Republicans have given up on healthcare

[Matthew]

2 hours ago, CdnFox said:

Now add on GST  and PST (hst in ontario). Carbon tax.  Municiple tax. other taxes

Ok, let's do the math.

SALES TAX: As calculated earlier, I'm making the equivalent of $108k CAD and paying $52k CAD. Sales tax in Ontario is a whopping 13%. Let's suppose I spend 2/3 of my remaining income in Ontario that year on things that qualify for the GST/HST. That's $36960 x 0.13 = $4805. Sales tax in my state are 6% (similar to much of Canada). So in my state that would be an equivalent of $2218 CAD. So that's a difference of $2587 CAD higher in Canada.

FUEL TAX: In Ontario like in the US there is a gas tax. It's confusing af but best I can gather is that it's currently 14.3 cents per liter (CAD). The US has federal and state gas tax. In my state it totals to 30 cents per gallon (USD) equal to 7.9 cents per liter, which converts to 10.8 cent per liter in CAD. I drive about 20,000 miles per year and my car gets about 26mpg. So that's about 769 gallons (2911 liters) of gasoline. In Ontario I'd pay $416.27 CAD and in my US state I'd pay $314.39 CAD. Difference of $102 CAD higher in Canada

PROPERTY TAXES: Keep in mind that in the US all public schools are primarily paid for via property taxes, while in Canada they are primarily paid for via provincial taxes. So I'm guessing my municipal taxes are a lot higher. I picked a nice town in Ontario that is pretty similar to my own, Barrie. My house is worth about $220,00 CAD. So I used the property tax calculator on the Barrie website, which came up with a total of $2977 in property tax. My property tax last year was $4103 CAD. Difference of $1126 CAD higher in the US

Previously my tax comparison had my total Canadian taxes at $29,229 CAD and my total US state and federal taxes + health insurance cost at about $52,000 CAD. If we update this tally to reflect these fuel, property, and sales taxes estimates, then the total comes to $32,020 CAD in Canadian taxes vs $53126 CAD in American taxes + Health Insurance.

I'll look at the rest of your post in a bit, that all took me a while to think about, but I did find it very interesting.

Edited August 19, 2024 by Matthew

[Matthew]

2 hours ago, gatomontes99 said:

Ffs, you can't count state and federal taxes or SS tax. Medicare is sketch since you aren't using Medicare.

The point of my little side quest exercise is to compare the total tax burden and healthcare costs for someone making my income in Canada vs the US. In the US working people pay medicare and social security to cover the people who are retired. I would have expected Canada to have much higher taxes, but it turns out that you guys are paying A LOT less after factoring in health insurance premiums.

[CdnFox]

13 minutes ago, Matthew said:

Ok, let's do the math.

SALES TAX: As calculated earlier, I'm making the equivalent of $108k CAD and paying $52k CAD. Sales tax in Ontario is a whopping 13%. Let's suppose I spend 2/3 of my remaining income in Ontario that year on things that qualify for the GST/HST. That's $36960 x 0.13 = $4805. Sales tax in my state are 6% (similar to much of Canada). So in my state that would be an equivalent of $2218 CAD. So that's a difference of $2587 CAD higher in Canada.

FUEL TAX: In Ontario like in the US there is a gas tax. It's confusing af but best I can gather is that it's currently 14.3 cents per liter (CAD). The US has federal and state gas tax. In my state it totals to 30 cents per gallon (USD) equal to 7.9 cents per liter, which converts to 10.8 cent per liter in CAD. I drive about 20,000 miles per year and my car gets about 26mpg. So that's about 769 gallons (2911 liters) of gasoline. In Ontario I'd pay $416.27 CAD and in my US state I'd pay $314.39 CAD. Difference of $102 CAD higher in Canada

PROPERTY TAXES: Keep in mind that in the US all public schools are primarily paid for via property taxes, while in Canada they are primarily paid for via provincial taxes. So I'm guessing my municipal taxes are a lot higher. I picked a nice town in Ontario that is pretty similar to my own, Barrie. My house is worth about $220,00 CAD. So I used the property tax calculator on the Barrie website, which came up with a total of $2977 in property tax. My property tax last year was $4103 CAD. Difference of $1126 CAD higher in the US

Previously my tax comparison had my total Canadian taxes at $29,229 CAD and my total US state and federal taxes + health insurance cost at about $52,000 CAD. If we update this tally to reflect these fuel, property, and sales taxes estimates, then the total comes to $32,020 CAD in Canadian taxes vs $53126 CAD in American taxes + Health Insurance.

I'll look at the rest of your post in a bit, that all took me a while to think about, but I did find it very interesting.

Buddy, this has been calculated 100's of times.  It's a common discussion amongst canadians.  And no, you've made several errors in your calculations, for example fuel taxes have gst on them etc etc.  And they even charge gst ON the fuel tax as well as the fuel. 

I have zero interest in spending hours educating you on all of this. You're being silly. 

On average canadians historically pay 45 percent of their income in taxes and in the last year or so it's gone up.  period.  Here's one of many documents discussing it and taxes have gone up since this was published

Canadians face bigger tax burden than you think | Fraser Institute

In 2023 the total tax bill for the average family equaled 46.1 per cent of its income.

The average family income in Canada was 98,390  and that's AFTER spousal discounts and child discounts etc.  Individuals making that much without those tax breaks would pay more. 

What that means is someone in canada earning what you do would pay around 10 plus thousand more in taxes. 

And that would give them 'free' medical but that doesn't include any pills etc etc. They still have to pay for that. There will also be user fees for access to medical services and it doesnt' really include dental  (there's a very limited dental plan coming on line but taxes are going up to pay for it).  Some provinces have even run a medical surcharge where you had to pay an extra 50 buck s a month (single person) for your health care. 

 

So when you actually look at it - and many experts have - canadians spend a LITTLE less in health care than the us does. But they get far less service.  THere are proceedues you can't get in canada you can in the states, wait times are DRAMATICALLY longer, and access is getting harder and harder. 

 

It used to be better.  But our system isn't scaling very well at all.  In the 2000's the two systems were closer together.  Nowadays - wait times in emergency rooms frequently exceed 18 hours. 18 freaking hours. I have experienced that myself. 

Thats if they're open. ERs are closing regularly either entirely or for weekends and evenings or rotating days because our system cannot keep up. 

So when people suggest they might prefer a system where those in charge are MOTIVATED to provide services...  that's not necessarily a bad thing. 

 

 

[gatomontes99]

37 minutes ago, Matthew said:

The point of my little side quest exercise is to compare the total tax burden and healthcare costs for someone making my income in Canada vs the US. In the US working people pay medicare and social security to cover the people who are retired. I would have expected Canada to have much higher taxes, but it turns out that you guys are paying A LOT less after factoring in health insurance premiums.

Omg! So many things are wrong with these comparisons.

First, social security has nothing to do with medicine

Second, state and federal taxes don't go to health care.

Third, Canada mandates prices. That means Canadians pay in other ways like scarcity of providers, quality, etc.

It is absolutely assimine to make these comparisons.

[Matthew]

52 minutes ago, CdnFox said:

On average canadians historically pay 45 percent of their income in taxes and in the last year or so it's gone up.  period.

I've demonstrated that the for me personally the taxes and healthcare costs in Canada for someone who makes my income and lives in my size town are FAR FAR less than my actual taxes + monthly healthcare premiums in the US. $32K vs $53K. You're admitting that the tax burden is 45%, that would be $35k for my income. My Tax + Healthcare cost burden is 67% of my income.

And I did include thousands of dollars in sales tax, not that you have $20k in sales tax that I accidentally missed. Obviously, if I took out the $24k in healthcare expenses out of the US side of the column, then Canada would be way more expensive. But this thread is about healthcare costs. Ultimately, what I get for healthcare services is roughly similar to what you get for healthcare, and I have to pay astronomically more for it.

Edited August 19, 2024 by Matthew

[Matthew]

42 minutes ago, gatomontes99 said:

Omg! So many things are wrong with these comparisons.

First, social security has nothing to do with medicine

Second, state and federal taxes don't go to health care.

Third, Canada mandates prices. That means Canadians pay in other ways like scarcity of providers, quality, etc.

It is absolutely assimine to make these comparisons.

The comparison answers the question of what you get for healthcare via your taxes compared to what I pay for taxes coupled with an even higher burden paid annually to a health insurance corporation. I pay more to one health insurance corporation every year than I pay to my federal, state, and local taxes.

[CdnFox]

38 minutes ago, gatomontes99 said:

Omg! So many things are wrong with these comparisons.

First, social security has nothing to do with medicine

Second, state and federal taxes don't go to health care.

Third, Canada mandates prices. That means Canadians pay in other ways like scarcity of providers, quality, etc.

It is absolutely assimine to make these comparisons.

Its' hard to compare the two systems apples for apples, for the reasons you just mentioned and more. Unlike the us we have both federal and provincial health care money and it isn't even the same percent year to year, we have a plethora of taxes they don't (we even have tax on tax). 

Sometimes a better way to come at it is total expenditure per capita. 

In canada we spend about  8740 bucks per person per year in health care

Per capita health expenditure Canada 1975-20233 | Statista

In the states its more, a bout $13,493 per person.

Whether you pay that from taxes or directly - there you go. 

But - they get MUCH faster service, more access to more operations, and wider coverage.  THey also have enough doctors and nurses. 

However - even THAT comparison is not fair because the us number includes all drugs,  our canadian number includes SOME drugs and medicines but not all by ANY stretch.  There are tonnes of drugs people take long term that they pay for themselves or are paid for by private plans and that's not included in that figure. 

That's about another 1500 bucks per person on average.    So even there it starts to get hard to do a straight up comparison. There are other factors as well 

 

 

 

[Matthew]

59 minutes ago, CdnFox said:

It used to be better.  But our system isn't scaling very well at all.  In the 2000's the two systems were closer together.

Well, you guys are probably spending a lot less per capita. I'm spending 20k more per year than someone who makes my income in Canada. Would you be willing to see a tax increase of $20,000 per year to boost your healthcare services? (not that it would actually take anything close to that amount).

[CdnFox]

9 minutes ago, Matthew said:

I've demonstrated that the for me personally the taxes and healthcare costs in Canada for someone who makes my income and lives in my size town are FAR FAR less than my actual taxes

No, what you demonstrated was that you don't understand how canadian tax works. 

Which is understandable, you're not a canadian.  But no. 

Canadians do pay less than the us. Calculating how much exactly can be very difficult. You can see my reply to gatomontes99 for yet another way to look at it (which is still not quite accurate but there you go). 

And even with that i forgot to include private health care plans and costs which add up to a few hundred billion on top of what the gov't spends (but that also bites into the drug costs). 

It's not nearly as much less as you think. 

And it recently took me 5 years to get a family doctor when i moved, and my local emergency room is shut down part time right now. I can't get an ambulence here due to a shortage of drivers.  etc etc. 

So when you compare the quality of service (as much as possible) americans pay a little more but they GET more.  

And its entirely reasonable for someone to say "i'd rather pay and get what i need than save a few bucks and die in a waiting room for lack of services.  (has actually happened a number of times in canada last year). 

 

 

[CdnFox]

6 minutes ago, Matthew said:

Well, you guys are probably spending a lot less per capita. I'm spending 20k more per year than someone who makes my income in Canada. Would you be willing to see a tax increase of $20,000 per year to boost your healthcare services? (not that it would actually take anything close to that amount).

Less.  Not a lot less. But we get less. And that does mean people die who didn't need to, straight up.  There's been a number of stories about it. 

To be honest canada's system is pretty crap right now and isn't a good example to mimick.  If you want to see health care done right you want to take a hard look at france, where they do use a combination of public and private care that's publically funded and it works very well. Probably one of the most efficient "Best of all worlds" options out there. 

[CdnFox]

10 minutes ago, Matthew said:

 Would you be willing to see a tax increase of $20,000 per year to boost your healthcare services? (not that it would actually take anything close to that amount).

Sorry - forgot to address that entirely. 

To bring our level of spending up to yours we'd probably only need to be taxed/charged another 3000 dollars a year or so.  For some people less, because they already do pay for personal insurance. 

And that is a serious debate in canada.   The problem is that it's not that straight forward - we're already very heavily taxed Much more than you, and we don't spend money on military or other things we need to. 

So do we want to spend even more on taxes? Business is already leaving our country for the first time in history. 

Or should we spend more on healthcare and less on something else?

See - the problem with blending it in with your taxes is you don't really see where your tax money goes. Gov'ts can misuse or blow the money and it's not easy to track, and you really have no say in how much goes to healthcare. 

If its PRIVATE i can control precisely how much i want to go to healthcare, and how much i'd like to spend on other things in my life. I could decide i'm a pretty healthy person and don't need as much health coverage, or decide i'm at risk and beef it up. 

So it's kind of an impossible question to asnwer - becasue if i DO pony up the extra 3 grand there's no guarantee the gov't will spend it on healthcare - and if they do there's no guarantee they'll continue to do so.  When we started this the feds bumped taxes to cover 50 percent of health care costs. - now they cover about 30 percent and they pocket the difference in taxes. 

There is a LOT to say for not giving your gov't control over your medical choices.  There's benefits to a public system - but it's not as straight forward as you think AT ALL, the lived experience in Canada started out great but its' pretty horrible at the moment. 

[Matthew]

9 minutes ago, CdnFox said:

No, what you demonstrated was that you don't understand how canadian tax works. 

I'm sure I left out some minor expenses on each side but even just going by your 45% stat shows I was probably pretty close

13 minutes ago, CdnFox said:

i forgot to include private health care plans and costs

That's a good point, looks like on average many Canadians spend a few thousand dollars a year on supplemental insurance.

15 minutes ago, CdnFox said:

americans pay a little more

I still don't see how you're arriving at this. Even if we bump the taxes up to 45% of income and throw in $5000 of private supplemental insurance, it's still $15,000 per year more in the US than Canada for someone of my income level. Americans spend 17% of their GDP on healthcare compared to your 12% (and that's with a 27% higher GDP per capita)

21 minutes ago, CdnFox said:

they GET more.  

And its entirely reasonable for someone to say "i'd rather pay and get what i need than save a few bucks and die in a waiting room for lack of services.  (has actually happened a number of times in canada last year). 

This happens in the US too. Keep in mind, even on my modest middle class income I'm paying a huge amount each month and only about half of Americans can afford such an absurd expense. 15 million people have no insurance at all and probably tens of millions have just the most basic catastrophic care insurance--or insurance that still requires thousands of tens of thousands of dollars deductible payment before the insurance will pay for anything. So the number of Americans dying due to having no access to any routine care or preventative care or a realistic way to pay for procedures is very high.

My aunt is 60 years old, makes close to minimum wage as a nursing home aid. She's probably below the poverty line, can barely walk due to a lack of cartilage in her knee. She's certainly not in on any waiting list for a knee surgery because she would have no way to pay for such a procedure. 47% of Americans live paycheck to paycheck and aren't well insured. Compared to the US, Canada's inconveniences with their underfunded system are small potatoes. And yeah I'm not suggesting that Canada has some great healthcare system. I'm not sure how it even came up--probably because of all the f-ing Canadians here.  

[herbie]

We do have a great system. Our doctors are so f*cking smart they don't need a $20,000 MRI scan to tell your leg was blown off with a shotgun.

They're also more interested in replacing that missing pound of flesh than ripping off more for the benefit of a massive line of fellow profiteers.

Not that I;m saying your doctors are like that. You just simply cannot argue that if everyone every single step of the way must earn a profit it's a better system.

[Matthew]

27 minutes ago, CdnFox said:

the problem with blending it in with your taxes is you don't really see where your tax money goes.

This problem is even worse with privatized healthcare. By design, about 1/3 of your monthly overpriced premium is goes to shareholders, corporate bonuses, etc. There is no ethical rule about what the insurance company can or can't spend that money on. When governments use the money, it's big public scandal if a few million of it was used for some unsavory purpose--precisely because there are laws and public scrutiny, which naturally creates a perception of systemic malfeasance even if the institutions run pretty well. My dad was a hospital pharmacy manager for decades and even though he's a pro-trump republican conservative ultra-capitalism kind of guy, he has no faith in privatized medicine pharmaceutical companies, health insurance companies, etc.

[CdnFox]

55 minutes ago, Matthew said:

I'm sure I left out some minor expenses on each side but even just going by your 45% stat shows I was probably pretty closestem. I'm not sure how it even came up--probably because of all the f-ing Canadians here.  

Talking about something you're not familiar with doesn't make you look very bright 

CONTINUING to talk about it after someone's pointed out you're wrong and  don't know about it makes you look dumb like rock.  Be smarter than the rock   

Quote

That's a good point, looks like on average many Canadians spend a few thousand dollars a year on supplemental insurance.

Well even that gets a little complex - the employer usually pays half (Sometimes none sometimes all). So for example i pay something like 75 bucks for my insurance at work but my employer pays more like 100 on top of that.  AND - if you have a family that's covered it goes down per person as an average.

It's not easy to figure out entirely. But - sure somewhere around 2 grand a year with employer and employee combined ish.  Depending on the coverage. But then not EVERYBODY gets that, smaller employers don't always offer health benefits. 

Quote

I still don't see how you're arriving at this. Even if we bump the taxes up to 45% of income and throw in $5000 of private supplemental insurance, it's still $15,000 per year more in the US than Canada for someone of my income level. Americans spend 17% of their GDP on healthcare compared to your 12% (and that's with a 27% higher GDP per capita)

I've shown what the average per capita expenditure is in the states.  I've shown what it is in Canada. While i get you're proud of your math, it does not add up to what the official sources say.  Therefore there are factors you're either getting wrong or missing and i don't feel like crawlilng through your math to figure it out. The per capita expenditure works very well for the point we're discussing and while its' not perfect either its' easy to adjust for some of the variables and accurate enough for discussion purposes. 

Per capita after drugs but not including dental amercians spend around 3000 bucks a year more than canadians on health care on average give or take. 

 

Quote

This happens in the US too.

Really.  When was the last time someone died in a us waiting room because they were there for over 24 hours? It's happened a few times in canada just this last year and we have 1/10 the population.

Here's the average wait time in ontario - it's up to 22 hours now 

Insight: Why are patients spending 22 hours in the emergency room waiting for a hospital bed? | CMA

In the states its 2 hours 44 mins. 

Longest Emergency Room Wait Times by State (2024) | AutoInsurance.org

almost one tenth the time. The two cannot be compared. 

Quote

Keep in mind, even on my modest middle class income I'm paying a huge amount each month and only about half of Americans can afford such an absurd expense. 15 million people have no insurance at all and probably tens of millions have just the most basic catastrophic care insurance--or insurance that still requires thousands of tens of thousands of dollars deductible payment before the insurance will pay for anything. So the number of Americans dying due to having no access to any routine care or preventative care or a realistic way to pay for procedures is very high.

Sure but that has nothing to do with quality of care.  For what they pay for americans get better quality of care. They just spend more and get the 'good stuff', and those who can't die. 

Now -the question becomes is it fair to rob some people of their health to improve the health of others?  Because that's what's happening in Canada.  There are legitimately some who say yes.  There are many who would say no.   That's the real debate.  

Quote

My aunt is 60 years old, makes close to minimum wage as a nursing home aid. She's probably below the poverty line, can barely walk due to a lack of cartilage in her knee. She's certainly not in on any waiting list for a knee surgery because she would have no way to pay for such a procedure. 47% of Americans live paycheck to paycheck and aren't well insured. Compared to the US, Canada's inconveniences with their underfunded system are small potatoes. And yeah I'm not suggesting that Canada has some great healthcare sy

Sure .  Meanwhile one of my relatives just barely got in for cardiac surgery in time and almost died after an extesive and long wait and will go through a more painful recovery as a result despite the fact they worked hard all their life and made good money and paid lots of taxes.  So - why'd he almost have to die just so some drug addict can get their free overdose treatment?

The answer is probably somewhere in the middle. But some of it is simply a moral question. Your aunt mae more money than she would have not having to pay the level of taxes we do. The downside is she has to prepare or save for her health in her elderly years when it costs the most. 

 

In any case the practical upshot is that it's hard to say one system is objectively better.  There are pros and cons, and if you're more socialistic you'll appreciate the 'good of the disadvantaged' argument and if you're more individualistic you'll probably say you'd like to be in charge of paying for what you get.  The balance lies somewhere in the middle most likely as with most things 

 

 

[BeaverFever]

On 8/17/2024 at 5:01 PM, gatomontes99 said:

In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment. This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.

Supply v Demand will always prevail. If cost can't be changed, something else must be sacrificed. The sacrifice is going to be availability or quality.

The country's health-care system is suffering from an acute shortage of doctors — even as hundreds of qualified Canadian physicians trained abroad are turned away each year because of a tangle of red-tape and bias, experts say.

Sure, you can say that it doesn't cost much to have healthcare in Canada...but do you have health care? There is a severe shortage of doctors.

Over the summer, physicians, politicians and policy experts have rang the alarm bells, warning Canadians about the beleaguered state of our health-care system. While many of the proposed solutions focus on individual issues (the physician shortage, for example), few address the systemic nature of the problem. In reality, Canada’s health-care system has been on the verge of collapse for years, and its long past time to consider the sort of meaningful reforms needed to repair it, if not outright save it.

Well Canadian system is  not perfect but Fraser Institute is a known right wing propaganda think tank. 
 

For example while wait times have definitely increased Fraser Institute doesn’t want you to know that referrals for time sensitive treatments and serious conditions like cancer treatments have much much shorter wait time than non- urgent referrals for things like cataract surgery or knee replacements 

And that there is no wait time for preventative care like family doctors or emergency care like when you’re hit by a car. 
 

Meanwhile the wait times for Americans who can’t afford healthcare is the rest of their lives

The stats are in: Canadians have better outcomes than Americans for most medically preventable fatalities In general, in Canada illnesses are identified sooner, treated sooner and Canadians have better recovery rates and fewer post-procedure fatalities. And that’s reflected in better overall population statistics like infant mortality, childbirth mortality rate

[Matthew]

57 minutes ago, CdnFox said:

I've shown what the average per capita expenditure is in the states.

I don't give two shits about a per capita average that americans pay. Im looking directly at what i literally paid last year.

The reason per capita is useless is because only half of Americans like myself fully afford and pay for healthcare.

57 minutes ago, CdnFox said:

When was the last time someone died in a us waiting room because they were there for over 24 hours?

Well that's a story that you'll hear in every country where a citizen has a right to healthcare and can actually get into the waiting room.

The US equivalent scandalous story would be hospitals turning away dying ER patients or dumping indigent patients on skid row or people dying while waiting for an ambulance that never arrives. But again the real disparity are the millions of people who never even bother to go to a doctor.

57 minutes ago, CdnFox said:

Your aunt mae more money than she would have not having to pay the level of taxes we do. The downside is she has to prepare or save for her health in her elderly years when it costs the most. 

Made more money? Again she's in poverty working full time and lives paycheck to paycheck. In 5 years she'll qualify for Medicare and will get treated, if she can make it that long.

57 minutes ago, CdnFox said:

Meanwhile one of my relatives just barely got in for cardiac surgery in time and almost died after an extesive and long wait

Sounds like your system is just underfunded since you're paying so much less into it. Like you said, either you pay and get the good stuff, or you just get sick and die. Which one is canada doing?

Edited August 19, 2024 by Matthew

[Matthew]

19 minutes ago, BeaverFever said:

Meanwhile the wait times for Americans who can’t afford healthcare is the rest of their lives

Exactly

[CdnFox]

48 minutes ago, Matthew said:

I don't give two shits about a per capita average that americans pay. Im looking directly at what i literally paid last year.

So, you're looking at your incorrect math and attempting to extrapolate an effective comparison of two nations with a combined population of approximately 440 million people from that ... RATHER than looking at a comparison of what the average person experienced. 

Ok.  Well.  There you go. 

Quote

The reason per capita is useless is because only half of Americans like myself fully afford and pay for healthcare.

Means nothing. The medical care given in the states cost that much. 

 

Quote

Well that's a story that you'll hear in every country where a citizen has a right to healthcare and can actually get into the waiting room.

Nope. You'll hear people dying but not because they had to wait 22 hours. 

 

Quote

The US equivalent scandalous story would be hospitals turning away dying ER patients or dumping indigent patients on skid row or people dying while waiting for an ambulance that never arrives. But again the real disparity are the millions of people who never even bother to go to a doctor.

No - that has nothing to do with the cost of delivering medical services.

Quote

Made more money? Again she's in poverty working full time and lives paycheck to paycheck. In 5 years she'll qualify for Medicare and will get treated, if she can make it that long.

So she's poor. Is that my fault? Did i do that? So why should i pay for it?

Truth be told i don't really believe that 100 percent, i do believe there's benefit in a medical social safety net but it's 100 percent a valid argument and one made by many.

Quote

Sounds like your system is just underfunded since you're paying so much less into it. Like you said, either you pay and get the good stuff, or you just get sick and die. Which one is canada doing?

A little of both.  We have funding issues but they're largely because we've gone full public.  That tends to lead to funding issues that don't exist when you have more private.  The reason the us spends more is because they CAN spend more.  That's a CHOICE on an individual basis.  I don't have that choice. I'm a slave to the gov'ts decisions. 

 

47 minutes ago, Matthew said:

Exactly

So why should the people who can afford it have to die as a result?

I"ve asked that  a few times now.  I note you've failed to answer. 

 

[BeaverFever]

4 hours ago, CdnFox said:

Its' hard to compare the two systems apples for apples, for the reasons you just mentioned and more. Unlike the us we have both federal and provincial health care money and it isn't even the same percent year to year, we have a plethora of taxes they don't (we even have tax on tax). 

Sometimes a better way to come at it is total expenditure per capita. 

In canada we spend about  8740 bucks per person per year in health care

Per capita health expenditure Canada 1975-20233 | Statista

In the states its more, a bout $13,493 per person.

Whether you pay that from taxes or directly - there you go. 

But - they get MUCH faster service, more access to more operations, and wider coverage.  THey also have enough doctors and nurses. 

However - even THAT comparison is not fair because the us number includes all drugs,  our canadian number includes SOME drugs and medicines but not all by ANY stretch.  There are tonnes of drugs people take long term that they pay for themselves or are paid for by private plans and that's not included in that figure. 

That's about another 1500 bucks per person on average.    So even there it starts to get hard to do a straight up comparison. There are other factors as well 

 

 

 

No Your comparison is way off

1) The Canadian coverage includes all “medically necessary” services for virtually 100% of the population whereas US coverage excludes nearly 30 million who are completely uninsured and and about 60 million more who are considered “underinsured” with very limited coverage  

2) Even Americans with health insurance are still massively out of pocket if they have any serious or substantial costs over and above what they pay for insurance. For example the most common type of insurance in USA is 80/20 insurance where the plan covers 80% and the patient covers 20%  That may sound reasonable until you realize that a stay in intensive care at a US hospital can easily cost $10,000 PER DAY.  Not to mention deductibles, co-pays, exclusions and various limits on any number of treatments So despite paying tens of thousands for COVERAGE you’re also out tens of thousands more for ACTUAL CARE 

3) The US system price-gouges for example  hospitals famously charge patients up to $20 for aspirin …not for a bottle of aspirin but for ONE aspirin pill

It’s no wonder healthcare is the leading cause of bankruptcy in the USA while healthcare related bankruptcy is unheard of in Canada 

Edited August 19, 2024 by BeaverFever

[CdnFox]

47 minutes ago, BeaverFever said:

No Your comparison is way off

1) The Canadian coverage includes all “medically necessary” services for virtually 100% of the population whereas US coverage excludes nearly 30 million who are completely uninsured and and about 60 million more who are considered “underinsured” with very limited coverage  

That's a pretty small part of the population and even they have access to some medical services.  And it includes some very rich people who spend a LOT of money to get the most premium health services that we wouldn't see here. 

As i said - difficult to compare apples to apples.  But not 'way off'. 

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2) Even Americans with health insurance are still massively out of pocket if they have any serious or substantial costs over and above what they pay for insurance. For example the most common type of insurance in USA is 80/20 insurance where the plan covers 80% and the patient covers 20%

As i pointed out, that's what the health care cost americans per capita.  It doesn't matter if it's private or insurance paid. That's what they paid for their medical services. 

Your argument is that 'it sucks to pay money' but as previously noted they save a buttload on their taxes compared to us as well 

 

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3) The US system price-gouges for example  hospitals famously charge patients up to $20 for aspirin …not for a bottle of aspirin but for ONE aspirin pill

So go to a cheaper hospital   You'd be surprised what some of our own hospitals pay for certain things. But the bottom line is that  is the total they spent on health care, asprin included. And if you're dying and need assistance you can get into an emergency room with a short wait that doesn't involve changing the date on your calendar. 

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It’s no wonder healthcare is the leading cause of bankruptcy in the USA while healthcare related bankruptcy is unheard of in Canada 

well considering it's against the law in Canada to pay for medical services covered by the act, i should HOPE you're not surprised  but while it isn't a cause for bankruptcy, it IS a cause of death. So think about that for a minute. 

So i'll ask the same question i asked Matthew -  why should a person who can afford health care die so that someone else they don't know can have access to it? Why is that fair?

[Deluge]

On 8/17/2024 at 12:25 PM, Matthew said:

Healthcare is in the top 3 of concerns for Americans.

For you Canadians, here's how it works in the US. Through my employer I pay about $1500 per month to an insurance corporation for a mediocre family health insurance plan. In the event that i need some kind of medical treatment, I must pay about $5000 out of my own pocket before the insurance pays anything. It doesnt cover dental or many eye expenses.

Increase in these insurance costs has been steady and linear for many decades. To try to address this, in 2010 democrats passed the ACA, which required everyone to buy insurance, created a subsidized insurance marketplace for lower income people, and made many very popular restrictions on what insurance corporations can no longer do to their insurance customers.

Meanwhile, since the 1960s through Medicare, older Americans (who are mostly republican, by the way) can just go to the doctor and the government pays for most of it. This is the model that most democrats would like to see expanded for everyone. In 2010 democratic party leaders went with an existing republican market-based plan in a doomed hope of getting some of them on board with the legislation.

Since 2010, the ACA is widely appreciated for what it does do, but it has shortcomings. Republicans have long vowed to end the ACA. When they controlled the entire congress and the presidency from 2016-2018 they had an easy pathway for doing anything they want to do to change or improve healthcare, but did not do so. They attempted a straight repeal of the ACA, it failed, and that was it.

Today, the republican platform has just this minimal and vague 3-sentence statement on the subject of healthcare:

Is it now safe to say that Republicans have no major ambitions for trying to do anything with Healthcare?

Why hasn't Obamacare fixed this, comrade? 

[User]

On 8/17/2024 at 1:25 PM, Matthew said:

For you Canadians, here's how it works in the US.

This is not quite how it works... 

Employers offer health insurance plans as they are required to for full-time employees and are incentivized to do so by decades of tax laws that give them some tax benefits of doing so. 

Yeah! Big government bureaucracy controlling our lives. 

There are any number of what are called High Deductable plans they can offer as well as copay plans. They do not all function as yours and with the high deductable plans you can have a savings account you can contribute to tax free. Which, the government doesn't keep up on, as health care costs increase, they do not increase that account contribution limit to keep up with the deductable costs. 

Yeah! Big government bureaucracy controlling our lives. 

High Deductable plans are actually wonderful for those who are young and healthy, you pay almost nothing for your insurance and only pay a little for routine doctor appointments. 

Also, most of these plans cover the costs of routine checkups and care appointments. So, there is no out of pocket either way. 
 

On 8/17/2024 at 1:25 PM, Matthew said:

It doesnt cover dental or many eye expenses.

Most employers offer separate plans for these. 

You can also use your savings account for these expenses... which again, isn't enough to cover it all. 

Yeah! Big government bureaucracy controlling our lives. 
 

On 8/17/2024 at 1:25 PM, Matthew said:

Meanwhile, since the 1960s through Medicare, older Americans (who are mostly republican, by the way) can just go to the doctor and the government pays for most of it.

LOL, no. Like Social Security, these are entitlement programs we all pay into our entire working lives. The government is taxing our income for almost 50 years at almost 1.5%.

Even then, there are several Medicare plans, only those who worked a certain time qualify for the best, and as you said, you still pay some copays on top of it. 
 

On 8/17/2024 at 1:25 PM, Matthew said:

This is the model that most democrats would like to see expanded for everyone.

No, it is not. They call it that... but there is no way to expand it, as it is entirely based upon taxing people their entire working lives... if you start giving this to everyone... it isn't Medicare for all anymore, it is just Universal Health care, but that name doesn't poll as well so Democrats have to be deceptive, because hey, look, if its good enough for Grandma and Grandpa, then why not everyone!

Nevermind all the other negative crap that goes along with Medicare. Doctors hate it, many won't even see patients on it. Why? Because it is a government bureaucracy and trying to get paid is like trying to get milk from a bull. It is not worth the hassle. 

I am not looking forward to this at all. But... I have been forced to pay into it my whole life... and just like Social Security, I could do better on my own without it. 

On 8/17/2024 at 1:25 PM, Matthew said:

Since 2010, the ACA is widely appreciated for what it does do

The average person has no idea what it does. Only as time has passed and people have forgotten what little they did know, has it barely started to poll over 50%. 

It was not popular at first and it was mainly passed on a lie, one of the biggest lies ever told by a President over and over again. 

It was a crap law that didn't help most of the people, targeting the extreme minority. The few good things in it could be on one page, yet the law was almost 1,000 pages long of... you guessed it:

Yeah! Big government bureaucracy controlling our lives. 
 

On 8/17/2024 at 1:25 PM, Matthew said:

Is it now safe to say that Republicans have no major ambitions for trying to do anything with Healthcare?

Oh, on this we can agree. Republicans seem happy to go along with the status quo for the most part or just opposing all the bad crap Democrats want to do, which is still good. 

I wish the Republicans would get serious about incentivizing private health care plans, like car insurance. 

Instead of giving employers all the tax incentives, give them to the people. It would be amazing if I could just pay out of pocket for all the day to day stuff and pay for actual insurance to help if I get cancer or some other crazy unexpected thing. Let me see the costs and negotiate what I want and the level of services I want. 

There are doctors who do this today, where you can buy into their family practice for like 100 bucks a month and go as often as you want... imagine how much better that would be for everyone to go where they want, get what they want, and have more control over their choices. Then let insurance be insurance, cheaper because you are only using it as insurance when needed. 

 

[Rebound]

On 8/17/2024 at 5:01 PM, gatomontes99 said:

In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment. This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.

Supply v Demand will always prevail. If cost can't be changed, something else must be sacrificed. The sacrifice is going to be availability or quality.

The country's health-care system is suffering from an acute shortage of doctors — even as hundreds of qualified Canadian physicians trained abroad are turned away each year because of a tangle of red-tape and bias, experts say.

Sure, you can say that it doesn't cost much to have healthcare in Canada...but do you have health care? There is a severe shortage of doctors.

Over the summer, physicians, politicians and policy experts have rang the alarm bells, warning Canadians about the beleaguered state of our health-care system. While many of the proposed solutions focus on individual issues (the physician shortage, for example), few address the systemic nature of the problem. In reality, Canada’s health-care system has been on the verge of collapse for years, and its long past time to consider the sort of meaningful reforms needed to repair it, if not outright save it.

The doctor shortage in Canada has two possible causes:

1) Not enough medical schools, or 

2) Holy F*ck!!!, they’re treating the poor instead of prioritizing healthcare for the wealthy.  Communist! 
 

Build more medical schools, you dopes.  

[BeaverFever]

12 hours ago, CdnFox said:

That's a pretty small part of the population

No it’s not, it’s nearly 1 in 3 Americans, which is why healthcare expenses are the leading cause of bankruptcy in the US. 

 

12 hours ago, CdnFox said:

and even they have access to some medical services

Yeah in charity facilities filled with homeless police and drug addicts   And in many states medical charities will set up tents in country fairgrounds and uninsured people line up for days just for a chance to be seen by a doctor it’s like a UN program third world country. 
 

12 hours ago, CdnFox said:

And it includes some very rich people who spend a LOT of money to get the most premium health services that we wouldn't see here. 

No, wealthy “self-insured” individuals who choose not to have insurance are counted separately. And besides that would be statistically insignificant number in a country of nearly 90 million uninsured or underinsured 

 

12 hours ago, CdnFox said:

Your argument is that 'it sucks to pay money' but as previously noted they save a buttload on their taxes compared to us as well 

The average American pays more for health insurance than Canadians pay in healthcare taxes.  In 2023, the average annual premium for employer-sponsored health insurance in the U.S. was about $7,911 for single coverage and $22,463 for family coverage in addition to out of pocket deductibles and copayments when care is needed. Meanwhile the conservative  Fraser Institute estimated that the average Canadian family paid about $11,885 USD in taxes ($2,975 per person assuming family of 4) for public healthcare in 2023, which they stated includes all income taxes, sales taxes, and other indirect taxes that contribute to healthcare funding. Given that FI is a right wing anti-government pro-privatization group that often puts out exaggerated statistics to support its ideology, we can rest assured their numbers are not understated. 
 

12 hours ago, CdnFox said:

So go to a cheaper hospital

Ok I’ll just confirm that I know you’re obviously joking when you say that but it’s worth pointing out that in USA your insurance decides what hospital you can go to (if you want to be covered) and your employer decides what insurance you can have and all the hospitals bill excessively. Meanwhile I don’t think Canadian hospitals are gouging public insurance like that firstly because they receive “global funding” for stuff like aspirin and other general supplies and for the things they bill for rates are negotiated and controlled. 

 

13 hours ago, CdnFox said:

And if you're dying and need assistance you can get into an emergency room with a short wait that doesn't involve changing the date on your calendar. 

Same in Canada. The people with the long ER waits are not the people who are dying, they’re people with minor injuries or illnesses like needing stitches or a broken arm set. Still, these times need to be improved. 
 

13 hours ago, CdnFox said:

well considering it's against the law in Canada to pay for medical services covered by the act, i should HOPE you're not surprised  but while it isn't a cause for bankruptcy, it IS a cause of death. So think about that for a minute. 

So i'll ask the same question i asked Matthew -  why should a person who can afford health care die so that someone else they don't know can have access to it? Why is that fair?

Again the statistics show that for the exact same illnesses and treatments, Canadians have better healthcare outcomes than Americans. A big reason for that is the huge disincentives Americans have to access primary care meaning they miss opportunities for early diagnosis, prevention, and less complicated treatments. Even many good plans have deductibles that don’t kick in until you’re several hundred or several thousand out of pocket. Americans die because having to spend $250-$500 for an annual physical checkup just to be told everything is fine means many Americans don’t even bother getting one until they start to feel so ill that spending that kind of money is worth it. Often their illness is far more advanced by then and more drastic interventions are needed and/or post-treatment recovery is more complicated.  And then once your insurance coverage limit is reached you’re discharged whether you’ve fully recovered or not. But not before they’ve found ways to bilk your insurance for  everything under the sun that they think they can get paid for  

 

So your question has 2 faulty premises:  

1) That the person “who can afford healthcare” represents the average American when in fact it doesn’t  Only relatively wealthy Americans can afford healthcare. The rest can only afford healthcare as long as they don’t get seriously ill or injured.  

2) That excess deaths are occurring Canada when in fact they are occurring in USA