Sanding our assholes with 150 grit.

Americans in Canada rated the US health care system as better

http://www.openmedicine.ca/article/view/39/43

<quote>
Americans living in Canada generally rated the US health care system as being better than the Canadian system. However, they acknowledged the inefficiency and inequity of the US system, and nearly half preferred the Canadian system despite its perceived problems.
</quote>

I have no doubt the US system at its best is better, but I at least, even with an income far above normal, don't interact with this system. I deal with a system that constantly wants to deny me coverage because of preexisting conditions. And when genetic tests become more common this will get even worse. And who is doing all these tests? The same people who will use the info to screw you.

So I'll take a marginal system where I can get coverage than a sterling gold system where I can't.
Permalink son of parnas 
July 3rd, 2007 12:58pm
A really good change to the insurance system would be removing the ability to exclude for a preexisting condition.  That's something of a pain in the ass, and it helps to drive insurance rates up for the Blue Cross programs who wind up picking up the public charity cases.
Permalink Send private email Clay Dowling 
July 3rd, 2007 1:08pm
I assume Canadians in America are living at a higher standard than non-Canadians in America.
Permalink Send private email sharkfish 
July 3rd, 2007 1:16pm
"I assume Canadians in America are living at a higher standard than non-Canadians in America."

...than THE AVERAGE American-born.
Permalink Send private email sharkfish 
July 3rd, 2007 1:16pm
> So I'll take a marginal system where I can get coverage than a sterling gold system where I can't.

You're not in your company's pool? Or was this a hypothetical.
Permalink Send private email heartsheep 
July 3rd, 2007 1:24pm
> You're not in your company's pool?

I am not in a company.
Permalink son of parnas 
July 3rd, 2007 1:27pm
Which rates you among the truely screwed.  For those who aren't aware, if you're not a part of a group plan the best you can get is a catastrophic policy.  Plans that cover office visits are unheard of.  And catastrophic plans are pretty damned expensive.
Permalink Send private email Clay Dowling 
July 3rd, 2007 1:28pm
Speaking of which, there was a plan afoot here in Michigan last year to make a statewide group, so that anybody who was self-employed or worked for a place that didn't provide insurance could buy in on a group plan.  It doesn't seem to have gone anywhere, but I thought it was an excellent idea.
Permalink Send private email Clay Dowling 
July 3rd, 2007 1:29pm
> t I thought it was an excellent idea.

It's a good idea, but it's another band aide. Soon health care will be so expensive companies won't be able to provide good coverage, so attaching your self to a master won't help anymore.
Permalink son of parnas 
July 3rd, 2007 1:32pm
It's already there for companies who depend more on quantity of labor than skill of labor.  Large manufacturers like auto companies have been pushing a government health care plan for years.

You're right that it's a band-aide.  It's just the we should probably stop the hemorrhaging now before the patient dies.  Then we can fix the bigger problem.
Permalink Send private email Clay Dowling 
July 3rd, 2007 1:47pm
> I am not in a company.

Hmm. Massachusetts beckons.
Permalink Send private email heartsheep 
July 3rd, 2007 1:53pm
An "excellent" system that costs three times more per person served than any other system, and leaves out 15% (45 million uninsured out of 300 million total) entirely, probably shouldn't be rated "excellent".

After all, it's the last 10% of a software project that takes 90% of the effort.
Permalink SaveTheHubble 
July 3rd, 2007 2:06pm
Ah, and this survey (done in 2005) covered 310 expat Americans, who had been living in Canada and using Canadian health care for 2 or more years.  51% made more than $100,000 a year.

Thus, they had NOT been paying American health-care premiums for 2 years or more.

Well sure, I'd rate a really expensive health-care system great, if I didn't have to pay for it, and I assumed it would cover me.  But that's kind of a bogus metric, no?
Permalink SaveTheHubble 
July 3rd, 2007 2:10pm
Michigan's plan is better than that passed in Massachusetts last year which mandates that you MUST buy health insurance, or face heavy fines for each day you refuse to do so.

They call this system "The nation's first universal health care plan."

Talk about doublespeak.
Permalink Practical Economist 
July 3rd, 2007 2:52pm
An implementation today is better than a plan tomorrow. Though far more criticizable.

Yes, people get fined if they don't have insurance ... you know who those people are? Middle class 20- and 30-somethings avoiding the $185/month premium because they think they are healthy enough to stay out. Poor people don't get fined, they have subsidies.
Permalink Send private email heartsheep 
July 3rd, 2007 2:55pm
You are right, the cut off point is $9500 salary. If you make less than that, you get a free ride.

Notice that the result is that the rich people and the companies in Mass. both are paying LESS in their premiums as a result of this program. Also, the state has a new source of revenue in all the fines and fees they are charging for this program, though whether it is worth the loss of productivity because of the people who refuse to pay the fines and are put in prison at a cost of $120,000 per year to the state. But we can solve that by simply charging them this, call it a 'hotelling service reimbursement'.
Permalink Practical Economist 
July 3rd, 2007 3:34pm
Related as to how smart people should respond to the Massachusetts system and what it means for Amerikkka:

http://justicefornone.com/article.php?story=20050527204356114
Permalink Practical Economist 
July 3rd, 2007 3:36pm
I wish they'd stop calling it "health insurance".  It's health care coverage.

And these hybrid programs that force the employer to get involved are a bad idea.  Single payer, that's the way to go.  I wonder how long it will take for this country to finally bite the bullet and simply expand Medicare to anyone who wants to participate.  Medicare's administrative costs are miniscule compared to other health care providers.
Permalink AMerrickanGirl 
July 3rd, 2007 4:10pm
That is absolutely true, and it's because Medicare is able, unlike everyone else, to dictate what procedures will be paid for and for how much, and there is no negotiating with them.

As a result, and because most health care systems now are for-profit, we have this weird system of massive overcharging and doing lots of unneeded crap only because those are the things that Medicare's reimbursement at least allows a profit on. So, Medicare gives like $5 for an x-ray, but an x-ray including the electricity and technicians salary and film and envelope costs more like $50. So doctors go easy on x-rays for medicare patients, but then load up on risky exploratory surgeries where they can make a profit.

Converting everything to Medicare I think will have the unintended side effect of drastically reducing the quality of care in that treatment decisions will be made on what a la carte items are profitable, whether or not they are advisable.

Another side effect is that since Medicare reimburses for a 7 minute consultation with an obstetrician, regardless of the situation, how long do you think most obstetricians will then see their patients?

I think any solution involves forcing the system to be non-profit.
Permalink Practical Economist 
July 3rd, 2007 4:18pm
Very true.

The primary problem there is in R&D.

Without incentive to dump tons of money into potential cures and treatments you may not end up with so much new (and costly) procedure.

I think the way to do that is still private. Just offer bounties for specific things, kind of like the X-prize.

So if you solve X, you get a bunch of cash.
Permalink Send private email JoC 
July 3rd, 2007 5:27pm
Right, except that almost all R&D is already paid for by the federal government (= middle class taxpayers), who then transfer the patents on the successful results, free of charge, to the for-profit corporations. Same deal as with oil fields where the government transfers public land to corporations for resource exploration. Both are transfers of publicly paid for resources to private corporations for profit. So your taxdollars go to subsidize/remove risk for the profiteers.

Surely this system could be safely modified while retaining all the benefits of research.
Permalink Practical Economist 
July 3rd, 2007 6:29pm
----"So, Medicare gives like $5 for an x-ray, but an x-ray including the electricity and technicians salary and film and envelope costs more like $50."----

The last X-Ray I had at a private hospital cost $4; Lankan doctors salaries are much lower than US technicians but even so the $4 included the profits of the medical centre. $5 is much nearer the real cost thzn the absurd $50 you quote.
Permalink Send private email Stephen Jones 
July 5th, 2007 6:54am
It's out of thin air estimation, but I don't think $5 would cover the film and envelope. Much less the other costs involved.

The government (lowest) salary for a radiologist is $78k.

http://www.payscale.com/research/US/Job=Radiologist/Salary
Permalink Send private email JoC 
July 6th, 2007 12:07pm

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