightly news for weeks on end with an eyepatch from her Lasik gone wrong and the hundreds or maybe thousands of dollars from the "settlement" (like she'd get from the "solution" being touted) are gonna make her the poster girl for government hosing "the little people".

[shmokes]

I don't think this has to be an all or nothing thing.  The U.S. system sucks.  BAD.  It's awful.  But it's not like we have to have either ours or Canada's system.  I think Canada's system, as it is, is better than ours.  It certainly is statistically. 

That said, I think it's stupid that Canada outlaws a parallel private healthcare system.  They are the only nation, of all the many industrialized nations with socialized healthcare that does this.  I don't think that people with money should be denied the ability to go above and beyond what's provided by the state, just like a person in the U.S. can hire private security guards to supplement the police.

But with that said, Canada's healthcare system, as is,  is better at preventing death from preventable causes than the U.S.  And it costs WAY LESS.  They don't just pay less in healthcare costs than us.  They pay LESS THAN HALF what we pay.  And for their money they get statistically better healthcare.  Chad can b1tch to high heaven about how sucky the system was, but it works on paper.  People are recovering better and more often.  They are living longer.  If nothing else, the waits clearly aren't killing them.  And frankly, other countries do it a lot better than Canada.  Many of them pay far less and get significantly better access and have better mortality stats without such long waits.

My point isn't about which system we should have, my point is about how badly our system sucks, how much we pay for it, and what can we borrow to make it better.  I suspect that in many situations our system is much better for people who have access.  Mortality stats are probably skewed in America because they take the population as a whole into account instead of only the population who has access to basic healthcare.  People who actually have decent insurance might actually get superior healthcare to the average Canadian, but that isn't shown well in statistics that include the lower middle class and below, who don't have any access aside from ER. 

I think a hybrid system would be best.  A system that has universal coverage, like Canada in many respects, but one that still has private supplemental insurance and copays (sharing time-of-service costs would reduce frivolous use). 

I don't think Canada's system is the model for the world.  I just don't think it sucks nearly to the extent that ours does (and costs far far far less). 

[Zakk]

If Canada gets a two tiered system I'll be one of the first in line.  I'd like to send the family to emerg for that fractured collarbone, but when cancer comes a-callin I'd like to pony up and have whatever it is cut out tomorrow, as opposed to waiting till it spreads to the four corners. 

[Grasshopper]

One of the problems with insurance based systems is that you only get the full benefits if you are able to keep up premium payments throughout your entire life. For example suppose you had a heart attack 5 years ago but made a good recovery. You then unexpectedly lose your job and find you have a choice between paying your medical insurance premiums or putting food on the table. Most people would stop paying the premiums.

The problem is that when you eventually get another job and find you can take out medical insurance again the insurance company will take account of your past medical history, and because you've had a heart attack the company will regard you as a high risk. So they will either charge you a cripplingly high premium or they will refuse to cover you for any heart-realted conditions. Either way you're screwed.

Basically the people who are most in need of medical insurance are the people who are least able to afford it.

[fredster]

I think they changed that, as long as you keep up premiums.  As long as you were covered when the event occured, you are covered.  There is no pre-existing conditions anymore.  I had cancer and had to have cat scans all the time, still do from time to time, and it's not a preexisting condtion.

I don't know anybody that has health insurance outside their employer unless it's medicare.  I know that when I checked, it was $500 + a month.  Cobra extension off this company's insurance is $729 a month.  Very expensive.  I don't know who can afford that.

Shmokes makes a good point about the Canadian system, they don't allow private doctors. Now England does.  Anybody from the UK that can weigh in?

Our system has problems, but I don't think it sucks.  I still don't know how much the Canadian system costs.  Overall, they pay more for taxes so it's really hard to tell.  But if you factor in the premiums we pay, well, it might be equal.

Where are the stats and who made them that the Canadian healthcare system is better?

[shmokes]

A couple are:

World Health Organization

and

Nation Master

[ChadTower]

I don't know anybody that has health insurance outside their employer unless it's medicare.  I know that when I checked, it was $500 + a month.  Cobra extension off this company's insurance is $729 a month.  Very expensive.  I don't know who can afford that.

I have insurance outside my employer, have for several years.  That is changing at the start of September, though, as I'm finally going with a company plan.  I have been an independent contractor during this period, paying fully out of pocket for medical care for myself and my family.  The numbers you are quoting would only cover an individual.  I have been paying roughly $1250/month for quality family coverage since about 2002.

[patrickl]

In the Netherlands we have sort of a two tier system right now. You are government insured (people with lower income) or privately insured (higher incomes). It will change back to a single social plan soon. I haven't looked into the specifics, but I can't see how that's gonna improve things.

We had long waitinglists, but they are largely brought down by showing people which hospitals don't have waitinglists (or a shorter one) for their treatment.

What I usually don't like about when the government does something is that it costs them a huge amount more than it does when private companies take care of it. For instance I run a small company and because of that I was forced to participate in a government insurance plan for when I would be unable to work due to disease or injury (sorry don't know the english term for it). Their plan cost me twice as much as when I was privately insured for the same before and the government plan offered less coverage so that I had to pay extra to get it back up to specs!

[ChadTower]

We had long waitinglists, but they are largely brought down by showing people which hospitals don't have waitinglists (or a shorter one) for their treatment.

This falls down where I grew up.  There was only one hospital.  To get to another you had to drive several hours.

For instance I run a small company and because of that I was forced to participate in a government insurance plan for when I would be unable to work due to disease or injury (sorry don't know the english term for it).

Disability insurance.

[fredster]

Wow, $1250 a month? Wow.

Shmokes, I don't see where those links are conclusive at all.

[ChadTower]

Wow, $1250 a month? Wow.

Yep.  We make pretty heavy usage of it, too.  No hesitation to call a doctor, see a specialist, bring the kids to the pediatrician for any reason.  Hell, I will have an MRI on my back tomorrow morning to verify the healing process for the disc I injured.