Single payer healthcare system discussion

Duke said:

Wayslow said:

I work for a company that has great medical, drug and dental coverage. Part of this coverage includes access to care outside of Canada. It can be used in case of a critical illness that either has a long wait time or if there’s new treatment not yet available in Canada. No one has had to use it yet and I hope not to be the first but it’s nice to know I have options.

 

At the risk of sounding like a douche: Why does that type of coverage even exist?  I thought national health care was the bestest thing ever.

 

OK, maybe the point of that was to sound like a douche.  I think I'll leave this thread before I get even more pissed off.

 

It exists because the provincial governments who pay the medical bills don't want to pay other jurisdictions to do it at their rate, and the people that do it don't want to trust a government insurance company to pay the bill. It falls very much into the earlier conversation about hospital bills based on insurance companies paying vs. cash payment. 

Travel insurance for a Canadian is cheap, cheap, cheap.  $20 gets you covered for a week in the US if you are even remotely healthy...Of course, the biggest cost is the plane they send to fly you home after the American  emergency room has stabilized you.

Duke said:

Sorry, it was a rhetorical question aimed at supporters of nationalized health care, not at you.  My apologies to you.

I am continually bombarded by people insisting how much better and more effective socialized medicine is, and frequently told how much better Canada's system is than the US's.  Based on that propaganda, I am questioning why insurance coverage that makes it possible to get healthcare outside of Canada should ever be necessary.

 

Just because it's better (your words not mine) doesn't mean it's perfect in every way.  Unless, of course, you have insurance that lets you take advantage of all the options.

But you're far too smart to not know that.

Medicare is not free.

Since it is for those on social security a good chunk is taken out of the monthly check to help pay for coverage.

Duke said:

In reply to tuna55 :

This.

In the first half of 1990s not much was getting built in the private sector, so as an architect one of our revenue-generating specialties was renovating public housing projects.  We spent a lot of time touring and surveying typical taxpayer-funded public housing.

In about 1993 or so we were renovating a development of housing authority townhouses in southeastern Pennsylvania.  The residents were always extremely interested in what was going on, of course, so we would talk to them a little.

I met an older woman who was considered the 'queen' of this particular housing project, because she had lived there since it was built.

In 1967.  So tell me again about how the average stay is 13 months?.  Now, this woman was maybe in her mid-60s.  Which meant she had moved into this taxpayer-funded complex at about age 40... and never left.  She had no full time job I ever saw because she was always there during the week with her nose in our business.  Maybe she worked nights or weekends - but I have no reason to believe it.

She was also getting other public assistance because I saw her food stamp books all over the dining room.  This was back in the day when they were actual coupons.  I can only assume that she had been doing so since 1967 as well.

I can tell you a hundred stories about things I saw in public housing units all around the PA / DE / MD area, which I'm sure are typical of those in the other 47 states.

Most units were pretty shabby, and shabbily kept by their tenants; unclean and a bit crowded with junk.  About 2 in 10 looked like a 'normal' lower-middle-income household, reasonably clean and taken care of.  About 2 in 10 were jammed full of expensive rental furniture, big TVs and stereos, gaming systems, etc.  Way more stuff than we had as a young double-income professional couple.  Funny how those units always seemed to be smokers, too.

And about 1 in 10 was scrupulously clean, neat as a pin, and furnished with maybe an obvious thrift store sofa, a couple milk crates, and a small old TV.  I never minded helping those folks.  The others, not so much.

 

So now you are condemning a whole program because of the conduct of a few?  I'm sure the lady in question did in fact move in as claimed.  That happens.  What wasn't explained is how did she wind up in public sector housing?  Is she retarded? Some serious medical condition? Does she suffer from Down's syndrome Is she crazy? Only sane if on her medication?  or some other severe medical condition?    I do know no one gets on welfare if they can avoid it.  
 

If you doubt me please try to apply. 
 

Public sector housing is not welfare.  It is an assistance program because few people on welfare can afford housing. Most  of that receives major funding from the government or charities. Or a mix of state, local, federal,government  and charities. 

While individual workers don't profit from such programs  the power behind the company often bribe their way into a winning bid through political contributions. So the profit must be high!  

However it is rare indeed to get such housing. There is massively higher demand than availability. . I'm sorry I'm really tired and hungry so I won't look it up but off the top of my head one in every 3.? (May be a whole lot worse one in 7 ? ) Gets a place in government sponsored housing.  

 Yes I can believe some/ most places are pigsties.  You're dealing with the lowest of American's.   Inbreeds, retarded, mental instability, Down syndrome,  And their children and their children-interbreeding with others of such dubious character. Yes, sex goes on in such places.  
 

My question for you is.  None of these people are really Stirling examples.  So what should we do with them if not for Welfare and other programs that take care of them?  
 

Remember, doing nothing is the most expensive choice.  

iceracer said:

Medicare is not free.

Since it is for those on social security a good chunk is taken out of the monthly check to help pay for coverage.

So they give you back your money that they took from you originally so they can take it from you again. Super awesome. I wonder how much you lose to parasitic friction in THOSE transactions. 
 

The simple fact is that we spend more - sometimes much more - for healthcare than any industrialized country. 

This would be just peachy if everyone had good outcomes.  Problem is, we spend far more AND have poorer outcomes than comparable countries. 

Follow-up exams after surviving cancer are a "pre-existing condition"

TL;DR:  Woman successfully beats breast cancer, needs to have annual mammograms for a period to ensure it is staying beat.  Switches jobs, gets different health insurance.  New health insurance DOES cover mammograms as regular health checkups, except in her case because they found an excuse by calling it a pre-existing condition.  Even though the kind of mammogram she needs is a less intensive procedure than a typical one because they know what they are looking for.

Duke said:

iceracer said:

Medicare is not free.

Since it is for those on social security a good chunk is taken out of the monthly check to help pay for coverage.

So they give you back your money that they took from you originally so they can take it from you again. Super awesome. I wonder how much you lose to parasitic friction in THOSE transactions. 
 

2% compared to private insurance average net cost of 35%.  
Which is a big part of why private insurance is so expensive yet America doesn't have as good health results as the other industrialized countries in the world.  

I'm not going to get into this too much, but I went bankrupt in 2007 after a cancer diagnosis.

I had a quite good personal policy and was well taken care of, but because of loss of work, personal financial outlay, etc etc. I was completely broke, all savings gone. 

If I didn't have my mothers aid financially (which many don't) I'd have been on the street.

And thru all this I couldn't deduct a single cent off my taxes, not for premiums, not for out of pocket, nothing. (My income that year was over the maximum for any deduction, though certainly not a lot of money given the region in which i live)

Fixing the Tax code to make premiums and out of pocket deductible would certainly be something we could do rather than deductions for personal jets.

Foxworx said:

I'm not going to get into this too much, but I went bankrupt in 2007 after a cancer diagnosis.

 

I had a quite good personal policy and was well taken care of, but because of loss of work, personal financial outlay, etc etc. I was completely broke, all savings gone. 

If I didn't have my mothers aid financially (which many don't) I'd have been on the street.

 

And thru all this I couldn't deduct a single cent off my taxes, not for premiums, not for out of pocket, nothing. (My income that year was over the maximum for any deduction, though certainly not a lot of money given the region in which i live)

Fixing the Tax code to make premiums and out of pocket deductible would certainly be something we could do rather than deductions for personal jets.

Thanks for the post. My dad and I were discussing our situation with my daughter after she passed. Had it been my brother in the same situation, he would have declared bankruptcy. It literally would have been his only option other than bleed mom and dads retirement (and my brothers inheritance) dry - for hospital bills for their deceased granddaughter. Obviously there is something massively wrong. For those whom are fortunate, like me, the system works pretty well overall. For those who are less fortunate, like my brother, it doesn't. 

CJ said:

Problem is, we spend far more AND have poorer outcomes than comparable countries. 

How much of that has to do with our overall health and lifestyle vs other countries? Maybe that was covered earlier in the thread, I haven't read all of it. 

Now I can't condemn anyone as I need to get my fat ass back in shape as well. 

Foxworx said:

I'm not going to get into this too much, but I went bankrupt in 2007 after a cancer diagnosis.

 

I had a quite good personal policy and was well taken care of, but because of loss of work, personal financial outlay, etc etc. I was completely broke, all savings gone. 

If I didn't have my mothers aid financially (which many don't) I'd have been on the street.

 

And thru all this I couldn't deduct a single cent off my taxes, not for premiums, not for out of pocket, nothing. (My income that year was over the maximum for any deduction, though certainly not a lot of money given the region in which i live)

Fixing the Tax code to make premiums and out of pocket deductible would certainly be something we could do rather than deductions for personal jets.

I had intestinal cancer a few years ago. It was caught early during a routine colonoscopy. My surgery was less than a week after diagnosis. We had a lot of things to worry about but what is was going to cost wasn’t one of them. I have no idea what my surgery, hospitalization and follow up treatment cost but I assume it was incredibly expensive. I was also fortunate to have private insurance coverage that took care of the extras like a private room and in home post surgical care.

As I noted in an earlier post I’m lucky enough to have options outside of our socialized healthcare system but I’m also fortunate to have never needed to use them.

Bottom line is a large chunk of my pay cheque goes to cover the cost of our system but I try not to resent it since it seems to work pretty well. 

z31maniac said:

CJ said:

Problem is, we spend far more AND have poorer outcomes than comparable countries. 

How much of that has to do with our overall health and lifestyle vs other countries? Maybe that was covered earlier in the thread, I haven't read all of it. 

Now I can't condemn anyone as I need to get my fat ass back in shape as well. 

Lifestyle plays a part, obviously, but there are plenty of fat and lazy Canadians and Europeans. My exposure to health care, even as a full-time employee, is that using it can be seen a last resort. You have to have insurance but you can still.be financially crippled for life if you get the wrong kind of sick. You might not get fully better because of the cost of missing work (albeit sometimes this is a personal choice) or the cost of ongoing treatment vs. what you can afford. How many people have we seen in our personal/professional lives who put off going to the doc as long as they can, hoping it will get better on its own? How many stop going when they feel better rather than continue treatment? I would argue that it's too many people to simply be coincidence or dislike of doctors. 

I've gamed online with a bunch of Europeans and the consensus is that people go to doctors more frequently and much sooner. They don't wait nearly as long to get help because they don't have a "what if I can't afford it and it ruins my kids lives" monkey on their back. I believe that the potentially crippling cost of healthcare in the US is a not insignificant factor in serious illness which then feeds the cycle with the cost of treatment for serious injury. 

There is no reason for Americans to fear personal ruin for going to a doctor. Healthcare, much like the Tax Code, does not represent The People anymore and both need to be rebuilt from the ground up.

tl;dr The sicker we are when we seek treatment, the more it costs. Period. Whether insurance, your wallet, or the government is paying it costs more when your treatment is more serious. More reasonable healthcare might well lower healthcare expenditures. 

Wayslow said:

Bottom line is a large chunk of my pay cheque goes to cover the cost of our system but I try not to resent it since it seems to work pretty well. 

I'm curious how much actually does go towards the healthcare taxes?  

I just ran the numbers from my last pay stub and my insurance premiums, Medicare tax own HSA contribution total less than 10% of my gross pay.

Ian F said:

Wayslow said:

Bottom line is a large chunk of my pay cheque goes to cover the cost of our system but I try not to resent it since it seems to work pretty well. 

I'm curious how much actually does go towards the healthcare taxes?  

I just ran the numbers from my last pay stub and my insurance premiums, Medicare tax own HSA contribution total less than 10% of my gross pay.

You're doing good.  My health insurance premiums alone are close to $700/month starting Jan. 1st.

Ian F said:

Wayslow said:

Bottom line is a large chunk of my pay cheque goes to cover the cost of our system but I try not to resent it since it seems to work pretty well. 

I'm curious how much actually does go towards the healthcare taxes?  

I just ran the numbers from my last pay stub and my insurance premiums, Medicare tax own HSA contribution total less than 10% of my gross pay.

If I could get insurance for 10% of my income I'd be all over it. Even with my "insurance is extortion" mindset.

Ian F said:

Wayslow said:

Bottom line is a large chunk of my pay cheque goes to cover the cost of our system but I try not to resent it since it seems to work pretty well. 

I'm curious how much actually does go towards the healthcare taxes?  

I just ran the numbers from my last pay stub and my insurance premiums, Medicare tax own HSA contribution total less than 10% of my gross pay.

I was curious so I did the same thing, although it's not as accurate. I am paid twice a month (15th and last day, if those days fall on a weekend, you get the Friday before), so over the course of a year I will have 4 different paychecks. 72, 80, 88, and 96 hour paychecks. 

Using the 80 hour paycheck, my premiums/Medicare/HSA, is right at 6% for me. Jumps to around 10% if I include what I pay for my girlfriend. 

I pay $1,370/mo for health insurance for my family. That's me, my wife, and two small kids. That's way more than 10% of my gross pay, and I also still have to pay into Medicare and SS of course! Add in federal, state, and city taxes, and the average Canadian tax burden of 30.7 percent is sounding pretty dang good to me.

Don't get me wrong, we can afford it and I'm happy living here, but I don't delude myself into thinking there's no better way of doing things.

frenchyd said:

Duke said:

In reply to tuna55 :

This.

In the first half of 1990s not much was getting built in the private sector, so as an architect one of our revenue-generating specialties was renovating public housing projects.  We spent a lot of time touring and surveying typical taxpayer-funded public housing.

In about 1993 or so we were renovating a development of housing authority townhouses in southeastern Pennsylvania.  The residents were always extremely interested in what was going on, of course, so we would talk to them a little.

I met an older woman who was considered the 'queen' of this particular housing project, because she had lived there since it was built.

In 1967.  So tell me again about how the average stay is 13 months?.  Now, this woman was maybe in her mid-60s.  Which meant she had moved into this taxpayer-funded complex at about age 40... and never left.  She had no full time job I ever saw because she was always there during the week with her nose in our business.  Maybe she worked nights or weekends - but I have no reason to believe it.

She was also getting other public assistance because I saw her food stamp books all over the dining room.  This was back in the day when they were actual coupons.  I can only assume that she had been doing so since 1967 as well.

I can tell you a hundred stories about things I saw in public housing units all around the PA / DE / MD area, which I'm sure are typical of those in the other 47 states.

Most units were pretty shabby, and shabbily kept by their tenants; unclean and a bit crowded with junk.  About 2 in 10 looked like a 'normal' lower-middle-income household, reasonably clean and taken care of.  About 2 in 10 were jammed full of expensive rental furniture, big TVs and stereos, gaming systems, etc.  Way more stuff than we had as a young double-income professional couple.  Funny how those units always seemed to be smokers, too.

And about 1 in 10 was scrupulously clean, neat as a pin, and furnished with maybe an obvious thrift store sofa, a couple milk crates, and a small old TV.  I never minded helping those folks.  The others, not so much.

 

So now you are condemning a whole program because of the conduct of a few?  I'm sure the lady in question did in fact move in as claimed.  That happens.  What wasn't explained is how did she wind up in public sector housing?  Is she retarded? Some serious medical condition? Does she suffer from Down's syndrome Is she crazy? Only sane if on her medication?  or some other severe medical condition?    I do know no one gets on welfare if they can avoid it.  
 

If you doubt me please try to apply. 
 

Public sector housing is not welfare.  It is an assistance program because few people on welfare can afford housing. Most  of that receives major funding from the government or charities. Or a mix of state, local, federal,government  and charities. 

While individual workers don't profit from such programs  the power behind the company often bribe their way into a winning bid through political contributions. So the profit must be high!  

However it is rare indeed to get such housing. There is massively higher demand than availability. . I'm sorry I'm really tired and hungry so I won't look it up but off the top of my head one in every 3.? (May be a whole lot worse one in 7 ? ) Gets a place in government sponsored housing.  

 Yes I can believe some/ most places are pigsties.  You're dealing with the lowest of American's.   Inbreeds, retarded, mental instability, Down syndrome,  And their children and their children-interbreeding with others of such dubious character. Yes, sex goes on in such places.  
 

My question for you is.  None of these people are really Stirling examples.  So what should we do with them if not for Welfare and other programs that take care of them?  
 

Remember, doing nothing is the most expensive choice.  

 

 

 

 

I think it's important to completely exorcise case studies from debate.  There is always "that one person" or "that small group" that can be used as an example, but it doesn't represent the whole population.

Its incredibly powerful for Oprah and Springer, but it doesn't further any cause in the grand scheme.

I'm all for the capitalist endeavor.  If you make money, great.  If you don't, great.  You do you.  What I can't abide is the government intentionally and corruptly giving $1.22T back to the 1% and asking us to shoulder the burden because our legislators benefit from it while we have real, solvable, tangible problems that could be entirely eliminated with a small fraction of that tax revenue.  I also can't sit by while people turn away from the real issue, shift the blame to "lazies," and support the intentional unequal distribution of wealth.  The same people who clamor about capitalism and "let me keep my money" are completely disregarding that they are the victims of the very problem they fight against.  They scream "don't take my taxes for welfare" while ignoring the fact that their taxes are being ripped from them to support the 1%.  They may talk about being charitable, but they are just passing the money up the ladder and further raping the lower income people.

I'm not suggesting we take all the money and give it out equally for everyone, but it has been a proven, known fact for hundreds of years that societies in which the law provides greater opportunities for people to achieve sustainable wealth and therefore a more equitable distribution of wealth are stronger and more successful than those that don't.  I'm not talking about socialism or governments giving handouts to poor people, I'm talking about setting up a system in which success is facilitated, not thwarted.  By that I mean not taking trillions from the middle class and stuffing it in the pockets of the already rich in return for campaign donations and swaying political favor.  I want to see a system set up to facilitate a less biased distribution of wealth so that we can achieve success on our own instead of disproportionately giving it to the rich.  We can't get there by dictating that we spread it out, we need to set up a system where you can succeed in your own way.  We don't have that by a long shot.

Hundreds of studies have shown how a capitalist society that incorporates things like UBI, universal or single payer healthcare, and subsidized education are among the happiest and most successful societies on the planet.  We do the opposite.  We have the highest cost for healthcare, welfare dollars for those who need it are incredibly difficult to attain, and we destroy people's financial lives with student debt... all while ignoring some of the main causes of the compromised population; mental health.  It's little wonder we have high crime rates and high suicide rates.  We're broken.

So any argument for increasing exclusiviity, tightening welfare restrictions, or furthering the "I wanna keep my money" are not really valid to me when there are trillions of dollars that the government gives to the 1% while we fight amonst ourselves by shooting a person over french fries.  Taking a step toward more exclusivity is a step toward serfdom.  We need to evolve, not devolve.

In reply to Ian F :

Interesting question and to be honest I wasn’t sure so I did a little research. The answer is it depends. An average family of four with a total income of $127k will pay about $6k towards our healthcare system annually. This number represents an average. The lowest income earners pay far less to nothing whereas the highest shoulder a larger burden. 

Looking at the taxes is not going to give you a realistic number.  There are all sorts of costs in the system that are being taken on by the private system (e.g. uninsured / un-reimbursed hospital visits), so you need to add in some of your insurance costs, which are (for many) mostly paid for by an employee.  I am sure there are other sources of "bleed" also.

dculberson said:

I pay $1,370/mo for health insurance for my family. That's me, my wife, and two small kids. That's way more than 10% of my gross pay, and I also still have to pay into Medicare and SS of course! Add in federal, state, and city taxes, and the average Canadian tax burden of 30.7 percent is sounding pretty dang good to me.

Don't get me wrong, we can afford it and I'm happy living here, but I don't delude myself into thinking there's no better way of doing things.

OUCH. For my girlfriend and I, I pay around $175/month for health/vision/dental. And it's excellent. 

Her RA meds and doc visits only end up using about what the company puts in the HSA every year.

aircooled said:

Looking at the taxes is not going to give you a realistic number.  There are all sorts of costs in the system that are being taken on by the private system (e.g. uninsured / un-reimbursed hospital visits), so you need to add in some of your insurance costs, which are (for many) mostly paid for by an employee.  I am sure there are other sources of "bleed" also.

Which is one of the reasons for the (mostly) successful Canadian system.  Single payer has eliminted the rampant profiteering, which means that when I (or the government in the case of Canada) pay my insurance premium, I'm not paying insane money to cover a $200,000 ailment for an uninsured person.  If you take away the craziness of how our unchecked healthcare economy operates, you don't have the situation where people have to choose between rent or seeing a doctor for the flu.

z31maniac said:

dculberson said:

I pay $1,370/mo for health insurance for my family. That's me, my wife, and two small kids. That's way more than 10% of my gross pay, and I also still have to pay into Medicare and SS of course! Add in federal, state, and city taxes, and the average Canadian tax burden of 30.7 percent is sounding pretty dang good to me.

Don't get me wrong, we can afford it and I'm happy living here, but I don't delude myself into thinking there's no better way of doing things.

OUCH. For my girlfriend and I, I pay around $175/month for health/vision/dental. And it's excellent. 

Her RA meds and doc visits only end up using about what the company puts in the HSA every year.

The under 10% figure I stated is just for me.  The famliy plan at my company is more than 2x that for the base plan.  A lot of my coworkers complain about our health plans, although I haven't had too many issues. That said, I work in a very employee-competitive industry and the health insurance is sometimes stated as a reason for leaving.  The company adds nothing to an HSA, although it does cover a fair amount or those who have HRA plans.  Since I don't really go to the Dr very often, I go the HSA route. 

z31maniac said:

OUCH. For my girlfriend and I, I pay around $175/month for health/vision/dental. And it's excellent. 

Her RA meds and doc visits only end up using about what the company puts in the HSA every year.

I'm betting your employer kicks in a ton of money for you to get that premium. I'm self employed, so shop on overall cost not just the employee's share, and it all comes out of my pocket directly. A (I'm sure larger) share comes directly out of your employer's pocket, but indirectly out of yours as it's still a cost for them of employing you.