I'm no Canada expert, but I'm pretty sure that there *are* private doctors in Canada. Like in the US, healthcare in Canada is administered by private doctors and hospitals; the difference is that the government pays for your treatment instead of insurers. The version orange.toaster described sounds more like the UK to me.

Also, I really can't speak on the overall tax burden (which is presumably higher in Canada, since the US doesn't have a tax to support healthcare other than Medicare), but the cost as a whole is definitely higher in the US (15% of GDP) than Canada (10% of GDP, which is smaller to begin with).

@Draugnar - Because they choose to work a second job to pay their debt instead of declaring bankruptcy? That doesn't sound like much of a choice. It also looks like anyone who does "choose" that option will take a lot of heat from ag7433 for being a slacker.

3 comments:
1. I agree completely with the comment above (from Dingleberry?) that insurance was supposed to be for catastrophes. We need to go back to that. We need access to doctors and nurses and hospitals and scripts, but we don't need to have every routine visit covered. What most people don't undestand is that they are NOW paying MORE in the US every month for insurance than they would pay for these routine visits. For example, Mass. is very expensive. Insurance costs $1200/month for a family plan. No way will a family spend that every month except when there is a catastrophe. Sure your employer pays most of it, but then thats money the employer can't put into your pocket!!! Most workers do not understand that. It would be better for workers to buy a $1000 deductible policy, pay for their own routine visits and spend only $300/month for catastrophic insurance. THe only losers would be the insurance companies.

2. I went to Cuba last year and got a parasite, high fever, etc. At 10 PM a doctor, nurse, and translator came to my HOTEL room and stayed 3 hours. gave me an IV, lab test, and scripts for the next day. total cost was $95. No way you would get anything like that quality of care in the US

3.I work in government so I am biased BUT the only real objection to health care reform is coming from insurance companies. They are the only ones who stand to lose if we have reform. ANd what do they object to? That the public sector will be more efficient and cost LESS than they do. Oh my God. You have to laugh.

@grncton - Did you read what I wrote? They don't have to declare bankruptcy. They can effectively ignore the debt as medical debts can not be forcibly collected in the US. And phone calls from collectors can be stopped with a simple certified letter requesting that all future communication be in writing only. The Fair Debt Collection Practices Act requires debt collectors to abide by that request. So you get a bunch of letters instead of phone calls and toss them like junk mail. Most sheep just don't realize their rights and their protections both in debt collection and medical bills.

I was unemployed six months in Ohio where consultants don't get to collect unemployment. I've still got debts from then. I just ignore the letters and have set up with the court a fair and reasonable payment agreement for ALL my old debts that the court administers. 15% of my net pay goes to Boone County, KY court where they distribute it. If a request for attachment comes in, I can either protest it and have a hearing or, if I agree, just write a simple letter accepting the debt and the agency/company is added onto the list. Approximately $700 a month goes to pay off the old debts and I don't lose a single night's sleep over it nor worry about declaring bankruptcy. Once the debts are paid off, in about 7 years my credit will be restored and all without any declaration of bankruptcy or using some debt relief agency that takes their cut from the payments and/or gets the debt reduced, which can come back to haunt you as the remainder can be sold off to another agency in the future.

@Crazyter - "That the public sector will be more efficient and cost LESS than they do. Oh my God. You have to laugh." Sorry, but I laugh at that statement, T. I know you are in government (we've talked about it before) but government bureaucracy would most definitely NOT be more efficient and cost less. Last I checked, the private sector doesn't pay hundreds for a hammer. The government bureaucracy has so many layers and so many palms to grease at the Federal level that it could NEVER be as efficient or inexpensive as the private sector.

Dragnar-Exactly. That is why I am laughing. Because I have heard 3 times on the news this summer that the biggest objection is that the "public option" will cost less and therefore "undermine" the private plans. Well if this is true, fantastic, bring it on and lower everyones's costs. Or if , as you say, government is not more efficient, then it won't undermine the privates, so what's the problem?

The problem is that it will undermine in direct costs because everyone will pay for it in their taxes, even if they don't use it. Therfore, with little or no direct costs to the recipient, it will undermine the private insurance who doesn't get to collect money from the general fund and it will be substandard and loaded with bureaucracy with government buffoons making the decision to cover or not cover it. It will cost the american tax payer more, but the visual out of pocket (people don't consider taxes as ot of pocket) will be considerably less.

It's a similar issue I had with McCain's plan. It'll make the perceived costs less, especially for the young people who don't need all ythe extra services so that they all jump ship on the employer sponsored plans. Those plans then will get a huge rate hike because they no longer have the large membership to spread the risk across, causing the older employee's rates to go up or even causing the medium or larger business to stop providing coverage altogether.

Think of it this way... You pay for something provided by the government through your taxes even if you don't use it. If you want a private alternative, you still have to pay the taxes for the public version. where is the incentive to stay with the private version and effectively pay twice for it? That's why many states have voucher programs for schools. they make up for the fact that your tax dollars are being collected for the public school but your kid is going to private school where you have to pay again.

>I'm pretty sure that there *are* private doctors in Canada

Orange.toaster must have meant that there are no *privately-paid* doctors in Canada. The doctors, nurses, hospitals, etc don't work for the government, but they are only paid by the government.

(Even this is not true for, say, cosmetic surgery. But we're not worried about that.)

I would like a system as in Canada but with the change that privately paid care is also legal. Individual doctors and hospitals could accept either or both. I would also *really* like to see some economic analysis of how much that change in the law would change the health care system in Canada.

I'm quite late to this conversation, but Kestas, I am very much in favor of reform.

In my experience, and that of most of my friends, the current health insurance system in the US doesn't work very well. It costs too much and there is a profit motive to not pay for care.

I think the market is great for many many things, but I've come to the conclusion that healthcare (or at least insurance) isn't one of them.

DJB and Draugnar have articulated very well why health insurance companies work the way they do, and it makes sense for them to be run the way they are as profit making companies, but to me that's exactly the problem. To run an insurance company well as a business is, I think, in many ways in opposition to the goal of providing good healthcare to the population.

I'd love to switch to a single payer system, (or even an NHS like system, though that'd be pretty hard to set up in the US at this point, not just politically but also in a logistical way) but at least at this point in time, I think the best we can hope for here in the US is to regulate the private insurance companies, and ideally to provide a strong public option to compete with those private insurance companies. I'll take a disinterested government bureaucracy over a private one with a profit-motive to deny me care.

I know people are concerned about the costs and bureaucracy, but the costs are already higher per capita than just about anywhere in the world, and I recall hearing an interview on Fresh Air a year or so ago that pointed out that the bureaucratic costs among all the the various insurance companies were also higher than in almost any other system around the world.

People worry about rationing, but to my eye we already have that. It's just based on income rather. If you're rich and/or have really really good health insurance (which is in turn likely costing you or your company or both a whole lot), you get fast good healthcare. If you aren't in one of those categories, you have to wait, and when you do get healthcare it's second rate at best.

@Draugnar - You have pointed out that people don't have to pay medical bills, etc. That sounds to me an awful lot like we already have a system where we're all paying for everyone's coverage then. It's just really inefficient. So why not just acknowledge this fact and go ahead and switch to a more efficient single payer system. We're all paying for it anyway.

@Draugnar - I'm glad things worked out so well for you in your case. At $700 a month for 7 years, it looks like you're paying close to $60,000. Obviously you can afford that, but I know plenty of people whose finances wouldn't be able to handle anything close to $700 per month, let alone keeping that up for 7 years. Besides, if everyone were to try to play the system this way, how would doctors get paid? In installments over a 7-year period? This might work to keep you from going bankrupt, but it's really just delaying your payments and meaning that the people on the receiving end (the doctors and hospitals) are getting hurt.

Dragnar-You say "You pay for something provided by the government through your taxes even if you don't use it." But right now that's exactly the problem with the current system, just substitute the word "insurance company" for the word "government"

I completely agree with these comments:

"DJB and Draugnar have articulated very well why health insurance companies work the way they do, and it makes sense for them to be run the way they are as profit making companies, but to me that's exactly the problem. To run an insurance company well as a business is, I think, in many ways in opposition to the goal of providing good healthcare to the population."

(Draugnar) "pointed out that people don't have to pay medical bills, etc. That sounds to me an awful lot like we already have a system where we're all paying for everyone's coverage then. It's just really inefficient. So why not just acknowledge this fact and go ahead and switch to a more efficient single payer system. We're all paying for it anyway."

@grncton - First, understand that my $700 is 15% of my takehome. 25% is standard garnishment and, in states with voluntary garnishments/court sponsored debt management, 15% is pretty normal. So for someone taking home say $2000 a month, it would only cost them $300. With the courts being involved and a willingness to do the voluntary administrative garnishment, the courts will usually drop any interest requests of the creditors. Of course, we have had to tighten the belt. I play WoW and softball every week, my wife does bingo every week, and we have a Netflix subscription for additional entertainment, but eating out is restricted to one night a week at Skyline (for those not in greater Cinci, Skyline is a Cincinnati/Greek-style Chili Parlor), and one fancy night per month at someplace nicer. so it can be done. You learn to tighten the belt and you just do it.

A far as replacing the word "government" with "insurance company"... I can pcik and choose which plan I'm under and if I opt out (say my wife had it, so I didn't need it) I wouldn't have to pay for it. Can't do that with taxes or they put you in jail. So no, you can't just substitute the two phrases, CrazyTer. That is completely naive to think the two are the same thing, and makes me wonder about your qualifications to run a small town or village or township or county or whatever it is you manage (I forget).

I believe is easier to tighten your belt from U$s 4666 to U$s 3966 than it is to tighten from U$s 2000 to U$s 1700.

Also, the other guy needs to tighten his belt for 15 years, instead of 7.

@Draugnar: Which server? :P lol (I've been Blackrock since release date.)

@Everyone: You're all right and wrong at the same time ^_^

@ kestasjk
I am not going to read the other responses but I do want to reply. This is an idea that has been tried too many times before and fits in the same category as communism in theory it sounds great in reality it will never work due to human issues and greed on the part of doctors and other medical personal. Plus our economy is on the verge of collapsing and our government ignores this fact and decides to make nationalized health care. Brilliant idea.

@jmo -
If "it will never work" then why is Canada still around? I'll be the first to say their system isn't perfect. But it works just fine and generally tends to get somewhat higher satisfaction ratings than ours. So I'll need more convincing to believe that a plan like the Canadian one will never work.

the Canadian gov also wasn't trillions of dollars in debt when the plan was implemented.

What of the debt? There is good debt and bad debt.
War on drugs - bad debt
War on Health care - good debt

I am saying that when the Canadian gov initiated it they had more economic resources available then the US currently does. If our gov (our=US citizens) straightens out the economy then fine do whatever with health care, but because the gov cannot seem to fix the economy that needs to be the main priority and whoever argues nationalized health care will help fix the economy is a fool or misguided.

@ag7433 - are you going to respond to what I asked you yesterday?

@Jamiet:

Hospital to Hospital: The person is a junky and addicted to perscription drugs. Even the courts agree.

Knocked up: Yes, raising kids are a full time job. My wife is a stay at home mom. My mom was too. But this is a choice and a luxury. If you can't live this lifestyle, then don't have 5 kids from 4 different men to live in a one bedroom appartment, without any father figure (help) or income.

From personal experience, if our family couldn't afford "mom" staying at home, she had to get a job and ask other family/friends to watch the kids. Nobody should have the OPTION to choose to get paid by the government for watching their own kids. That's incredible you're trying to justify this.

I can see the ad now, "Women, do you have more than one child? Are you sick of working? Yes? Do you want to be paid for watching your OWN kids? Then you are in luck! All you need to do is quit your job."

@ ag7433: "The person is a junky and addicted to perscription drugs"

Addiction is a recognised metnal heatlh issue. In the British NHS system this person would get free help to cure their addiction.

"Raising kids are a full time job" / "This is a choice and a luxury"

It's because people like you view time spent bringing up children properly as a "luxury" that society has so many problems. If people actually acknowledged that giving children a good, caring upbringing is a necessity, and NOT a "luxury", we'd have a much happier, better-adjusted populace. You almost seem to be arguing that poor people should not be allowed to have children.

MENTAL health. Not 'metnal'. Doh.

Jamie,
That's an interesting point, but where do you draw the line between whether you can afford a kid? I agree that poor people should be allowed to have children. I also don't want millions of single moms with 20 kids that I have to support. So where is the line to draw saying 'ok, when you had 2 kids, you were staying at home and being a good mom, but now with 10 kids, its obvious you're just milking the system for extra welfare money'?

BEFORE having children, you need to figure out whether you can afford it. AFTER the fact, I agree the child shouldn't suffer. But I don't have a solution.

@Jamiet: The argument here is circular, and I'm not interested to debate it with you. If you can't acknowledge that a person should be have personal responsibility on the choice to have children, then this is pointless to discuss.

Poor people should have children, and many do while still being employed (or at least trying to be) and creating a quality support system for the children.

Dingle - I agree with you that it's a difficult question and I was perhaps taking too simplistic an argument. I just felt that ag7433's original comments gave the impression of not putting very much value on the importance of the work done by stay-at-home mothers who are deliberately staying home to give their children the best possible upbringing.

What they are doing IS work, and it is work that brings benefits not just for their own family, but for society as a whole, by producing well-adjusted children who grow up to be useful and productive citizens - so to a certain extent I think state support for such parents is legitimate.

But I agree it is difficult to say where you would draw the line - I accept your point.

@ ag7433: "I'm not interested to debate it with you"

I think it's a shame that you bring up an important social issue and then don't want to debate it, but I guess that's up to you.