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Thread: Questions for our Canadian RTF'ers on Health Care

  1. #11
    Senior Member Matt McKenzie's Avatar
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    Quote Originally Posted by zeus3925 View Post
    Here you go, Ron.

    http://www.medicalnewstoday.com/articles/9994.php

    It isn't perfect but it is considered by most measures to be the best. When I visited France 2 years ago, French citizens I spoke were enthusiastic about their health care system.
    Are they enthusiastic about the tax rate? Would you be enthusiastic about Americans being taxed at the French rate?
    Matt McKenzie

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  2. #12
    Senior Member ErinsEdge's Avatar
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    The reality is that people in this position skimp on health insurance by being underinsured and uninsured, and then they hope for the best. While they cannot be denied care urgently needed to preserve their lives, they are not required to be provided any other form of care. Radiation or chemo treatment of cancer, for example, would fall into the category of things that they would not qualify to receive (which doesn't mean that some health care providers wouldn't provide treatment anyway.). In fact, what they tend to not receive is preventative care. As a consequence they become ill more often and their illnesses are more serious when first treated. It is generally estimated that 20-40,000 people per year die as a consequence of not having health insurance.
    No, this is the reality. Many people will not pay one cent for health insurance and will not get it even if it is forced on them. Good luck at fining them. I know people like this that are self employed. I have even directed them to places that give almost free care and they won't do it. However, in the old days when they had cheap insurance through work they were at the Dr all the time. I also hear about how in Canada the Doctors care about you and have wellness programs and they don't in the US. That is poppycock. If you go to a doctor he is going to harp on you to eat well, don't smoke, loose weight and exercise but they can't make people do it. I have even heard people advocating wellness programs stand there and could lose 70 pounds. It's about responibility. The only health program that will really work is when each person has to take responsibility of where money is spent and that's why it would be better to give people a HSA and let them spend it and take responsibility than a handout.
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  3. #13
    Senior Member dnf777's Avatar
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    Quote Originally Posted by M&K's Retrievers View Post
    I believe about 50% of the uninsured are so because they don't want to buy it not because they are uninsurable.
    That may be very true. As a gainfully employed, insured citizen, my selfish concerns are now past the uninsured, and focus on the 50% of medical-expense-related bankruptcies that occur in this country. How is that?? (roughly 60% of all bankruptcies are medical related, and of those, HALF are with folks who HAVE insurance)
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  4. #14
    Senior Member subroc's Avatar
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    Quote Originally Posted by YardleyLabs View Post
    ...If those 30 million people receive insurance, either because of government subsidies, or because some generous person decides to pay premiums for them...
    I believe it is the same thing.
    subroc

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  5. #15
    Senior Member zeus3925's Avatar
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    Quote Originally Posted by Hookset View Post
    Are they enthusiastic about the tax rate? Would you be enthusiastic about Americans being taxed at the French rate?
    A lot of this comes out in the wash. Expenses out of pocket for health care premiums vs. taxes for health care.
    Zeus

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  6. #16
    Senior Member Gerry Clinchy's Avatar
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    If you are a single parent household working two jobs for 60 hours per week at $10/hour, your monthly earnings will average $30,000 per year. Taxes will consume $3-4000 of that and rent another $12,000. Health insurance premiums would be another $12,000, leaving about $80-100 per week for all other expenses including food for four. You would not qualify for any form of governmental assistance. The reality is that people in this position skimp on health insurance by being underinsured and uninsured, and then they hope for the best. While they cannot be denied care urgently needed to preserve their lives, they are not required to be provided any other form of care. Radiation or chemo treatment of cancer, for example, would fall into the category of things that they would not qualify to receive (which doesn't mean that some health care providers wouldn't provide treatment anyway.). In fact, what they tend to not receive is preventative care. As a consequence they become ill more often and their illnesses are more serious when first treated. It is generally estimated that 20-40,000 people per year die as a consequence of not having health insurance.
    Family of four: Since this is a single-parent household, that means there are 3 kids?

    However, tax wise, if someone earned $30,000 and paid $12,000/year for health insurance, they would deduct part of the $12,000 on their income tax return (about $11,100 ... the amount of 7.5% of gross income). However, here in PA, they'd still be paying State Income Tax and Local 1% income tax, neither of which allow any "deductions", which comes to 4.09% ($1227). However, with 3 kids at this income level they might qualify for some tax reduction at the state level. I'm not sure exactly how that works. And they couldn't get away with not paying SS/MC: about $2,175.

    However, there are some programs for providing insurance for the children in mid-income households.

    That said ... why not fix this particular problem with an expansion of Medicaid, a program already in place. Except that a lot of people who qualify don't apply for Medicaid, we are told, due to the cumbersome process for doing so. Fix that.

    However, back to the thread ... what do people who actually have a govt program for health care think of it? I do believe that having a public option is a step toward the govt providing the whole magilla.

    I don't think that it is a fair comparison to compare health care to defense. The Constitution does specify that defense is a duty of the Federal govt. And there are definitely times when the Defense Dept falsl prey to the same problems as the rest of govt-run programs ... the oft-cited $600 toilet seats and $200 hammers.
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  7. #17
    Senior Member YardleyLabs's Avatar
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    Quote Originally Posted by Gerry Clinchy View Post
    Family of four: Since this is a single-parent household, that means there are 3 kids?

    However, tax wise, if someone earned $30,000 and paid $12,000/year for health insurance, they would deduct part of the $12,000 on their income tax return (about $11,100 ... the amount of 7.5% of gross income). However, here in PA, they'd still be paying State Income Tax and Local 1% income tax, neither of which allow any "deductions", which comes to 4.09% ($1227). However, with 3 kids at this income level they might qualify for some tax reduction at the state level. I'm not sure exactly how that works. And they couldn't get away with not paying SS/MC: about $2,175.

    However, there are some programs for providing insurance for the children in mid-income households.

    That said ... why not fix this particular problem with an expansion of Medicaid, a program already in place. Except that a lot of people who qualify don't apply for Medicaid, we are told, due to the cumbersome process for doing so. Fix that.

    However, back to the thread ... what do people who actually have a govt program for health care think of it? I do believe that having a public option is a step toward the govt providing the whole magilla.

    I don't think that it is a fair comparison to compare health care to defense. The Constitution does specify that defense is a duty of the Federal govt. And there are definitely times when the Defense Dept falsl prey to the same problems as the rest of govt-run programs ... the oft-cited $600 toilet seats and $200 hammers.
    Tax deductions only help reduce Federal income taxes, not social security and medicare taxes. They are of almost no use at all to the majority of the population. My calculations assumed that few taxes would be paid beyond SS/Medicare. A single parent family of four working 60 hours/week accurately describes a large percentage of the families that I work with on a volunteer basis. In fact, in NJ and PA, the family would be eligible to receive limited Medicaid benefits under the SCHIP program, but would lose that if their income went over $35,000. Expanding Medicaid is actually one of the primary features of the Senate health care plan. There is a little bit of sleight of hand here since 50% of the cost of that expansion would fall on State governments. In fact, many liberals would prefer to see the entire issue addressed through expansions of Medicaid and Medicare. That would have the effect of creating a single payer system. However, those programs are not set up to accommodate partially subsidized coverage where the government pays part of the cost and the individual pays the balance. The approach of using private insurance offering consumers choices and providing the equivalent of vouchers that can be used to pay a portion of the premium cost was actually done to provide greater choice and avoid forcing a single payer system.
    Last edited by YardleyLabs; 11-02-2009 at 12:27 PM.

  8. #18
    Senior Member Gerry Clinchy's Avatar
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    Quote Originally Posted by YardleyLabs View Post
    Tax deductions only help reduce Federal income taxes, not social security and medicare taxes. They are of almost no use at all to the majority of the population. My calculations assumed that few taxes would be paid beyond SS/Medicare.

    Yes, Jeff, that's what I was figuring, too ... the SS & MC were "inescapable" regardless of income level (the $2175). And the local 1% tax is pretty much inescapable as well (that goes to the school districts).

    A single parent family of four working 60 hours/week accurately describes a large percentage of the families that I work with on a volunteer basis. In fact, in NJ and PA, the family would be eligible to receive limited Medicaid benefits under the SCHIP program, but would lose that if their income went over $35,000.

    So, they would not be paying the $12,000 for health insurance? Or would they pay some amount to supplement the basic Medicaid?


    Expanding Medicaid is actually one of the primary features of the Senate health care plan. There is a little bit of sleight of hand here since 50% of the cost of that expansion would fall on State governments. In fact, many liberals would prefer to see the entire issue addressed through expansions of Medicaid and Medicare. That would have the effect of creating a single payer system.


    Well, a single-payer system for a portion of the population ... the 15% currently not insured? That is quite different than applying it to 100% of the population.


    However, those programs are not set up to accommodate partially subsidized coverage where the government pays part of the cost and the individual pays the balance. The approach of using private insurance offering consumers choices and providing the equivalent of vouchers that can be used to pay a portion of the premium cost was actually done to provide greater choice and avoid forcing a single payer system.


    However, the public option is still on the table at this point.
    I just don't have a lot of faith that the govt option would ultimately turn out to be cheaper than private insurors. Was just reading how much Amtrak is losing on each passenger they carry ... ranging from $5/person on its best-used routes between Boston, NY, DC ... up to $500+ on some other routes. Govt keeps putting more $ into bailing out the losses each year. Sounds like deficit spending to me.

    There is no question that there has to be some "deductible" on a govt option in order to involve some personal responsibility.

    I can recall that some workers at one of my employers, for whom the employer paid the entire health insurance premium, couldn't understand why they had to pay anything for their health care (i.e. the deductible, which was a reasonable one). They expected everything to be free. I'd be willing to bet that many who are in favor of the govt playing a larger role (in the general population) are thinking the same thing. Perhaps those of us on this forum have understanding of the concepts of deductibles and co-pays ... but many people do not; especially if they have not had coverage before.

    One factor not mentioned in the dicussion of Canada, France, or UK v. US ... what are the population differences? I'm not up on those figures, but I thought I saw mentioned in some thread that the populations needing coverage are not as large as the US.
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  9. #19
    Senior Member YardleyLabs's Avatar
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    Quote Originally Posted by Gerry Clinchy View Post
    I just don't have a lot of faith that the govt option would ultimately turn out to be cheaper than private insurors. Was just reading how much Amtrak is losing on each passenger they carry ... ranging from $5/person on its best-used routes between Boston, NY, DC ... up to $500+ on some other routes. Govt keeps putting more $ into bailing out the losses each year. Sounds like deficit spending to me.

    There is no question that there has to be some "deductible" on a govt option in order to involve some personal responsibility.

    I can recall that some workers at one of my employers, for whom the employer paid the entire health insurance premium, couldn't understand why they had to pay anything for their health care (i.e. the deductible, which was a reasonable one). They expected everything to be free. I'd be willing to bet that many who are in favor of the govt playing a larger role (in the general population) are thinking the same thing. Perhaps those of us on this forum have understanding of the concepts of deductibles and co-pays ... but many people do not; especially if they have not had coverage before.

    One factor not mentioned in the dicussion of Canada, France, or UK v. US ... what are the population differences? I'm not up on those figures, but I thought I saw mentioned in some thread that the populations needing coverage are not as large as the US.
    Most of the families I work with receive neither Medicaid or private insurance. They earn too much for Medicaid but work multiple part time jobs with employers that do not hire full time to avoid paying for health insurance. They have trouble paying rent and hope for the best on health care. Most will not go to a doctor for themselves unless there is a life threatening emergency. France, England, Germany, Switzerland, etc., have smaller populations individually than the US. They do not have a problem with uninsured people since everyone has coverage. None of the coverage is provided through employers. It is provided through a national health insurance program and through private insurance policies that people may choose to purchase to cover expenses not covered by the national plan. Switzerland, which ranks first based on most measures of health care, has care that is almost entirely provided by private practitioners but paid for by national insurance. The one public component of the health service system is that each canton (equivalent politically to our states) operate a cantonal hospital. The national insurance plan covers 100% of the cost of services in the cantonal hospital or an equivalent cost in a private hospital. Private hospitals flourish, but the competition with the cantonal hospitals -- which are generally outstanding -- encourages them to keep their costs down.

    I suspect that a public plan will be more expensive than some private plans and cheaper than others. Under the proposals being considered, people would be able to use their public subsidy "vouchers" to buy coverage from either public or private providers. There would be some restrictions on the ability of people receiving coverage through an employer plan to switch to a different plan. This provision is specifically designed to protect insurance companies from competition.

    I suspect that the existence of a public plan -- which by law would not be permitted to receive any public subsidies beyond the premiums charged to persons covered -- would result in lower premiums for private plans than would be seen in the absence of a public plan. This is seen now in states where there is a large non-profit provider (typically BC/BS) of coverage. In these cases, the non-profit tends to hold a large percentage, but not all, of the total market and prices charged by all competitors are lower than in states without a strong non-profit provider. Private insurers recognize this and are therefore opposed to such competition.

  10. #20
    Senior Member Ron in Portland's Avatar
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    Quote Originally Posted by zeus3925 View Post
    Here you go, Ron.

    http://www.medicalnewstoday.com/articles/9994.php

    It isn't perfect but it is considered by most measures to be the best. When I visited France 2 years ago, French citizens I spoke were enthusiastic about their health care system.
    Thanks for the information. I appreciate it.

    There are a few items that, if this is considered to be one of the better systems, really concern me.

    It mentions the "...working population has twenty percent of their gross salary deducted at source..." and this is for a fund that covers 80% of the population. The other 20% have different funds. This is followed by "The contribution of financing through personal income taxes has gradually increased" (hard to imagine that happening in the US, eh?). Still, it was an interesting link to review. Their system still has room (and the need) for supplemental insurance. I take this to mean if you want better coverage or more effective insurance, you pay more. Also, they still have private, profit-oriented hospitals.

    On top of this, there's still a co-pay of as much at 20-30% for some things. More for prescriptions. There's 100% payment if you qualify below a certain income level. I'd be curious what that level is and how it would translate to a similar system here in the US.

    I guess where I'm going with this is I have little confidence that a govenment overhaul of the health care system is going to reduce my level of service while increasing my costs, both direct and through taxation. Looking at other systems, they don't appear to be the catch-all model that seems to be waved around a lot. I really don't think there is such a thing.

    Thanks again.
    Ron
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