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TOPIC: Health Care, Health Insurance

Health Care, Health Insurance 2 years 11 months ago #15823

  • Kawboy
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Big Six, Rick G, KZQ, Tackelhappy and Tonto, Thanks for the feedback. Very interesting. It just shows how different the health care system is handled and just might help explain why the USA is struggling to "get it right".

In Canada we have a program to help our first year high school kids pick a career path which helps them decide what classes they need to take in high school to reach their career path. We call the program "Take you kids to work day" In the spirit of the program I asked my son what his plans were for Take your kid to work day and he said "I guess I'm going to the nuclear plant with you. My first reaction was Great !! but then I asked him why he would choose the nuclear plant. He told me he didn't have a choice. Not so I said. What do you think you'd like to be when you grow up? Maybe a doctor he said. Well, lets see if I can take you to see a doctor and discuss the career path. Makes more sense than going to a nuclear plant if you really think you want to be a doctor.
So I arranged for an interview with Cameron's doctor to talk about what's involved, what a typical day is for a doctor, responsibilities, training, and monitary compensation since why go to all the work if the money isn't there. This interview happened in 2001. It was an eye opener for me and for Cameron.

7 years of unniversity, 2 years of internship, $150,000 setting up a practice. Then up came the compensation. He started by saying if he really wanted to make money, he'd move his practice to the USA because he would probably make 5 times what he makes in Canada. As a doctor in Canada he was limited to a maximum yearly billing of $187,900 to OHIP so in a nutshell, that's his maximum possible wages he could make. But if he went stateside 5 times that amount without busting a sweat.

The hospitals in Canada are funded by the Federal Government.

Most really good places of employment have what we call Extended Health Benefit Plans which cover things like semi private stays in hospitals (2 patients to a room) a limited amount of physiotherapy and chiropratic services, most of the prescribed drugs although they have moved to the generic substitutes of the prescribed drugs.
Usually included along with the Extended Health Plans is a Dental Plan and depending on the plan purchased by the employer it could be a minimal plan or a fully covered plan.
My employer was Ontario Power Generation which was at one point Ontario Hydro. The only thing I paid for was my OHIP portion. The employer paid for everthing else. Our drug plan required that I pay the first $10.00 of perscription fees per year then the plan paid all of the rest for the remainder of the year. My extended health also covered eye glasses up to $700 per every 2 year period. Our dental plan covered for absolutely everything except full coverage crowns and bridges They covered 80%. So I have 8 crowns in my head and each one cost me out of pocket about $250.00 each.

As a manager at the plant I can tell you that between the Hydro contribution to our pension plan plus the Extended Health Benefit Plan, the employer portion of the OHIP contribution and the Dental Plan the cost to the employer for that coverage worked out to almost $25.00/ working hour of the employee. So the average employee works 2,000 hours per year. That makes the cost to the employer $50,000/year/employee and that helps explain why it's such a dilema. And I have to add, all those benefits carry on for me for the rest of my life. Nothing changes. And all of the benefits I receive also cover my wife and all of her needs just as if she was an employee. That coverage would also extend to my children up to the age of 18 or to the age of 21 if they were in full time school.

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Last edit: by Kawboy.

Health Care, Health Insurance 2 years 11 months ago #15824

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The big problem with health care is that costs are spiraling out of control. Primarily because the latest treatments are expensive and because these treatments to a large extent work we live longer and that in itself leads to even more costs as the population is ageing due to unnatural causes.
We all enjoy our retirement and want to make it as long as possible. We live an unnaturally long life and the costs of that must be born by us whether it be by higher insurance premiums or higher taxes to pay for a national health care program or a bit of both.
To me what it boils down to is that it's not the high cost of living but that the cost of living high is rapidly catching up with us in more ways than one. Until we as a whole learn to distinguish our needs from our wants things will continue to get worse and ever increasing costs of medical and health needs are fairly much at the top of the list so therefore we need to curb our wants a bit and make some adjustments. Getting rid of the enormous and obscene profits from the health care industry and using that money to actually treat patients things will keep getting worse until we all have the best health care that money can buy and that means no money and you die.

Cost of medicines is enormous. In Australia we have the PBS (Pharmaceutical Benefit Scheme) and for any Australian resident the cost of any prescription item covered by that scheme (most are covered) is around $40 and for any resident who is receiving a government benefit such as aged pension or disability pension the cost for that same prescription is around $6.50 and after 56 prescriptions in a year are filled then there is no cost.
I for one am very grateful of this scheme as it saves me thousands of dollars every year.
I also choose to go to a GP who does not bulk bill and charges me $70 for each visit because I get very good primary health from him as against going to a clinic who does bulk bill and I have no choice of doctor and the basic care is just that or often below basic.
Any time I have needed urgent hospital treatment or emergency care it has been without fault and the elective surgery or treatment (the surgery that can wait for a while) hes been very good once I actually get it but there has been times where I have had to wait a long time but usually it is only a few weeks to a few months.
Where I live (in a rural area 250km from the capital city) if I had private insurance I would get the same surgeon as I would if I went with the public hospital system and in he same hospital and the wait time may be a bit shorter.
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Last edit: by RickG. Reason: Fix typos

Health Care, Health Insurance 2 years 11 months ago #15888

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I've been going through a bit of hell lately. A week ago Sunday I experienced sum bright flashing lights in the periferal of my right eye. Thought it was just a new thing I had to go through with the aging process. Then on Monday morning I started seeing millions of spots and then a series of dark clouds wisping past my field of vision when I looked up then down then straight ahead, I knew this wasn't right so I called my opthamologist for an emergency appointment. He wasn't available. Told me to go to the hospital. Now here in Canada at the moment (well for the past 15 years) waits in emergency in a hospital can be from 1-10 hours dpending on the nauture of your emergency. When this vision problem happened to me, I was standing right outside of a optomitrist office, so why not try to get in to see him.
Stuck my head in his office. He saw me right away. All I had to do was offer up my government issued Health Card. I was seen in less than 30 minutes. No cost to me. His diagnoses was a posterior vitreous detachment. Something that happens to 60% of all aging men and women but more so for men. There's also the possibility that you can experience a retinal detachment from this vitrious detachment. The optomitrist told me that I should still see my opthomologist and consequently I had an appointment to see him yesterday. He was concerned with my retina and sent me to St. Michaels hospital where they have a retinal and vetrious specialty wing. Best in Canada. Again, all I needed to do was present my Health Card and i was in to see the retina specialist in less than an hour. Conclusion, yes I have a retinal detachment. They have removed some of the vetrious fluid from my eye and put an air bubble in there to push the retina back up in place and today if the air bubble proceedure went well, they will use a laser and secure my retina back in place and save my eye.
So the bottom line as I see it (no pun intended) I'm glad to be in Canada while this shit is happening to me. I'm siting here worried about losing the sight in one eye. The last thing I need to woory about is how to pay for this procedure or if I couldn't pay for it, losing the sight in one eye. For me, losing my vision or my mobility or my mind = life is over for me.
There's this feeling amongst the young that they shouldn't have to pay high health insurance costs if they are healthy. I look at it as banking funds for future needs. I've been healthy my entire life. Only had my tonsils removed at 5 years old and a cartilidge removed from one knee in my early twenties otherwise just my annual check up.
Just thoughtt that this health example migth shine a light on this health insurance topic.

Stay healthy !!!

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Health Care, Health Insurance 2 years 11 months ago #15889

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This issue is not simple in US, period.

First off the method of influencing public policy in the US is down right criminal. Companies and investor groups band together and throw millions of dollars behind a politician who they hope will represent their interests. They call these special interest groups Political Action Committees or super PACS. The supreme court ruled in the Citizens United case that corporations have the same rights as an individual when it come to the First Amendment and therefore can freely donate as much money to any candidate as the choose.

So the debate over health care has actually turned into a debate about the heath insurance industry and not about sick people... big surprise there. The issue is the American people are not represented in the debate, this is about banks, investors, and insurance companies protecting their bottom line. It is the reason I oppose the "individual mandate" requiring people to buy insurance. It forces you to pay whatever they want to ask, because in many states insurer's have a legal monopoly on their coverage. Insurers have no competition, and offer terrible plan benefits at ridiculous prices.

This scenario was doomed to failure, the law known as Obamacare was designed to fail and force the debate about single payer health care. The architects of the bill freely admit this fact. The idea was to transition to an European style health coverage system but a number of things went wrong.

1. The public insurance option got removed, because the banks and insurance companies did not want to compete with the government.

2. The insurance companies were able to legally form a monopoly in many states and are free to do what ever they want (for the most part).

3. Trump won... that is still a shocker even to some of his supporters.

4. The republicans held the House and the Senate... the Democrats were banking on a Clinton presidency and a weakened Republican party.


The result is that the republicans are torn in half right now. The small government conservatives want to go back to the way things were and repeal the whole mess with no replacement. The guys with big money backing want to protect their investor groups and insurance companies that are making shitloads of profit right now. Trump who is neither republican or democrat, just wants to keep his campaign promise of repealing the ACA (Obamacare).

I can't see a workable result coming form this situation. The concept of interstate completion that Trump wants got nixed by the insurance industry ( because it would affect their bottom line) and we are only talking about insurance reform and not true health care reform.

Insurance is just that, insurance. Trying to get insurance with a pre-existing condition is like getting into a car accident first and then trying to buy insurance to fix your car, its absurd. There needs to be a mechanism for people who lose their insurance and are sick to get health care that is simply too expansive to afford on your own. That is not being talked about.

I myself am fortunate to have 100% of my family's health insurance paid for by my employer, with a plan that has not changed since the 1970's. I pay very little or nothing for most medical needs. My first child spent a week in neonatal intensive care, the bill was over $30,000 and paid about $1,500 out of pocket when all was said and done. My case is unfortunately an exception and not the rule here in the US.
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Health Care, Health Insurance 2 years 11 months ago #15892

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Since your last presidential election Tyler, the rest of us have taken a much keener interest in your country and specifically Obamacare.
It was always going to be very difficult to come up with a system first time up that would suit most people , compare to the rest of us who have lived in social democracies that have had state run universal health care since the day they were born. I have never known anything else. Got an injury, a sickness- then walk in the front door of any hospital or clinic anywhere across the whole country and the problem will be looked at , at no cost to you. But the system we have today didn't happen overnight, but more than 60 years of fine tuning.
But the government, either provincially or federally owns everything resulting in seamless care because each patient is essentially dealing with the one provider, no matter where they are.
So the principal is that everyone pays an equal share, helping the less fortunate and sharing the burden.
But then the down side. In 2006 when I was looking for a faster bike to deal with what appeared to be ever increasing road speeds, faster than what I thought the Kawasaki was happy with, I bought a 2006 Hayabusa in Montana because it was nearly $4000 cheaper than in Calgary. And millions of dollars flowed south of the border over the next few years for all sorts of products. Canadian dealers had always justified the higher prices because of the cost of doing business here -mainly these social costs- health care,/pensions , old security etc.
As a society, we have to decide what we want , and then have to except that someone has to pay for it. But it seems to me, that as the middle class shrinks further and further, - the poor can't help because they don't earn enough and the rich and famous send theirs off shore, how and are we going to keep all this going. It's ok for me right now. But we are a dying breed.
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Health Care, Health Insurance 2 years 11 months ago #15894

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The United States is just that... 50 individual sates plus the District of Columbia that agree to play nice with each other under the rules outlined in the constitution. The Federal government has authority over international issues and defense, but is pretty crippled in its ability to enact domestic policy compared to many other countries. Our government was designed that way form its inception, on purpose, to limit federal "interference" with the states and the individual.

Single payer health care does not fit into that type of government. It may be the necessary way to run health care as a nation, but it would require a significant shift in the role and structure of our government to do. I doubt it will happen any time soon.

Also you have to consider the tax revenue to pay for it. Most people who are "middle Class" in America end up paying somewhere between 10 to 15% of their gross earnings in federal income tax. The idea is to tax the "wealthy" to pay for universal health care, but in reality the middle class folks like myself will have to pay more too. For the average working American who gets employer benefits for health insurance, they will see their bottom line affected and that right there is why the politicians know they cant make single payer health care in the US. The working American will not tolerate the tax burden.

The average American just wants to take care of themselves and their families and want the government to stay the hell out of the way.

Right or wrong that is just the way it is here.
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