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TOPIC: Health Care, Health Insurance

Health Care, Health Insurance 1 month 3 weeks ago #15809

  • Kawboy
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To start, I realize this is not a KZ1300 typical topic but as I've stated before we come together with a common interest and grow together around the operating, maintenance and modifications of the mighty KZ1300. We also share stories of riding adventures and pics of all things we love. In the true spirit of sharing life with our brotherhood I thought I would try stimulating a whole new topic and just see where this goes. Feel free to post your thoughts on the topic or even your thoughts on whether this type of topic should be allowed on our site.

I’ve been watching with earnest, the American Presidential Election (2017) for the past 18 months. American Politics is much more interesting than our Canadian Politics. It would appear that preparing for and going through the process of voting in a President or the by elections is a never ending process.
In this past Presidential Election, one of the fundamental topics of concern has been Obama Care or more properly called The Affordable Health Care Act. I found the whole topic incredible. In Canada we’ve had government run health care since (for the province of Ontario) October 1969, (48 years). For me, that would be health care I place since I was 13 years old.
For as long as I can remember, I’ve never had to consider whether or not when I got sick or needed help with my health, that I could get health care without a cost. Basically, if I got sick and went to a doctor, the cost of seeing a doctor or follow up at a specialist or going to a hospital would not cost me one penny out of my pocket. So in stating this and watching this recent Presidential Election I decided to look into just exactly what I’m getting for health care and what is it costing me.
In order to better understand our Health Care System on Ontario, I went to our health care site to investigate. If you care to investigate for your own purposes here’s the site. www.health.gov.on.ca/en/public/programs/ohip/ In simple terms, anyone residing in the province of Ontario for a period longer than 153 days per year is entitled to health care. Health care is defined as the right to seek medical attention be it for physical or mental illness from a doctor of your choosing. There is a process for getting an assigned doctor and it’s defined in our Health Care Act. If your doctor decides that you need further follow up with a specialist or need hospitalization and prescribes treatment, that treatment will be offered to you at again no additional cost. This covers everything and almost anything. Need a lung transplant- covered, gall bladder removed – covered, cancer treatment- covered. If a doctor prescribes treatment- covered, period. And you can’t be denied health care. If you ride a motorcycle, sky dive, extreme snowboarding, scuba dive, or whatever you can imagine, under no circumstances will you be denied health care. I have a cousin who got involved with a wanted person by our RCMP. They stole a car and a high speed chase ensued. There was a car accident which ended in my cousin suffering head injuries. It now takes her 10 minutes to string 4 words together and speak. She is a ward of the province of British Columbia. Health care covered all of the medical and cost of living including the 24/7 support staff keeping her alive.
So how is this Health insurance paid for? Simple. People working in Ontario will pay into the OHIP fund anywhere from $60/year for base income of $17,000 and a graduated scale up to $900.00/year for a $200,600 base income. Employers also have to pay into the OHIP plan for each of their regular full time staff and that fee I can’t tell you at the moment. The fund is also supported through our Provincial Sales tax which is 7% on all goods and services. And then there’s a top up from the Federal Government as required to maintain OHIP services.
An Insurance plan is nothing more than a bank account which is shared by all of the people in the insurance plan. We all pay into the “bank account” and then bills that need to be paid and meet the requirements of the insurance plan are paid. The holder of the plan be it the insurance company or the government manage the collection of the monies and the payment of the bills. On a regular basis, the holder of the plan needs to review the income and outlay to determine if changes to the income or controls of the coverage need to change in order to maintain a healthy plan. For doing this, they take a fee. Or in the case of the government held plan, operate the plan as a non-profit entity.
So bottom line, for Canadians, Health Care is available to all people who live in our Province of Ontario and I should mention that all of the Provinces in Canada have similar plans. I never need to concern myself with the thought of whether I’m entitled to any health care when needed and can remain focused on getting better, not losing my house or life style. The maximum it could cost me personally is $900/year if I earned $200,600 base income or more. The system works. It’s been in existence for the past 48 years and it’s healthy, meaning self-sustaining.
I would be curious as to what health care is offered in other parts of the world and what exactly the costs are to operate. I have heard stories of our American brethren paying upwards of $5,000 per year for average coverage for a family of 4 and I wonder if maybe because health care is offered by individual insurance companies and the plans are smaller and more costly to operate than a government plan which covers millions of people all at that same time. I also wonder why it would appear that USA seems to be trying to start up their own system blind rather than looking at other systems that are presently in existence and working. Why reinvent the wheel, just duplicate it and maybe tweak it later down the road to fine tune it to your needs.
I am truly interested in what health care is in place around the world and at what cost plus I would also like a better understanding of the existing health care in the USA.
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Health Care, Health Insurance 1 month 3 weeks ago #15810

  • BigSix
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Hi Kawboy

I used to work in Germany and I am presently working in Switzerland, in both countries you are obliged to have a health-insurance.

In Germany you can choose:
- either you choose between various insurance-companies which all cover basically the same fundamental risks for a fee that varies slightly, this is the so called "insurance by law"
- or you can be insured privately which is basically a first class insurance, costs are usually higher, service too.

While the first targets mainly employees, the second aims at self employed person.

Though I mentioned there is a law, it does not mean everyone has an insurance. Typically there are two groups that don't have one:
- the really poor that consider it an expense they do not want to take, I consider that quite dangerous in case you get really ill
- those who earn so much money that the will cover their health expenses completely themselves without an insurance, they avoid that their costs get mixed with anyones through an insurance-model.

Now the costs (first model only)- they depend on your income and the company you choose, I used to pay to cover myself and my wife EUR 600/USD 630 month. That will cover most of the medical care, it will exclude medicine or part of the costs for it as well as dental care.

Now as we moved to Switzerland the system is much more liberal:

If you want you can get an insurance that will guarantee a single room in a hospital with lake-view, treatment by the top doctor in that hospital, all the new magazines and newspapers you can get, whatever. You just have to pay for it (which is the downside).
Insurance will cover the basic medical treatment, for anything else you will have to cover at least part of the costs (personal contribution) until a certain limit. Most insurance companies offer various limits, depending on that your fee varies.
If you grew older the risk for the insurance gets higher, accordingly you have to pay more. 5 years ago we were almost level to what we paid in Germany, now we are already exceeding it and are at around EUR 650/ USD 685 month for both of us.
Dental care is completely excempt, you have to pay everything.

I had to go to hospital last year, just a minor operation. The two days spent in hospital ended up at around EUR 3350/ USD 3525. I had to pay 10% of that as my personal contribution, limited to around EUR 700/ USD 730 has not been exceed at that time. Once the amount to be spent exceed my contribution, the insurance will cover everything (required from a medical standpoint).

Costs for healthcare/ insurance are raising year by year and are bringing those without low income (in both countries) to a level where they are struggling to pay for their day-to-day life.

The advantage to me being forced to be insured is that in case I break my leg or even get something serious like cancer my financial situation will remain roughly stable, I won't go bankrupt or homeless just because I had to pay because I got ill.

best regards,

Holger
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Health Care, Health Insurance 1 month 3 weeks ago #15811

  • RickG
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Australian health care has a similar aim. Medicare as it is called is a 2% of your taxable income for any hospital care. Emergency care is very good elective surgery has a waiting list dependent of the state because the hospital system is state run where medicare is federal.
For high end earners there is a surcharge above the 2% if they choose not to have a private insurance which is just as expensive as USA.
I was told by one person that it cost $450 per month for full cover which includes dental and glasses but even then you can be left with a big bill if the hospital you choose is not on the preferred list of the insurer.
What I see that the big problem with medical insurance is that more often than not the Doctor is a partner in the owning of the hospital and also the insurance company so there is his profit as a surgeon then hospital profit then insurance company profit and all want a big profit.
The single payer systems such as the Canadian and the Australian and British systems are primarily designed to be a not for profit so all the money goes to the treatment of the patient and not to line the pockets of share holders of hospitals and insurance companies.
The big problem we have in Australia is that depending on what side of politics is in power the system gets altered to suit their idea of a good system.
If we visit a GP (General Practitioner or local doctor) we pay a gap which does vary but if the GP bills the Government directly then it is a standard fee of about $40 but more and more GPs are finding it difficult to meet the requirements so don't bulk bill but charge me what they want then I claim back the standard fee of $40.
This current mob of mugs cant accept that it actually costs more than it did last year to run a GP practice and have frozen the $40 rebate to keep the costs down. the capitalist B*****ds just want Medicare out and a system like USA has where we all get screwed all the time.
The cost of health care is rising disproportionately to incomes and most other costs except the pollies pay and if an extra percentage point was added most of the people would not complain too much as it would make a huge difference.
The big problem is that the pollies just cant leave it alone and agree to a suitable level of funding to state hospitals and leave it there.
For me who is at the lower level of income since I retired the system works fairly well but hospital waiting times for even minor procedures can be a long wait but usually no more than 4 months and if it's an emergency I cant fault it. All 3 times I have needed emergency treatment the Hospitals have been excellent.
The Medicare system has been going for about 30 years now and due to successive short terms of each side of government there has been constant stuffing about with who gets what.
The federal government spends billions subsidizing the private insurance where probably 30% goes in profit to shareholders when it would get better value just using it for treatment of the patients.

I could go on for days but will leave it there as its midnight and bedtime
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Health Care, Health Insurance 1 month 3 weeks ago #15813

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Hi John,
Good topic which will take more than one post for me to address. But first let me run a few things by you that I think I know about Canadian VS US health care. My company has manufacturing facilities in Canada and the US. A good friend of mine used to be the general manager of a distribution facility in Ontario. At the time I had injured my back and needed a partial disketomy, which I eventually received and it was 100% successful. My friend, BOB, told me that several of his employees got tired of waiting for their back issues to be elevated from discretionary to medically justified and ended up coming down to a hospital in Detroit and paying out of pocket for their treatment.

On a slightly different note. When I design repair protocols for our products in the field I have to consider the whole costs of sending a technician out into the field. I the US that hourly cost is about $45.00US per hour. In Canada I have to factor in more than $65.00US per hour. That difference in taxing structure needs to be considered in this comparison. Does it not? Also these technicians make about the same wages no matter which side of the border they're working in.
Bill
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Health Care, Health Insurance 1 month 3 weeks ago #15816

  • tackelhappy
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I happen to be one of the few lucky people, along with my family living in a social democracy, not a capitalist one like the USA. I favour sharing the countries wealth and resources with the less fortunate and the canadian health care system is a reflection of that. So not only is my basic health taken care of, but thru my wife's employer - now a private insurer, I get eye glasses, dental, prescription all covered. But the system has to be paid for , so I would assume that my personal income tax rate is higher than in other countries and the extra coverage thru "Blue Cross " , my wife pays a portion and the employer a similar amount.
Most western democracies have a similar system to ours, with variations as some of you have mentioned. But I also remember the debates on the early days of Obamacare when americans were looking at the canadian social model/ health care model and didn't consider it worth copying.
But I am under no illusions. There will be a continuing erosion of all government provided services as the "market economy " consumes all of us and more and more jobs either go off shore or taken over by robotics/ artificial intelligence and more and more of us don't have job and the tax base that funds the system, crumbles. Piece by piece the system is being dismantled, because it has to . How can my $30.00 per hour job continue against the $6 a day worker in China. I'm glad that I'm a retired person still working, having enjoyed the huge social progress we made in the seventies and eighties.
Closer to home - how about a discussion on motorcycle insurance premiums and what you get for that cost- cause I pay alot. - but latter when this topic is done.
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Health Care, Health Insurance 1 month 3 weeks ago #15821

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Interetsing thread this one: here in the UK we have a raft of private health care providers and the good old NHS. The National Health Service (I spent half my working life in the NHS, and is something I still believe in) sounds similar to the model provided in Canada.

The NHS was launched in 1948, and was born out of the ideal that good healthcare should be available to all, regardless of wealth: and with the exception of some charges (drug prescriptions, optical services and dental services), the NHS in the UK is free at the point of use for all UK residents. It's not perfect, and there can be delays in awaiting non-emergency care, but Im reassured that its there when needed.

Its a massive organisation, employs over 1.5 million people (5th biggest emploer in the world) and deals with over 1 million patients every 36 hrs. It covers everything fromcradle to grave, including routine screenings, treatments for long-term conditions, transplants, A&E emergency treatment and end-of-life care, etc etc.

It really is an expensive beast to fund: funding comes directly from taxation; for 2015/16, the overall NHS budget was around £115 billion for a population of approx 65 million. Thats an awful lot of tax per each working individual :blink:
I think the model is unsustainable with an ever growing & ageing population: I read that 95% of health costs are incurred in last 5% of your life.

I've also had private health care (for my wife and myself) provide by my later employer (until I retired): pretty sure it was about £2500 Sterling per annum: irony was I never used it, but had to pay a tax penalty to the Inland Revenue Service of approx £1000 Sterling per annum, as it was deemed a benefit provided by my employer.

Cheers Tim
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