Sunday, February 20, 2011

Medical Poll–The Results Are In

The medical cost poll is complete. Of my 46 person sample, here are the results:

13% have no insurance
30% pay between $1000 and $2000 per year
13% pay $2000 – $4000
10% pay $4000 – $6000
6% pay $6000 – $8000
10% pay $8000 – $12000
15% pay over $12,000 per year per couple!

I think this is ridiculous! Almost a third of American couples pay over $6000 with 15% paying over $12000 and 13% having no medical insurance at all. And this in a country that feels justified in imposing it’s will and “way of life” on others all over the world!

We have full coverage as well as all the extras (unlimited ambulance, semi-private room, etc.) and we pay about $55 per month each. Yes, we have an annual family deductible of $300 for prescriptions but our total drug costs (0 for Norma and 2 for me) are less than that as I buy my prescriptions in Mexico and India. The only thing our medical will not cover is my annual PSA test. That costs me $60 and yes, I am fighting to change that.

We have never had to wait in line, we have always picked our own doctors, can change doctors at will and have never been refused treatment. I once had a free Lear Jet Air Ambulance ride from the Alaska border to Vancouver where they put my ankle back together the morning after I landed.

Yes Rae, I know there is a “Catch 22” situation for full time RVers who cannot prove residency in any one Province. This situation must and will be fixed.

Socialized Medicine does work!

22 comments:

  1. Have you counted how much income tax you pay per month in addition to your deductible/premium? When I was making 50K in Quebec, I was paying $800 in taxes per month directly to the Quebec medical insurance board.

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  2. I have only paid tax in BC. We pay Federal and Provincial tax, none directly to any insurance board. We also pay sales and property tax. I am sure some of these taxes go to finance our medical system but I am willing to pay it for the benefits we get. All our taxes combined come to less than that $800 per month.

    Yes, we both qualify for all age related deductions.

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  3. When I say 'directly', I mean that 50% of the taxes I paid to Quebec went to cover health care. And I didn't have a doctor.

    It's interesting that you're not even remotely interested in finding out where your money is going. I wish I could be so lackadaisical with my budget!

    So, I did some more research into the BC health care system/medical services plan and if what I understand is correct, you and I don't live in the same world at all.

    It looks like all you guys pay for health care is your monthly premium. Which would explain why income tax is fairly low in BC.

    Let's see--you're clearly eligible for health coverage, you only pay about 3K a year for services, and you have a doctor. It's no wonder you think our system works!

    The disparity in health coverage in our country is just as great as in the US.

    I'm going to keep harping about this because I feel that you paint a very biased view of our health care system. An American who lucked out on insurance, perhaps through work, could do a post like yours that paints a portrait of a functional US medical care system.

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  4. I am somewhere in the middle on this healthcare thing. I think both you and Rae have good points. I know when my heart acts up I get excellent care in Alberta, no waiting, and all the technological wonders I need working to ensure my longevity. The same can be said for my granddaughters kidney issues.

    BUT, when it comes to my wifes ongoing knee problem the story changes a little. Her doc booked her for an MRI last August and that MRI is scheduled to happen on May 17th this year. After the MRI is done an appointment with an orthopedic specialist will have to be booked, and that can be a long wait also, sometimes up to a year.

    On our southern swing this year we had an MRI done in San Antonio, took an hour and half to get it booked and another half hour to get it, the results were in the next day. Now we had to pay for that MRI ourselves and it was not any cheaper to do that in the US than in Canada but we decided that waiting till May to start the next process was too long. It will still take a long long time to get into to see a ortho person and probably an even longer time to book the likely replacement that seems likely to happen. So not having completed the process but from looking at the predicted wait times it will be at least 2 years from intial diagnosis to resolution. Not a fun time when there is no cartilage in that knee and the bone is rubbing on bone and there is already some marrow changes evident in the MRI.

    In the US system IF you had the necessary insurance or the cash the operation could have been done almost immediately and life would be heading back to normal.

    We are still struggling with whether we want to fund the operation ourselves and bypass that wonderful Canadian system or stay loyal to our GRËAT system and suffer through a couple of extra years.

    Plus and minuses on both sides and no one system is perfect for everything

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  5. In reply to JB, I've seen our health care system WORK. My dad had cancer and he somehow got on the gold star plan. He had one of the country's leading oncologists and was taking some cutting edge treatments. I was blown away because my step-mother died of a breast cancer that could have been cured had she not had to wait so long for treatment.

    I had the healthcare system in QC work in my favour once. What I discovered is that it's incredibly difficult to get into the system, but once you do, you're set, until you reach the end of your treatment and you're spit back out again.

    And every province is different.

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  6. Reposted reply to get my figures right. Sorry.

    Sorry, I spoke a little early. I checked my Quicken and here is what we paid in 2010.

    Total Income Tax +/-$5000
    Property Tax $1700
    TOTAL %6700

    We are paying less than $800 per month.

    We have a voluntary "sin tax" as well. Norma pays $10 for a pack of cigarettes that probably costs $2 and that extra tax goes mostly to the medical system. That is fine, smokers are the ones who should pay!

    BTW the $110 per month medical payments covers both of us so our medical premiums are about $660 each per year (directly paid).

    I agree with JB. Anything they can get away with calling "elective" can put you to the back of the line. My brother was still waiting for artificial knees in Alberta when he died.

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  7. One point that needs to be taken into account is the allocation of taxes. One example: the annual military budget of the U.S. is approx. $680 billion, as compared to the annual military budget of approx. $21 billion in Canada. I would much sooner see my taxes go to health care, rather than our bloated military system.
    Bill in Nebraska

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  8. Good point Bill. And many of us are of the opinion that Canada's 21 billion military budget is WAY too high and should be put into health care and education!

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  9. croft i think it was a good poll ,,we live in ontario and it says it does not have a two tiered health system ,,,,but,,,,,if you have money some of these things can and will be done for you..money talks and some poorer people have to walk..like the posts,,oh and we have friends who live in c.r. and just love it ,,having moved there from ontario about three years ago ,,ok have fun..

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  10. Lets see where do I begin.
    First of all I would like to say is that I live in the US. NY in fact.
    1. Rae. Both you and Croft are right about your health care systems and neither is perfect, it can be improved, but would you give up what you have in Canada for the system we have in the US?
    2. JB. The reason you could get an MRI so fast in the US is because there are MRI centers all over the US. These are privately owned and have to make money. So doctors will prescribe the MRI at the drop of a hat. Needed or NOT and bill the insurance company. That is one, of many reasons our health insurance is so high.
    3. Croft. The numbers you quote that we in the US pay do not include what the employer or the government in the case of Medicare contributes. The real cost of heath care per family can be much, much higher $6000 and up if you have a good plan. If you need an individual plan and have a preexisting condition. Forget it, you cannot get insurance.
    Also I agree that our Military budget is WAY over blown and yours is relatively small. But also consider that yours is small as compared to the US is because, right or wrong, we do so much of the so called "heavy lifting" for other countries.
    IMO
    Hope to see you on the road some day!!

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  11. "heavy lifting", aka being the world's police force. Iraq and Afghanistan are clear evidence of failed military policies, both in terms of the loss of life and the billions in cost with negative results.

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  12. Often the American idea of "National Defense" looks more like a bunch of grade eighters beating up a couple of grade fivers.

    ie: The Invasion of Grenada & The Invasion of Panama (there are others)

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  13. Great discussion here. I'm learning some new things about healthcare costs from your individual situations.

    Our two cents:
    40 year old female
    33 year old male
    Both in great health (good diet, lots of exercise, blah blah blah).

    We pay $1260/year for BC health insurance. That figure is going up to $1308 in 2012. Does not include prescriptions, dental, glasses, etc. If we add all those costs, we pay closer to $3000/year as a couple, no kids.

    Neither of us had union/government jobs and neither of us have a private/government pensions with paid health benefits.
    I DID have to wait 11 months on a waiting list for a family doctor in my small BC town because there aren't enough docs taking on new patients. And the wait to see the doc is easily 45 minutes or more, with an appointment. Same for my eye doc and dentist. The healthcare system in Canada isn't perfect, but overall it IS cheaper than in the USA.

    BUT taxes in Canada vs the USA definitely even things out. Not income or property taxes - sales and service taxes. During 2010/2011 we lived 6 months in Canada and 6 months in the States. Exact same living conditions in both countries, but it cost us 25% to 40% less in the USA for almost everything we pay for in Canada: rv pad rental, utilities, food, alcohol, pop, clothing, shoes, dog food, vet care, toiletries, household supplies, cleaners, electronics, sports equipment, entertainment, laptops, printers, stationary, small appliances, tools, an aluminum ladder, furniture, etc.
    Some foods (fresh or frozen fruits and veggies) are priced the same in both countries but not many things were priced higher in the USA.
    Real estate is cheaper in the States.
    Rent overall, is cheaper.
    Internet, cable and cell phone service seems to be half the price of Canada.

    But if the debate is only about the cost of healthcare, then yes, Canada wins.

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  14. When we retired we had the luxury of choosing between Norma's Government medical package and my union package. Both were good but but seeing how we had a worker friendly government in power in BC at the time, Norma's was better and that was the one we took. It included dental, eyeglasses and a $3k death payment.

    The government changed and things started going downhill rapidly. The first year they took away the $3k death benefit. Well, OK, all I need is a cardboard box for my ashes anyway. The $3k would have just bought my friends some good scotch.

    Two years later they dropped the dental and eyeglass coverage and offered to sell it back to us for an additional $160 per month or something. By now I had mostly gold caps, Norma had implants and we both buy our glasses in Mexico so we passed. We are left with is the enhanced medical with #300 deductible prescription coverage for $1320 per year. The total cost is a little bit more than that but the extra is paid by her retirement package.

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  15. Kelsi

    You say, "BUT taxes in Canada vs the USA definitely even things out. Not income or property taxes - sales and service taxes" and you make a comparison between living expenses in each. I think what is missing is how each funds health care. Because Canada funds government more from user taxes (sales and service) vis a vis the U.S. funding government more from income taxes that will naturally raise "living expenses" in Canada. Further, economic factors and differences in the valuation of the dollar (not so much so today though) impact "living expenses" in Canada. This is evident when you compare income taxes of each:

    Income tax rate of Canada:

    • 15% on the first $41,544 of taxable income
    • 22% on the next $41,544 of taxable income (on the portion of taxable income between $41,544 and $83,088)
    • 26% on the next $45,712 of taxable income (on the portion of taxable income between $83,088 and $128,800)
    • 29% of taxable income over $128,800

    Income tax rate in U.S.:

    Tax Bracket Married Filing Jointly Single
    • 10% Bracket $0 – $17,000 $0 – $8,500
    • 15% Bracket $17,001 – $69,000 $8,501 – $34,500
    • 25% Bracket $69,001 – $139,350 $34,501 – $83,600
    • 28% Bracket $139,351 – $212,300 $83,601 – $174,400
    • 33% Bracket $212,301 – $379,150 $174,401 – $379,150
    • 35% Bracket Over $379,150 Over $379,150

    Keep in mind that the U.S. does not have true universal health care, notwithstanding that it would be funded primarily from income taxes. In Canada your health care is funded primarily from your "sales and service" tax and the tax you pay depends mainly on your spending, rather than your income. My point is that your comments are two different issues. That is: costs for health care and taxation to fund government (and in the case of Canada that includes health care). I feel the system of taxation in Canada is more fair, however I doubt it would matter in the U.S. Unfortunately, people in the U.S. are in the mindset that taxes are too high (more evident in the case of income taxes) and they resent supporting any social programs. The same way I commented earlier about the huge disparity in how each country funds the military and that I would prefer we fund health care and not the military. In every U.S. budget the military is exempt from cuts. So long as this country continues down this path universal health care will not happen. As simplistic as it seems, I feel that no one should die because of a lack of health insurance or health care. Unfortunately, this happens in the U.S.

    Bill in Nebraska

    P.S. Thanks Croft for the forum.

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  16. Ah the infamous healthcare debate.

    In simple terms Canadian healthcare is acceptable when viewing it on the surface.

    Financially it seems that things are rosey (I too am a BC resident so will only reference that province).

    Now for some issues.

    The costs are quite hidden and in fact the money collected and spent on healthcare is very high and disproportionate relative to income. Looking at the provincial budget it in fact takes up 40% plus annually to run the medical system. Those funds come from many areas with the Medical premiums only comprising a portion of those costs. The rest comes from income taxes (and this is the disproportionate area as the more you make the more you pay so the socialized medicine program is in fact a subsidized system, not a system of equality), from lottery monies, etc.

    The next point is access to healthcare and a family doctor. You are fortunate to have a doctor. Our doctor retired and the result was months of searching to find a replacement (believe it or not, doctors now have you come in for an interview and if you have an existing medical condition they may or may not accept you as a patient - it did happen to us, this being in the greater Vancouver area).

    Add to that extensive wait times for treatment. I incurred a knee injury and had to go for x-rays and then wait 7 months for the MRI. Then another 4 months to see the specialist, then another 4 months of physio before surgery was scheduled which was another 4 months later. And the kicker was the question asked of me, so are you still able to work and was this a work related injury...answer no to the first and yes to the second and you go to the head of the line.

    So yes there are positives and negatives to all systems. Let's not but on blinders though.

    Better yet, why compare to the US only? Why not compare it other countries, ones that are top rated in the world?

    Thanks for listening.

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  17. Nebraska Bill - You raised some great points in your comment, but you over-simplified our tax system. We pay both federal and provincial tax in Canada, which varies depending what province you live in.

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  18. Kelsi and Anonymous:

    I concede your points.

    Fundamentally, I feel universal / public funded health care is doable. In simple terms it is a pool of insured where the premiums pay for the claims. For example, the initial proposed bill in Congress included early buy-in for age 55 for medicare. Not a "give-away", rather an option to pay a income based fee for medicare. Now, to me that seemed like a logical option for not only those under insured, but those uninsured. The side benefit would be that individuals who couldn't retire early because of health insurance costs would likely take advantage of buying into medicare early, thus opening up jobs for younger folks coming into the workforce. The problem in the U. S. is that the private for profit insurance companies are driven exclusively by profit. Thus, the exclusions, higher premiums for age, etc. and denial of coverage. Our current health care legislation and law attempt to address these problems, unfortunately, not with success. And, unfortunately, costs must come from taxes. For my tax dollars I support social programs that care for our people, rather than spending on the military and overseas subsidies.

    Bill in NE

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  19. We are starting to see that insidious head of capitalism pressing to make its way into Canada as well. Hospital Administrators are collecting unconscionable salaries and the health delivery system has split into districts allowing even more bloated bureaucracy into the system.

    My brother-in-law worked for many years in the provincial Government. His job was finding fraud in the system. The fraud he found was not at the patient level but amongst doctors and pharmacists with their multiple billing and phantom patients. You get a potentially good system and the greedy see their opportunity.

    Knees seem to be a problem. JB and Anonymous relate their tales and I have my own story with my brother in Alberta.

    He was a carpet layer most of his working life and blew out both knees on a "kicker". It was work related but try to prove it. Doctors agreed he needed two new knees but could never fit him in because they determined he could (sort of) get by the way he was so he found himself on the bottom of every list. Their working theory was, if you can walk in, you can walk out and there were always people in more desperate need of the surgeon's services . He eventually died at 82 complete with his old, torn up knees.

    In Comox, BC they had big fund raisers to help the Government purchase an MRI for the hospital which they finally sold enough hot dogs to buy. Problem was the Government would only supply funding to staff it 8 hours a day, 5 days a week. the rest of the time it sat idle with patients needing the service. The local paper exposed the hospital renting the MRI out to vets on off hours. If you were a dog, you could get right in but a human? Back of the line!

    I am not saying Canada's system is perfect. far from it, but IMHO it is better than our neighbour's to the south.

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  20. I'm on board with your post up to the point where you say 'socialized medicine does work'. I'd rather say 'it CAN work'; I'm convinced that we in the US can and have screwed it up. Congress is just too under the thumbs of various special interests to actually fix it.

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  21. I will meet you half way Don.

    Socialized medicine works if it is done right.

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  22. I'm with you Croft! I lurk on your site but have never commented before.

    I am a middle-aged, native-born Texan with a decent (by American stands) healthcare program through my work. It is still expensive with premiums and co-pays. I am grateful for what insurance my husband and I have.

    I love my country - would not permanently live elsewhere but . . . It is embarrassing that the U.S. is so far behind other industrialized countries and their health systems. My husband and I worked in the Czech Republic for two years on worker's visas and received excellent health care while there - regular check ups and emergency care. Yes, the clinics were plain, not fancy office buildings with the latest decor - but we had good care. It was paid by a tax out of our paychecks - no co-pays and worth every koruna.

    All Americans should receive health care. Why? It's the MORAL thing to do AND, don't fool yourselves, we are still paying for those who aren't covered now. How? The uninsured have to wait until they have a medical emergency, and they then get care in an emergency room, which could lead to a hospital stay. The cost is passed on to the insured through inflated medical costs (to cover those who can't pay) which leads to higher premiums by the insurance companies for the insured.

    I broke my femur in three places 6 months ago. I was in the hospital for 7 days. The hospital bill was $70,000 - that's $10,000 a day - NOT including the various doctor bills. That doesn't include my bill for physical rehab. Not only was I billed for my care, but it was jacked up to cover the uninsured or those who go bankrupt and can't continue to pay their medical bills.

    I'd rather pay higher taxes for a well-planned universal health care program than what we've been doing. We would have better preventive care; fewer people would wait until they are seriously ill to seek treatment. I believe everyone would benefit in the long run.

    Two other quick points - I hear complaints about Obamacare requiring everyone to pay some sort of premium in the future. There's talk about infringing on our freedom. Americans do remember that we are required to pay auto insurance in order to drive a car in the U.S., right? I don't hear an uproar about that.

    This is a question for the large number of church-going Americans, many of whom are vocal in political discussions. For those who cherish the sanctity of life - those who witness their belief in Christ and his teachings, like love your neighbor as yourself or suffer the little children to come unto me or the parable of the Good Samaritan - WWJD? Think about that.

    H. Colette

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