45 replies to this topic

[pebbles]

Kaleidoscope said:

Would the same type of system work in the States? I don't know. You're dealing with 300 million people, not 12 million and illegal immigration could cripple the system.

Canada's system is run by the provinces.  Federal gvm't pays a certain amount of money to each province for health care, plus whatever the province spends on its own.  I figure a State-based system would work well in the US.  

And non-citizens and non-residents of canada are NOT covered under our system, ditto for illegal immigrants.  Although it's a bigger problem for the US, I admit.  I think illegal immigrants already pose a financial and ethical dilemma under the current system in the US.

[pebbles]

DrinkTheElixer said:

I have worked in the NHS for 16 years and have never seen this happen - ever.  Often breaks are missed more than anything else.  If I added up the money I was owed for missed breaks and unnoficial overtime, I would be rolling in it. For the record, surgeons do not take a break for 'tea and stickies' in the middle of what they are doing.  I have worked in quite a few hospitals and despite your friends experience I can tell you that this is not normal practice. The idea of someone breaking off  mid-operation to have a cup of tea at 4.20pm is nothing short of ridiculous.

We stopped Rounds for the World Cup soccer.  No joke.  :cool:

[OneArpeggioPete]

pebbles said:

We stopped Rounds for the World Cup soccer.  No joke.  :cool:

:eek: what would have happened if canada had actually been in it?

:-)

oneArpeggiopete:cool:

[pebbles]

OneArpeggioPete said:

:eek: what would have happened if canada had actually been in it?

:-)

oneArpeggiopete:cool:

lol.....  :)   Many of our surgical residents come from Saudi Arabia - THEY at least had a team to cheer! :p

[OneArpeggioPete]

pebbles said:

lol.....  :)   Many of our surgical residents come from Saudi Arabia - THEY at least had a team to cheer! :p

i'm glad to hear your ward rounds were only curtailed for the group stage... :rolleyes:

:-)

oneArpeggiopete:cool:

[Sweden]

I though it was very interesting to read Christie's comments about the two systems.

I believe there are two important parts of this discussion. First you have the discussion regarding which system that "works best", is more efficient, firendly, accessible etc. With regards to this I presume you can find arguments both for privately and publicly founded healthcare, and it's more up the organisational aspects than anything else.

More importantly though, you have the more fundamental issue on whether healthcare should be provided by the government or other public bodies, for free or at very low cost to the individual. My answer is a clear 'yes'.

On another note...

Kaleidoscope said:

If you want a white filling my dentist would charge a private fee of 45.00 per filling (the 15.50 check up fee is additional).

'White fillings' as in porcelain/plastic fillings? As opposed to what? I can't imagine amalgam fillings being used anywhere, at least in the developed world, anymore.

/David

[OneArpeggioPete]

Sweden said:

'White fillings' as in porcelain/plastic fillings? As opposed to what? I can't imagine amalgam fillings being used anywhere, at least in the developed world, anymore.

/David

they are... in the second richest country in the eu. i just got one last week. you get white ones if you want to but you have to pay extra.

:-)

oneArpeggiopete:cool:

[Mary]

Christie, that was an interesting read, thanks for making that comparison/analysis.  

I don't have health insurance--haven't since I left my last job over a year ago.  The small office where I work doesn't offer it, and since I don't make much money, it's not something I can afford to keep up on my own.  This is common all over the U.S., obviously, but I think it has a particular impact in rural regions such as where I live, where there aren't a lot of big industries/companies operating with a lot of resources at their disposal.  I know many, many people around here who work full-time and beyond who don't get insurance through work, and who can't afford it on their own.  

The job market being what it is here, if I were to hold out for a job with benefits I'd basically have to wait until everyone already in those positions retires or dies off.  :p

Most of that, I can accept.  It was my choice to move back to this area, when I was making my decisions I understood the economic implications of living in an area like this and despite that, when I weighed my options this still won out.  Still does.  :)  And I know getting insurance through one's workplace isn't a right, it's a privilege, so I don't resent the fact that my employer doesn't do so.  

What I find maddening is that despite the fact that I work full-time and pay an assload in taxes considering how little money I make (over 1/4 of each of my paychecks goes to state/federal taxes, which seems like a lot to me particularly after moving back from Montana), if I wanted to apply for the state-run insurance plan I would, disturbingly, be at too high of an income bracket to qualify.  So I can't afford insurance on my own, I couldn't qualify for public aid if I wanted it...and yet, I can pay out 1/4 of each paycheck to support everybody else.  And to me, that seems fucked-up.

That said:

As with a lot of things in the US, it seems that over there healthcare is world-leading if you're rich, and non-existant if you're not.  

I have to say, I think there's a lot of truth to that.  I wish it wasn't that way, but I think it's getting more & more like that all the time.  Something's gotta give.

[lizish]

Mary said:

What I find maddening is that despite the fact that I work full-time and pay an assload in taxes considering how little money I make (over 1/4 of each of my paychecks goes to state/federal taxes, which seems like a lot to me particularly after moving back from Montana), if I wanted to apply for the state-run insurance plan I would, disturbingly, be at too high of an income bracket to qualify.  So I can't afford insurance on my own, I couldn't qualify for public aid if I wanted it...and yet, I can pay out 1/4 of each paycheck to support everybody else.  And to me, that seems fucked-up.

Mary, I know that you're in a Catch-22 of no-insurance, but, just want to point out that a 1/4  of a Pay Cheque tax rate is pretty low if you are expecting some kind of universal heath care program - even for a low income bracket.  

Up here, it would be a third to a half with lots of 'verticle demand curve' taxes on cigarettes, gas and booze. I would imagine the rate would be even higher in the EU.

[OneArpeggioPete]

lizish said:

Mary, I know that you're in a Catch-22 of no-insurance, but, just want to point out that a 1/4  of a Pay Cheque tax rate is pretty low if you are expecting some kind of nationalized heath care program - even for a low income bracket.  

Up here, it would be a third to a half with lots of 'verticle demand curve' taxes on cigarettes, gas and booze. I would imagine the rate would be even higher in the EU.

it differs from country to country here. in germany i'd be paying higher income tax than here, and have better healthcare. once you get into a reasonable income bracket it's both way more than 25%, though, and over here i pay ridiculous amounts of vat. neither countries have state healthcare. here the public system is overcrowded but reasonably effective, the private system is luxurious but not very effective (if you're really sick, doctors recommend to go public) and those under a certain income get all care for free. in germany, the system is based on mutual public insurance. the french system seems to be the most effective i've come across so far, but is also the most expensive for the tax payer. btw, to all those with irish connections doubting my sanity now - yes, the a&e crisis exists. yes, the system is underfunded, yes, i wouldn't want to need urgent care in any of the border counties etc. all the points made on the media are, as far as i can see it, valid. at the same time, however, i've seen more of the irish healthcare system than i'd ever want to over the past few months, and was more than impressed with the quality of care, competence and sheer kindness i found there.

:-)

oneArpeggiopete:cool:

[Mary]

lizish said:

Mary, I know that you're in a Catch-22 of no-insurance, but, just want to point out that a 1/4  of a Pay Cheque tax rate is pretty low if you are expecting some kind of universal heath care program - even for a low income bracket.  

Up here, it would be a third to a half with lots of 'verticle demand curve' taxes on cigarettes, gas and booze. I would imagine the rate would be even higher in the EU.

That's a really good point.  But well, after giving it some thought, I'd be happy to pay higher taxes if I felt like I was getting something out of the deal.   :p  

I know, I know, what I pay now goes into the general education/ transportation/environmental funds, so I am getting something out of the deal...but you know what I mean.  ;)  It'd be nice to feel like I wasn't throwing money into a bottomless pit and paying for other people's health insurance when I don't have my own...I think it'd feel more balanced, in a way.  Oh well, if nothing else this sort of thing serves to motivate me to get my butt back into school & to make with the movin' on up.  :p

[bizaleth]

My dad was the working poor. He owned a house, a car or two. He lived in a  small rural town with a low cost of living. He had some hefty debt until he sold his small business (he was self employed but never made more than $15,000 a year) at the beginning of the year and paid off his debt.

He had insurance but he had to pay for it. And it was catastrophe insurance, meaning that if he had gone to the doctor like he needed to and had had the open heart surgery he would've needed, that could've easily cost at least $50,000, he still would had to've paid $20,000. He didn't go to the doctor. Not just because of insurance, there were lots of reasons why he didn't go, the main one being fear. But one of his fears was having an expensive surgery that would bankrupt the family with no gaurantee that he would survive. Instead, he let it go and died of a massive heart attack.

I'm not trying to give everyone a sob story, I just want to point out that it is a sad, sad world when a person in what is supposed to be one of the most advanced countries in the world has to choose between his life and the cost of medical care.

[Tuatara Taupo]

There are too many strong and conflicting interests for our elected representatives to accomplish anything.

At the local level where I live, the county subsidizes health care for all children. I don't know if they have state or federal funding for that. In my county, a number of people have kids that they cannot support. Sadly, some people are expecting the government to provide more and more and more.

Many workers have medical benefits, and I appreciate the opportunity to choose for and pay for a plan that suits me. In my case for the past 20 years, I've had excellent HMO coverage at reasonable rates. Some HMO's are bad, but most are fine, just like any other entity.

What concerns me is the impotence of our elected officials. Concern is if they do try to legislate some form of universal health care that they are going to create a massive big set of complicated rules and bloated pricing and bloated overhead. (Notice for example the debacle with prescription drug plans for seniors that they enacted. It is so complicated that it's difficult for anyone to determine which plan is which. Plus, the drug companies influenced the lawmakers to ensure high non-competitive pricing for the gov't to pay for drugs.)  If universal health care means more of that kind of crap, then NO, I cannot support it.

I would support a universal plan that was simple, cost effective, and not controlled or "owned" by special interest groups. Such a plan should protect the taxpayer from absorbing bloated costs, elective surgery, corruption, inefficiencies, etc.

In San Francisco, for example, some homeless people routinely call 911 to complain of "chest pains" just to get a free ride in an ambulance, checked into a hospital, get a meal, and a bed for at least the night. It really happens over and over! And the taxpayer is forced to pay for that crapola. It's as if people have a right to be abusive!

Others think that the taxpayer should pay for Viagra.  Come on!

[Kaleidoscope]

Let's compare the income taxes paid on the same salaries (ignoring exchange rates) in the UK and in the US.

United Kingdom
Income Tax:          
Gross Income           £35,000                  
Personal Exemption    £ 5,035                  
10% of next £2,150   £    215
22% up to £33,500    £ 6,113

Income tax paid: £6,334.30 or 18% of gross salary. (The top income bracket is 40% of income over £33,500)

National Insurance (sort of like Social Security)
8% of income between £5,035 and £33,540 annually.

National Insurance paid: £2,280.40 or 6.5% of gross income

Total UK tax paid on £35,000 per year is £8,614.70 or 24.6%

US Tax

Federal Tax
Gross Income: $35,000 per annum
Personal Exemption $3,300
10% of income between $3,300 and $7,550 = $425
15% of income between $7,551 and $30,650 = $3,465
25% of income between $30651 and $74,200 = $825

Federal Income tax: $4,715 or 13.4% of gross income

Social Security & Medicare
7.65% of income = $2,677.50

California State Income Tax
Gross Income $35,000 per annum
1% of income up to $5,834 = $58.34
2% of income from $5,835 to $13,829 = $159.88
4% of income from $13,830 to $21,826 = $319.84
6% of income from $21,827 to $30,298 = $508.26
8% of income from $30,299 to $38,291 = $376.08
Total California state income tax = $1,422.40 or 4% of gross income

Total US Income tax: $6,137 or 17% of gross income.


Caveat: Now this doesn't take into account any deductions you can make in the US.  In the UK, you have no deductions because you don't file a return, the money is just deducted from your paycheck and taken directly from interest earning bank accounts. There is no equivalent mortgage deduction, but for child dependents you get a benefit paid to you in a check monthly, rather than a deduction on a yearly return.

Also, 35K is a very good salary in Britain anywhere outside of London. It would afford you a much better quality of life than $35K in the US in most areas.

Conclusion
You would pay 2,477 or 7% more in income tax in the UK. 7% more doesn't seem exorbinant to me for free health care in a system that I am fully confident in using.

Now sales tax (VAT) is something different entirely. And don't get me started on petrol taxes ;)

[bizaleth]

Kaleidoscope said:

You would pay 2,477 or 7% more in income tax in the UK. 7% more doesn't seem exorbinant to me for free health care in a system that I am fully confident in using.

I would agree with that.

I have crappy insurance. I work for the state and the program we have is terrible. Many universities have other insurance options: a PPO, HMO, etc. One usually costs nothing (no premium) and is usually the state plan while the other programs have premiums that go up as the deductible go down. We don't have that option. But, one of the main differences is that any sort of annual exam (physical, vision, dental) are paid for in full. With my insurance, they aren't. A physical--just a physical, no tests or anything--at my previous doctor was $100. That was out of pocket and it went towards my deductible. We don't have vision insurance and our dental is fairly standard minus the fact that our checkups are not covered 100%.

A healthy person will never meet a $500 deductible just going in for annual physicals. I never did and I never have. My insurance is only good for major medical events, not for the annual stuff the normal person has to deal with. The state began paying for a yearly health screening -- mamogram, exam, etc.

The university has been having problems keeping people and one reason are the benefits. If you are single, you don't pay for insurance -- it is covered 100%. If you have a family, you're screwed. As I mentioned, most schools have different forms of insurance to choose from. We don't because the state mandates that we are not given an option. I can only assume that someone, somewhere in the state gov't is getting a kickback for our shitty insurance. And it doesn't make me happy. Some people keep the state insurance for themselves and then go to an insurance company for their company where they can get better insurance for less.

Anyway, to combat some of the costs (mainly the cost to go for a doctor's visit), my university now has a faculty/staff doctor and she is awesome. It's affordable, test are done at cost, it is easy to get an appointment, and if you have an appointment at 3:00, you see the doctor at 3:00. And the cost is deducted from your paycheck. When it comes to insurance, the administration is pretty much stuck due to the state, but at least they are making an effort to combat medical costs.

[Sweden]

OneArpeggioPete said:

they are... in the second richest country in the eu. i just got one last week. you get white ones if you want to but you have to pay extra.

Good heavens... And the mercury-poisoning of both patients and dentists hasn't really been a concern, I presume?

[OneArpeggioPete]

Sweden said:

Good heavens... And the mercury-poisoning of both patients and dentists hasn't really been a concern, I presume?

i swallowed a massive ancient filling the other day (which is why i got the new one) and so far i have no symptoms of mercury poisoning. maybe our generation is desenitised to it by now. ;)

:-)

oneArpeggiopete:cool:

[Internet Legend]

Kaleidoscope said:

Social Security & Medicare
7.65% of income = $2,677.50

Don't forget, if you're self-employed, you pay twice that much. And even if you're not, your employer is paying another 7.65%, which is expressed in his overhead, and that's got to come from somewhere (in other words, consumers are paying for it somewhere along the line).

Thank you for that detailed analysis, Christie! I'd often wondered how it broke down.

We pay around $800 a month for private health insurance for a family of four. That's an HMO, too - it's nothing fancy. The kids and I have deductibles of $1000, but Kelly's is $2000 (he had to be covered by another plan designed for high-risk people without health insurance - it's a state-mandated insurance pool, or we wouldn't be able to insure him at all). Prescriptions and primary care visits are covered, except for a copayment, before the deductible is met. The copayments for prescriptions are based on a complex set of calculations, and they vary depending on what the drug is. They are not trivial. We have yet to meet a deductible in a calendar year, but we don't feel safe dropping the insurance.

I'd love to have national health, and not a mish-mash like the Medicare drug coverage, which was essentially designed by the drug companies.

[genera seven]

Internet Legend said:

I'd love to have national health, and not a mish-mash like the Medicare drug coverage, which was essentially designed by the drug companies.

I fall under Missouri Medicaid. This program is on a decline and has been for years. There used to be coverage for  dental (emergency and not aesthetic) and optometry. Now I think they might pay for the eye exam. They set it up to where if you have an illness that you pretty much have to get a certain kind of drug. This complements what Donna was saying. I see a pshyciatrist and am told what I can or can not have as far as medicines go. It sometimes amounts, to a medicine that if the system were to fail, would cost me roughly $500.00 to $1000.00 a month, out of pocket.

However, I do not see Medicare, giving this up easily. There are Ammendments that they put a really unpopular issue (like the Missouri Ammendment 3 which puts a tax on cigarrettes and that would go to HMOs and other health programs) with a health care "tag on" on it.

It's beurocracy at it's finest.

[Kaleidoscope]

genera seven said:

am told what I can or can not have as far as medicines go.

You will find that is the case with any subsidized health care system. The governing bodies make decisions on medications used based on cost vs. effectiveness, and safety.  That isn't necessarily a bad thing although it can seem random and/or unfair if you don't know the planning that went into it.