Analyzing Health Care

I think not

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My primary objective in this analysis is not to deride the good work done by those on all sides of this issue. Instead it's to show that while looking at Canadian and American comparisons is valuable, it's not OK to look on the surface and ignore the many complexities underneath that surface. Worse it's totally dishonest to take "facts" out of context or tell blatant lies.
Health systems everywhere are under financial strain--always have been and always will be. Canada certainly limits access to high technology and specialists by limiting investment in them upstream. The US does not, but citizens living in Canada are very unlikely to run into severe financial trouble because of their health--not so in the US. For those of you who will read this thread, please take under consideration that I am not part of the Canadian Health Care system and therefore I can only compile information based on research and not from personal experience. In addition I will offer information on how weaknesses of the US health care are sometimes skewed, but I will leave the critique by members of this board, I will only offer facts. So lets look first what I have compiled to be strengths and weaknesses in each system and we will run an in depth analysis of each:

THE CANADIAN HEALTH CARE SYSTEM

The Canadian health care system expresses the fundamental equality of Canadian citizens. The plan's coverage is comprehensive, universal, and accessible. Known as a "single payer" system, funding for medically necessary care is provided by the provincial governments through taxes (with guidance and some funds from the federal government). Patients are free to choose among providers, and physicians serve primarily in private practice on a fee-for-service basis. Hospitals are independent, nonprofit institutions overseen by boards of trustees.

Canada's health care system began as a grass roots action in Saskatchewan in the late '50s; by 1966 all provinces offered such plans.

The Plan's Strengths:

• All citizens have access to care; no one may be denied services on the basis of income, age, or health status.
• Benefits are the same for all citizens.
• The plan relies extensively on primary care physicians; 63 percent of all active physicians in Canada are in primary care.
• Canada achieves substantial administrative cost savings, since providers and insurers do not need to market themselves or employ vast staffs to process paperwork. Physicians bill the provinces directly and avoid the expense of verifying coverage, seeking approval to provide services, completing paperwork for multiple private insurers, or coping with double-billing and uninsured patients.
• Under a single payer, the provincial governments are able to set and enforce overall budgetary limits. Physician fee schedules are negotiated with the local medical associations and are binding; no additional billing is permitted.

The Plan's Weaknesses:

• Financing of Canada's health plan has been generous during periods of growth and tight when government must control its deficits.
• Access to some high-tech procedures has been limited by a shortage of equipment and hospital beds.
• Benefits are basic - only procedures deemed "medically necessary," are covered (e.g. optometrists and dentists may not be covered.)
• Cost over-runs - primarily in physician services - prompt provincial governments to increase cost controls, resulting in outcries of "rationing" by providers and, on several occasions, political uproars.
• Private insurance for covered care is not permitted because this would defeat the purpose of spreading the risk over the entire population. However, insurance is allowed to fill available niches, such as for dentistry, pharmaceutical drugs, and certain hospital services (i.e., private room charges).
• Long wait times for basic surgical procedures.
• In Canada, prescription costs are not generally covered except for those with low incomes. Private, employer insurance plans, or individual supplemental plans, usually cover prescriptions, with some deductibles and co-payments.

THE US HEALTH CARE SYSTEM

America does not have a "system" of health care as much as a tradition of laissez-faire practices that have developed over time. The central element is a financial arrangement that pays for health care services through employer-purchased insurance. Historically, patients have had the right to choose any physician, and physicians have been free to choose among specialties and to practice where and how they like.There are now more than 1200 private insurance companies in the US.

For some of the uninsured, the government pays for health care through Medicaid, the military, Native Americans, the Veterans Administration, and other state programs.

The System's Strengths:

• High-quality services are available for those with insurance.
• The US is at the forefront of clinical research.
• Major technological breakthroughs have occurred in treating numerous diseases.
• There are large numbers of physicians, especially specialists.
• Elderly Americans over the age of 65 are all covered under a universal program called Medicare

The System's Weaknesses:.

• 45 million Americans (17%), have no health insurance or coverage (the highest in the industrialized world).
• The cost of health care in the US is the highest per person in the industrialized world and growing the fastest.
• Administrative overhead is high - 19 to 24 percent of all health care costs, versus 11 percent in Canada.

There are so many issues to bring up it is vitually impossible to list them all, however this is a good start I found and what I have seen to be a very pressing issue on both sides of the border. I will first begin an analysis of the weaknesses of US Health Care. The first analysis I will be addressing is the uninsured Americans, I should have all the data compiled by tomorrow and begin that part of the debate. For those of you interested, take the time to think about the pros and cons of each system and by all means share your opinions.

Thanks and lets begin :)

P.S. Thanks to Vanni and Bluealberta I have spent dozens of hours reading the Romanow Report, Health Care Studies and statistics from various organizations on both sides of the border. So you two better take part in this :p
 

bluealberta

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I Think Not:

Thank you for your first "installment" on this topic. I think you have summarized things very well. In your analysis, I think that one of the really important things to determine is the cost to the consumer, or individual if you will, at the end of the day for comparable services. I don't know if this is possible, so would it be possible to provide some sort of net cost for comparable individuals in each country.

For example, for a Canadian earning $50k per year and a US citizen earning $40k per year (basically same income after exchange calculation), what is the cost of health coverage for a family of four, for example, after taking into consideration different federal tax rates (forget state/provincial taxes, they are too variable for this discussion), and items such as mortgage interest deductions. What part of the annual premium in the US is paid for by the employer and what part is paid for by the employee.

I don't know how deep you can or want to go, considering co-payments, deductibles, etc., but if you have any comparison as noted above that may give a reasonable idea of the differences or similarities between the systems.

Thanks again, I have been looking forward very much to your thread, and will continue to follow it closely.
 

I think not

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The average cost of health insurance for a family of four in the US is now (2005) $10,000. That's up 60 percent over the past three years – since 2002. Of that total, employers paid $7,289 and employees paid $2,661.

The $2,661 is deducted from the gross salary (before taxes). This in essence means that the federal government (by way of tax breaks) picks up 35% of the employees costs. In reality the $2,661 is really $1,729 annually.

Keep in mind these are national averages, in certain regions of the US (Northeast), they are higher and other regions (Southwest) lower.

Here's a sample of all four corners of the US:

Maine
Employee Contribution 29.1%
Employer Contribution 70.9%
Total Premium 100.0%

Florida
Employee Contribution 24.9%
Employer Contribution 75.1%
Total Premium 100.0%

California
Employee Contribution 23.8%
Employer Contribution 76.2%
Total Premium 100.0%

Washington
Employee Contribution 18.8%
Employer Contribution 81.2%
Total Premium 100.0%

For details on this data you may reference this website:

State Health Facts
 

I think not

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The information was derived from a number of resources, I will post links for your own information to review. That was the simplest form of list I can find to further the discussion. for all intensive purposes NONE of this information is mine. It's all from various organizations, Canadian as well as US. Better?
 

Dexter Sinister

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Oct 1, 2004
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No, the information in the OP came from one source, you did a straight copy and paste on it, and claimed it as your own.

Just keepin' you honest.

And BTW, the phrase is "for all intents and purposes..."
 

bluealberta

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Re: RE: Analyzing Health Care

I think not said:
Keeping me honest? Why dont you have a closer look at that link and compare the lists. And I assume you do know what "compiles" means

Keep going, 1. Don't let the naysayers detract you. Your figure of $2661 is what I also had obtained doing my research about 3-4 weeks ago, which I think got you going on this. (Sorry :cry: )

And since I live in Alberta and you live in New York, I would suggest that any accusations of collusion are false. Anyway, keep going, I really want to hear all your conclusions, etc.
 

I think not

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This is a sample mortgage breakdown I found off an accountants website, maybe this will help you blue. I'm not sure how that is relevant to health care, I'm sure Canada has the same tax deduction on mortgage interest.

Under the current tax code, mortgage interest on first and second homes is generally deductible as long as these loans total less than $1.1 million, making homeownership one of the best ways to trim your tax bill. The examples below illustrate how the mortgage income tax deduction affects the after-tax homeownership.

Homeowner Profile
Gross Income - $35,500
House Price/Mortgage Size - $115,000 - $23,000 down=$92,000
Loan Type - 30-year Fixed-Rate mortgage at 10%
Property Tax - 1.23% of home value ($1,415)
Filing Status - Files jointly/four exemptions

According to the tax code, this homeowner's deductions for mortgage interest and property taxes would be evaluated at a 15 percent marginal tax rate. Non-housing itemized deductions (i.e., state and local taxes, non-mortgage interest and so on) is estimated at $2,000 and the standard deduction is $5,450. Under the current tax system, the homeowner saves $1,071 because of the mortgage interest deduction. You can figure what your own costs and savings will be by substituting your own tax figures for those on the chart.

Example of the impact of the Mortgage Income Tax Deduction on Annual Homeownership Costs:

Before-Tax Homeownership Costs
Mortgage Interest=$9,177
Property Taxes=1,415
Total of Before-Tax Homeownership Costs=10,592

Itemized Deductions
Homeownership Deductions
Mortgage Interest=$9,177
Property Taxes=1,415
Non-homeownership Deductions=2,000
Total=12,592

Standard Deductions=5,450
Total Itemized Deductions=$7,142
Multiply Total Itemized Deductions by Marginal Tax Rate to get Homeownership Tax Savings: $7,142 x .15=$1,071

After Tax Homeownership Costs=Homeownership Tax - Before Tax Savings: $10,592 - 1,071=$9,521

Let me know what you need clarifying. And also I couldnt find any federal/provincial tax deductions for the Canadian Medicare system, I looked at Revenue Canada (best source I could think of), maybe you could shed some light.
 

bluealberta

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I think not said:
This is a sample mortgage breakdown I found off an accountants website, maybe this will help you blue. I'm not sure how that is relevant to health care, I'm sure Canada has the same tax deduction on mortgage interest.

Under the current tax code, mortgage interest on first and second homes is generally deductible as long as these loans total less than $1.1 million, making homeownership one of the best ways to trim your tax bill. The examples below illustrate how the mortgage income tax deduction affects the after-tax homeownership.

Homeowner Profile
Gross Income - $35,500
House Price/Mortgage Size - $115,000 - $23,000 down=$92,000
Loan Type - 30-year Fixed-Rate mortgage at 10%
Property Tax - 1.23% of home value ($1,415)
Filing Status - Files jointly/four exemptions

According to the tax code, this homeowner's deductions for mortgage interest and property taxes would be evaluated at a 15 percent marginal tax rate. Non-housing itemized deductions (i.e., state and local taxes, non-mortgage interest and so on) is estimated at $2,000 and the standard deduction is $5,450. Under the current tax system, the homeowner saves $1,071 because of the mortgage interest deduction. You can figure what your own costs and savings will be by substituting your own tax figures for those on the chart.

Example of the impact of the Mortgage Income Tax Deduction on Annual Homeownership Costs:

Before-Tax Homeownership Costs
Mortgage Interest=$9,177
Property Taxes=1,415
Total of Before-Tax Homeownership Costs=10,592

Itemized Deductions
Homeownership Deductions
Mortgage Interest=$9,177
Property Taxes=1,415
Non-homeownership Deductions=2,000
Total=12,592

Standard Deductions=5,450
Total Itemized Deductions=$7,142
Multiply Total Itemized Deductions by Marginal Tax Rate to get Homeownership Tax Savings: $7,142 x .15=$1,071

After Tax Homeownership Costs=Homeownership Tax - Before Tax Savings: $10,592 - 1,071=$9,521

Let me know what you need clarifying. And also I couldnt find any federal/provincial tax deductions for the Canadian Medicare system, I looked at Revenue Canada (best source I could think of), maybe you could shed some light.

Thanks for the information, I will study it a bit. No, Canada does not have a mortgage interest deduction. I am not aware of any deductions for our health care system. REvenue Canada is now called Canada Revenue Agency.

I wanted to give you this little anecdote: Last Tuesday I had to take my wife to the hospital emergency ward because the Rev pushed her down the stairs (Just Kidding, Rev :lol: 8) :wink: ). She did trip over the dog though, and twisted her foot/ankle bad enough we thought she may have broken something. Anyway, when we get the emerg ward, there is no one else there, so we think we should get looked at, diagnosed, and out of there quickly, right? Wrong. An hour and a half later, she finally gets an Xray, which revealed she had torn some ligaments in her foot. The emerg doctor said that a nurse would be in to put a tensor on it and left the room. Forty minutes later, I went looking for someone, because no one had come yet. Were the nurses busy? Not likely, since they all got together so sing a rousing rendition of Happy Birthday to someone over the phone while my wife was waiting. We saw the original doctor, who then came and put a tensor on her foot and after having her sit in a wheelchair for 40 minutes with her foot down, told her it was important to elevate her foot to speed recovery! Un-friggen-believable! Over two hours for an Xray and tensor. And others on here wonder why I have such a problem with our supposed model of good efficient health care.
 

I think not

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In all fairness blue, do you live in a rural area? Or is it urban? And perhaps the emergency room was full, if its full that can happen anywhere really.
 

I think not

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In all fairness blue, do you live in a rural area? Or is it urban? And perhaps the emergency room was full, if its full that can happen anywhere really.
And no mortgage interest deduction? Are mortgage rates typically low though?
 

bluealberta

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I think not said:
In all fairness blue, do you live in a rural area? Or is it urban? And perhaps the emergency room was full, if its full that can happen anywhere really.

Sorry, I wanted to mention I live in an urban center with a regional hospital for our area. There were no people in the waiting room, and none in the exam rooms. While we were there, an elderly gentleman was brought in my ambulance.

I was also speaking to someone involved in our local health units, and he told me that a lot of people are now starting to call 9-11 for what could only be classified as non-emergency reasons. Why? Because they are given priority when they arrive at the emergency ward. Great little system we have here, this publicy funded everybody fits system.
 

Jay

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I think not said:
In all fairness blue, do you live in a rural area? Or is it urban? And perhaps the emergency room was full, if its full that can happen anywhere really.


I'm not sure this is how the system was sold to us though. Were supposed to have the best health care in the world.
 

I think not

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There is no perfect system Jay. Even the French being #1 according to WHO, have their problems.

I've been to Greece and stayed there for a bit, WHO ranks them 14, Canada ranks 30th and the US ranks 37th.

Greece doesn't have waiting times, there hospitals and clinic are in a state of decay though. People recently operated are placed on cots in the hallway and medication is scarce. I dont think Canada does that. So what is the methodology of WHO when comparing health systems?
 

bluealberta

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I think not said:
There is no perfect system Jay. Even the French being #1 according to WHO, have their problems.

I've been to Greece and stayed there for a bit, WHO ranks them 14, Canada ranks 30th and the US ranks 37th.

Greece doesn't have waiting times, there hospitals and clinic are in a state of decay though. People recently operated are placed on cots in the hallway and medication is scarce. I dont think Canada does that. So what is the methodology of WHO when comparing health systems?

That is a good question, and what bias' are these people using? It bothers me when people can only describe Canada has "A good health care system", when they are asked what it is to be Canadian. Of course two other responses are "We have good beer" (which is true), and "We are not American", which unfortunately, is also true :cry: :wink:
 

bluealberta

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I think not said:
Blue, do you know what the tax rate is for the Canadian Medicare System?

I am not sure what you are asking. As far as I know, we don't have one, but if anyone else knows, please correct me. What specifically are you referring to, tax on what, or for what?
 

I think not

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bluealberta said:
I think not said:
Blue, do you know what the tax rate is for the Canadian Medicare System?

I am not sure what you are asking. As far as I know, we don't have one, but if anyone else knows, please correct me. What specifically are you referring to, tax on what, or for what?

The Canadian Medicare System is funded by way of the taxpayers since it is public funding, does anyone know what percentage of tax that is? Or is it all just distributed off a general tax?
 

bluealberta

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I think not said:
bluealberta said:
I think not said:
Blue, do you know what the tax rate is for the Canadian Medicare System?

I am not sure what you are asking. As far as I know, we don't have one, but if anyone else knows, please correct me. What specifically are you referring to, tax on what, or for what?

The Canadian Medicare System is funded by way of the taxpayers since it is public funding, does anyone know what percentage of tax that is? Or is it all just distributed off a general tax?

I see what you want. There is no specific amount of tax that is earmarked for health care. Basically, all our taxes go into one big pot to be distributed as the party of the day sees fit, or unfit, as the case may be. I suspect there may be a stat somewhere which would indicate the percentage of taxes paid which goes to health care, but I don't know where it is.

But anyway, if I pay $100 in tax, there is nothing set in stone that $10 of that has to go to the health care system. Maybe there should be something like this, then people would actually get more of an idea of what our "free" health care system actually costs. 8O