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 jelunc
Joined: 8/24/2008
Msg: 1
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Health Care Cost IncreasesPage 1 of 13    (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
With apologies to those of our neighbors who have had the foresight to provide health care for themselves and their neighbors through taxes and/or minimal fees...

As I was rummaging through paperwork to fill up my recycling bin for pick up this week I came across the latest notice of this year's health care increases.
It made me wonder how others are faring as costs ratchet up (or not).
My coworkers and I typically face a small premium increase in July. This fiscal year we were whacked with a 33 percent increase or a 25% jump, meaning that those of us who were hired prior to the early 2Ks went from paying a 15% premium to 20 and those hired later were hiked from 20 to 25%.
In addition we were presented with copays for expensive high tech tests... MRIs, PETscans, increases in hospital admissions, more for ER visits, that sort of thing.
An unprecedented set of increases is being instituted in February.
We will now be required to pay a deductible for our PPO/HMO.
The copays for tech tests has been increased by 33% already, in just 6 months.

It makes me wonder, as we keep hearing about how happy so many Americans are with their health care coverage, if others are experiencing the same thing.
Is this happiness an emotion that predates this sort of addition?
Was it ever satisfaction with actual coverage or just being darned happy to have some coverage?
Is it only uninsured people who need health care reform?
 arwen52
Joined: 3/13/2008
Msg: 2
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Posted: 1/31/2010 9:27:47 AM
Try being self-employed or unemployed. Imagine paying the entire premium yourself and getting hit with those increases. Imagine paying more money for less coverage than people in groups and being denied coverage for any preexisting condition. Imagine changing your plan with the same health insurance company you've had for years and having to reapply as if you were a new applicant, giving them yet another opportunity to deny coverage for preexisting conditions. Imagine being dropped for no reason by a company and having to find insurance all over again with one of the few companies that offer individual policies. Imagine getting sick on 12/28/09 and seeing the doctor on 12/31/09 and worrying your subsequent claims will be denied by the new policy, which begins on 1/1/10, because it will now be for a "preexisting condition" that began a couple of days before your policy changed. Imagine being turned down for insurance because you were merely *tested* for a condition that it turns out you didn't have.

Something like 80% of Americans get health insurance through their place of employment. They do not have to worry about any of this and they only pay a small portion of the actual cost. But you can lose your job at any time and join the ranks of those without employer provided insurance.

I have little patience with people who are covered and oppose health care reform. They've got theirs. They don't care about anyone else. They somehow think those of us who lack are undeserving. I only hope that they themselves get put in that position so they can see what it's like.

Yes, we need health care reform.
 JWG86
Joined: 7/5/2008
Msg: 3
Health Care Cost Increases
Posted: 1/31/2010 10:29:02 AM
With apologies to those of our neighbors who have had the foresight to provide health care for themselves and their neighbors through taxes and/or minimal fees...


Then move to Canada, take a 30% net pay-cut compared to what you are making now, and enjoy the "minimal cost" of your "free" healthcare.

Problem solved.

I currently do not have insurance, nor do I want reform in the form of HR3200. I want reform, just not HR3200. We NEED to fix our system, but some pork-laden monster with other agendas imbedded in it, just isn't it.
 dbz77
Joined: 12/5/2006
Msg: 4
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Posted: 1/31/2010 10:39:06 AM
I have little patience with people who are covered and oppose health care reform. They've got theirs. They don't care about anyone else. They somehow think those of us who lack are undeserving. I only hope that they themselves get put in that position so they can see what it's like.

Yes, we need health care reform.

Each individual state should handle it; health care reform is reserved to the states and the people, not the United States Congress.

How do you feel about price controls on health care?

In addition we were presented with copays for expensive high tech tests... MRIs, PETscans, increases in hospital admissions, more for ER visits, that sort of thing.

That hi-tech stuff explains why the average cost of health care is rising.

I bet that health care procedures that existed in 1910 do not cost as much as the procedures that you have listed.


Michael
 jelunc
Joined: 8/24/2008
Msg: 5
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Posted: 1/31/2010 10:57:53 AM

Yes, we need health care reform.


I agree totally, Arwen52, I have done the self-employed no insurance/ underinsured thing; I didn't like it much.
I didn't like telling docs I had to refuse medical care for my children because I didn't have the money to pay for X rays. That is a big part of the reason I switched to being an employee rather than independent.
So I am familiar with all of those imaginings.
I don't have much patience for those people who play "I've got mine..." either.
I hope we get you something reasonable and affordable soon.
 jelunc
Joined: 8/24/2008
Msg: 6
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Posted: 1/31/2010 11:04:00 AM

Then move to Canada

I am more likely to move to Mexico, but, thanks for the suggestion.
Can you share what you think we should have for reform?
 BellaDupree
Joined: 8/27/2009
Msg: 7
Health Care Cost Increases
Posted: 1/31/2010 11:14:37 AM
the following is from:
http://tax.yyconsulting.com/2009/06/tax-freedom-day-canada.html


Saturday, June 6, 2009
Tax Freedom Day - Canada & USA
Fraiser Institute just released June 9 is Canadian's Tax Freedom Day this year! We are three days ealier than year 2008. The main reason is that the economic slowdown has reduced tax collections even faster than it has reduced income.

So what is Tax Freedom Day? This is the first day that we have paid off all our taxes on federal, provincial and local levels, and we start to really earn money for ourselves. Fraiser Institute also has a handy online calculator to calculate your own TFD.

In 2009, Canadian family earned $88,432 in average and paid $37,699 in tax.

For US, Tax Freedom Day for 2009 is April 13, for a total average effective tax rate of 28.2 percent of the nation's income. This is eight days earlier than last year due to two major reasons: recession and stimulus.


I think a nice first step would be for the administration to stop that 2Billion in Medicare/Medicaid fraud, and use that for the uninsured/underinsured. Get that going and WORKING, and then take a next step.

You can think me selfish if you like, but I dont want to work , and I dont want anyone else to work and additional 58 days for you, or me, the government, my Aunt Sally or anyone else,

As a matter of fact I want all the government agencies up and down the line to become streamed lined, I want their benefits and pensions to be cut by a quarter, I want the built in cost of living increases to be phased out, lol I want, I want, I want, but that is where the money should be comming from to pay for health care.

All levels of government is blouted, getting a governmnet job should not be like hitting the jackpot.

and to the OP, you are not talking about the cost of health care going up, you are talking about the cost of your health insurance going up- maybe not even that, but the cost that you have to pay out of your pocket for your care. I think it is a bit odd that you complain about your out of pocket expenses but are all for EVERYONE to be out of pocket in the form of more taxes to pay for your health cares. Well unless you really beleive that universal coverage will some how pay for itself
 JWG86
Joined: 7/5/2008
Msg: 8
Health Care Cost Increases
Posted: 1/31/2010 11:19:27 AM
Can you share what you think we should have for reform?


No, I don't have the time to write it all up, nor the experience to suggest all things that need change. I just know that HR3200 and all the pork with it, are not what we need. Some of it is good, some bad, but it's not what's needed.

I can tell you that if we were to not have a 2:1 ratio of animal-shelters to human clinics, things would be a lot better. We need to increase our aid to the community. If we do that, we can prevent things from escalating into an uninsured/unpayed ER visit. Further, people are abusing the crap out of WIC. During the time I spent at the free clinic last week, I saw them put a woman on WIC because she fed her kid a hotdog. That's right. Feeding your child a hotdog qualifies you for WIC. Why? A hotdog is a choking hazard and they want you be able to get approved food that isn't.

Overweight or underweight mom? WIC. Now how many people do you think in Louisiana are overweight? I can tell you. A whole hell of a lot.

Federal money is being used and abused, and this HR3200 isn't going to be any different. We need to better spend what we've got.
 jelunc
Joined: 8/24/2008
Msg: 9
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Posted: 1/31/2010 11:32:50 AM
Michael says:


That hi-tech stuff explains why the average cost of health care is rising.

I bet that health care procedures that existed in 1910 do not cost as much as the procedures that you have listed.


that high tech stuff certainly explains some of the reasons why health care costs are rising.
I am not sure how the figures shake out (and I am not going to spend my Sunday afternoon trying to figure, even if I could) between income and medical costs in 1910 compared to 2010.
I did look up life expectancy for 1910, though, for US men it was just prior to turning 50. If we went back to that standard it would help SS funding a whole lot. I have an idea most of my male friends are not willing to make the trade.

Massachusetts, where I live, has universal coverage. I hear that Mitt Romney's health care program for Mass is breaking the bank.
Would other states handle it better, do you think?
I would like a reconciliation form of health care reform as it seems impossible to institute universal care nationwide.
I think that we also need as much regulation imposed on the health insurance industry as we do on the banking groups.
 Cebrhocabi
Joined: 8/26/2009
Msg: 10
Health Care Cost Increases
Posted: 1/31/2010 11:33:38 AM
Those who are against heath-care reform either own majority stock shares in the heath insurance and pharmaceutical industry or they have been bamboozled by the propaganda of rich, often delivered to them complements of talk radio. For those who have been bamboozled, they are advocating for a heath-care system that is against their own best interests--in my opinion.

You have a person who is sick, then you have a doctor willing to treat them. Between those two is the insurance industry making a huge money grab. A better solution--and one that would be cheaper for all--would be for everyone to pool their money, through taxes, to pay for heath care. Can't have that, however, because to many people are worry someone might pay a little less then them. They would rather continued to shovel more of their dough into the pig trough of the rich, rather than pay less, because someone might pay less, still.

For years, the government, which in the past has existed only for the benefit of the wealth few, has abetted this theft from "the people." Here is what President Nixon had to say when first considering the idea of HMOs:

http://en.wikisource.org/wiki/Transcript_of_taped_conversation_between_President_Richard_Nixon_and_
John_D._Ehrlichman_%281971%29_that_led_to_the_HMO_act_of_1973:

This is a transcript of the 1971 conversation between President Richard Nixon and John D. Ehrlichman that led to the HMO act of 1973:

John D. Ehrlichman: “On the … on the health business …”

President Nixon: “Yeah.”

Ehrlichman: “… we have now narrowed down the vice president’s problems on this thing to one issue and that is whether we should include these health maintenance organizations like Edgar Kaiser’s Permanente thing. The vice president just cannot see it. We tried 15 ways from Friday to explain it to him and then help him to understand it. He finally says, ‘Well, I don’t think they’ll work, but if the President thinks it’s a good idea, I’ll support him a hundred percent.’”

President Nixon: “Well, what’s … what’s the judgment?”

Ehrlichman: “Well, everybody else’s judgment very strongly is that we go with it.”

President Nixon: “All right.”

Ehrlichman: “And, uh, uh, he’s the one holdout that we have in the whole office.”

President Nixon: “Say that I … I … I’d tell him I have doubts about it, but I think that it’s, uh, now let me ask you, now you give me your judgment. You know I’m not too keen on any of these damn medical programs.”

Ehrlichman: “This, uh, let me, let me tell you how I am …”

President Nixon: [Unclear.]

Ehrlichman: “This … this is a …”

President Nixon: “I don’t [unclear] …”

Ehrlichman: “… private enterprise one.”

President Nixon: “Well, that appeals to me.”

Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”

President Nixon: [Unclear.]

Ehrlichman: “… the less care they give them, the more money they make.”

President Nixon: “Fine.” [Unclear.]

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.”

[Source: University of Virginia Check - February 17, 1971, 5:26 pm - 5:53 pm, Oval Office Conversation 450-23. Look for: tape rmn_e450c.]




To listen to the actual tape, go here:

http://www.whitehousetapes.net/clips/1971_0217_hmos/
 jack-d-ripper
Joined: 2/25/2008
Msg: 11
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Posted: 1/31/2010 11:43:41 AM
.


You can think me selfish if you like, but I dont want to work , and I dont want anyone else to work and additional 58 days for you, or me, the government, my Aunt Sally or anyone else,



How many days do you work to pay for your Health insurance ? Workmans Comp? Increased car insurance?


.
 BellaDupree
Joined: 8/27/2009
Msg: 12
Health Care Cost Increases
Posted: 1/31/2010 11:45:53 AM
are you trying to depress me?
 jelunc
Joined: 8/24/2008
Msg: 13
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Posted: 1/31/2010 11:49:48 AM
Nice try, JWG86, I am pretty sure that LA does confidential sessions for determining qualifications for WIC just like they do here in Mass. So while the mom may have said that she got it cuz of a hot dog...
WIC has an income means test.
There is no doubt that federal money is abused, state money is abused, if you saw how I spend my income you might think I abuse that, and I might believe you could spend your money better.
I am not sure what that has to do with your admission that we actually agree that changes need to be made to the way we deliver health care.
 BigDaddyJinx
Joined: 11/4/2006
Msg: 14
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Posted: 1/31/2010 12:12:22 PM

With apologies to those of our neighbors who have had the foresight to provide health care for themselves and their neighbors through taxes and/or minimal fees...

Then move to Canada, take a 30% net pay-cut compared to what you are making now, and enjoy the "minimal cost" of your "free" healthcare.

Problem solved.

Ugh what malarkey!

JW, I don't know why so many people use that old canard of "pay cut" crapola all the time, when they reference the Socialist Devil Country of Canada.

You couldn't be more wrong if you tried. Really. And I'll give an example.

In the US, with Company ABC employing you...you're making $30,000 USD/yr. Now, barring the **7 states that do not have personal income tax**, let's assume that you are paying taxes on income. They always get ya somehow, let's face it. We'll use a modest rate of 25% of gross (in some states this can get as high as 44.5%). And a base and average amount of state taxes at 8.25% roughly. So in a year, that person makes $25,000 - 25% ($7500) = $22,500. They consume, so let's say at least 50% of their net is paid out and taxed on the state/city/metropolitan rate. $11,250 @ 8.25% = $928.12. So doing the math, spending the 50% of their net pay on consumable and taxable items and such...that adds an additional $928.12 in taxes on top. Much closer to $12,250 spent now including taxes. So between Fed tax and state tax(es), the individual has lost now $8428.12/yr. And that only leaves $10,321.00/yr (roughly).

No we'll look at the Canadian counterpart, doing the same job and we'll use Alberta as the province (seeing as how I live here lol).

In Canada, with Company ABC employing me (as they do my US brethren)...I make $35,000 CDN/yr. Now, excluding the **provinces that currently have a PST or Provincial Sales Tax**, let's make everyone aware that I WILL be paying taxes on my income. It's unavoidable. We use the modest rate of 35% (though can get as high as 44%). And a base amount of 5% GST (Goods and Service Tax/Gouge and Screw Tax). So in a year, that person makes $35,000 - 35% ($12,250) = $22,750. Now we are already $250 AHEAD of our US counterpart. They consume, so let's say at least 50% of their net is paid out and taxed via GST. $11,375.00 @ 5% = $568.75. So doing the math, spending 50% of their net pay on consumable and taxable items and such...that adds an additional $568.75 in taxes on top. Much closer to $12,000 spent now including taxes. So between the Fed tax and GST, the individual has lost now $12,818.75/yr. And that only leaves $9931.25/yr (roughly). Our US brethren have more net remaining, some $389.75/yr...but wait...

We don't pay Health Care.

So even though we are seemingly "taxed more" which is false, and even though we are left marginally LESS in a year than our counterparts...do we have to pay for our Health Care? Nope. The US brethren does though, so they better hope they can make due with the $389.75/yr to cover those expenses.

And will they be able to? Nope. Not at all. Not a chance in Hell actually. With or without benefits packages, they will have to pay out of pocket for LOTS of things regarding Health Care. Their Canadian counterpart...will never have to.

So really, who wins here?

Seems pretty clear who wins. Hands down. Slam dunk. No contest.

Anything else to add?
 jelunc
Joined: 8/24/2008
Msg: 15
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Posted: 1/31/2010 12:24:47 PM
BellaDupree
These are the figure I found to attempt to make sense of the holes left by that Frasier Institute report.
The median household income in the United States is $46,326. Here in California people have a hard time understanding that yes, 50 percent of our population live on $46,000 or less a year. Even today, all the elixirs and remedies being thrown around fail to focus on income and the big brother of income, solid employment. Dual earner households have a higher median income at $67,348.

It seems to me that people are making half to 2/3 as much and then paying for health care in addition, looks like a wash to me. The added income covers the additional taxes, I think.
I certainly don't want to think that you are selfish, I think that you are in a place where you are worried about how you are going to survive.
I don't have those concerns, my needs are few, I will happily work to help you have better health care.
LOL, if you don't recognize that my increased copays are health care costs I am not sure how to convince you. I am paying more for health insurance and then more for any procedures. What term would you use?
I used those figures, my personal financial impact, in order to give people a reference point, to give folks a few examples to think about.
I have a hard time believing that people are as happy about their health care coverage as they were a year ago if we are all experiencing increases.

The gov't bloat is a different subject, I would love to tackle it.
Myself, I want all gov't services to go away for a while.
No FDA, no OSHA, no highway maintenance...
I think that is what we need. no services at all.
 Casper66
Joined: 3/2/2007
Msg: 16
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Posted: 1/31/2010 12:40:50 PM
^^^ great post Jinx. I too am a Canadian and getting sick and tired of being used as an excuse/example why health care would bankrupt the US by increasing taxes. Yes I pay a little more in tax but I don't mind because knowing that I can go and get medical attention when I need it is worth it and gives me peace of mind. In my personal experience I had non-malignant cancer years ago the tests and treatment didn't cost me anything out of pocket and I don't have to worry that I would be rejected in the future because of a pre-existing condition. My Dad have a heart attack 20 years ago requiring various treatments and a hospital stay and recently had a pacemaker put in, cost to us, nothing, my family wasn't bankrupted by this illness. I'm not saying our system would work for the US, but you have a unique opportunity to look at the various health care systems around the world and see what works best and provides the best coverage for US citizens.
 BigDaddyJinx
Joined: 11/4/2006
Msg: 17
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Posted: 1/31/2010 1:02:49 PM

In my personal experience I had non-malignant cancer years ago the tests and treatment didn't cost me anything out of pocket and I don't have to worry that I would be rejected in the future because of a pre-existing condition. My Dad have a heart attack 20 years ago requiring various treatments and a hospital stay and recently had a pacemaker put in, cost to us, nothing, my family wasn't bankrupted by this illness.

Casper -- That bold part being especially important.

Family illness...family bankrupt.

I see it and hear about it all the time. I have yet to hear a similar story come out of Canada. A family member develops an illness and needs treatment, and unless they have coverage (which most cannot afford) then the family members can elect to watch their family member die or they can sell everything they own to give them a few more years on their life. In the US, the way Health Care operates, you'd think one had checked into The Plaza instead of a hospital. You stay, get treated, and oh...here's your 5-figure bill minus gratuities.

Ugh.

Both countries have their strengths and weaknesses and of that there's no doubt...but knowing I can, at any time, get admitted into a Hospital and be treated ASAP and NOT have a "Oh, here's your bill" follow up...that alone is priceless. Nothing else matters to me beyond that. Knowing I will not be sent "down the road" to some hack n' slash county Hospital which may or may not be little better than a Vet, because I don't have coverage or "can't afford" treatment where I am...priceless.

Knowing that I will never be bankrupted as a result of illness or accident...priceless.

Call me crazy, but I like knowing I have $500 less each year compared to my counterparts, but I will never "lose it all" if I get sick, get hurt, or require immediate care. And I will never have to fear checking my mail for "the bill".

But all this flap about "take a X% pay cut to be in Canada" crap is just malarkey. I guess they can't see the facts and figures for themselves.

Meh.
 BellaDupree
Joined: 8/27/2009
Msg: 18
Health Care Cost Increases
Posted: 1/31/2010 1:09:16 PM

I certainly don't want to think that you are selfish, I think that you are in a place where you are worried about how you are going to survive.
I don't have those concerns, my needs are few, I will happily work to help you have better health care.


That is very nice of you, however unnecessary, I am not worried about my survival. and I dont need better health care, lol, I took responsibility for my health a long time ago.

However you could do something for me, you could work toward turning this monster sick care system we have into a real health care system, and where personal responsibiliy is incorporated into the equation, where the cost of the abusers of the system are penalized and not passed on to the taxpayers, or the premium payers.

You do understand that cost of allthese things you are talking about visits and tests and such are to cover those who dont pay? or the organization is paid by the government at a reduced rate?

A better use of our resources should be the first line of action, it is mind boggling the amount of money our government has at its disposal. At the rate we are taxed, (lol I am back to that) we should all have health care, we should all have schools that educate our children, and we should all have jobs that make our living, (even at the tax rates we are paying)

Our federal government is stealing from us and co-oping powers not given to it. I dont think there is any getting past that.

Again thanks for your offer, but I want YOU to enjoy the fruits of YOUR labor.
 JWG86
Joined: 7/5/2008
Msg: 19
Health Care Cost Increases
Posted: 1/31/2010 1:23:24 PM

Massachusetts, where I live, has universal coverage. I hear that Mitt Romney's health care program for Mass is breaking the bank.
Would other states handle it better, do you think?


Others have tried it. It went bankrupt within a year usually. Check out Hawaii's attempt a few years back.
 designingwoman
Joined: 9/4/2005
Msg: 20
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Posted: 1/31/2010 1:36:13 PM
California voted in a new single payer program. The Massachusetts program is not a single payer system, instead it uses private insurance.

Private insurance companies do not work as well as Medicare for making sure healthcare is provided.

I think people should be able to buy into Medicare regardless of age, income or health status. This choice being made available can easily be funded through the premiums paid by younger and more affluent enrollees. People can still use private insurance, as a secondary insurance as they do now with Medigap.

Good health to all who read this
 jelunc
Joined: 8/24/2008
Msg: 21
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Posted: 1/31/2010 1:54:48 PM
jwg86 says:


Check out Hawaii's attempt a few years back.


Hmmm, guess you didn't hear Rush Limbaugh rave about how great it was.
Hawaii's mandated coverage by employers is alive and well.
Any person working a minimum of 20 hours must be covered.
There was a program that was to provide universal care for those children left out of coverage that went bust. I believe they are now covered by schip(?).
VT's universal coverage for kids is working pretty well, I hear.
The only experience I really have with the Mass plan is thru a man I used to date who went for years w/o coverage and has been able to get knee surgery which enabled him to continue working rather than go on disability.
Seems like a good idea to me.
Nobody is pretending that systems, any of them, don't have problems.
LOL, I think it sucks that companies pay employees to play on social networks and game sites daily. That seems like a huge financial drain that consumers get to pay for.
But I love that my honey can yak with me from his office whenever he wants.
Hypocrisy is such a b*tch.
 tinkerbellcgy
Joined: 9/17/2005
Msg: 22
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Posted: 1/31/2010 2:27:31 PM

Knowing that I will never be bankrupted as a result of illness or accident...priceless.

Call me crazy, but I like knowing I have $500 less each year compared to my counterparts, but I will never "lose it all" if I get sick, get hurt, or require immediate care. And I will never have to fear checking my mail for "the bill".


What can I say other than thank goodness for Canada's universal health care for all citizens because if we didn't have it, I probably would not be sitting here today typing this post.

I was a healthy female who rarely sought out medical assistance from the time I ventured out as a young adult until approximately 18 months ago. In other words, the taxes I was paying toward universal health care were being used not for my benefit but for the benefit of other Canadians who needed those medical services.

Fast forward about 38 very healthy years until I started to feel somewhat unhealthy and made the trip to my family physician to seek out what was medically wrong with my health. The result was I was diagnosed with cancer and it was discovered at the time to be genetic and not lifestyle induced. [Sorry to take away any thoughts some of you may have had of flaming me.] In any event, after spending 30 days over 3 admissions in hospital, 6 mainstream chemo treatments and 8 maintenance chemo treatments over the ensuing 2 years, it has been calculated that little journey down the path of cancer will have cost upwards of $700,000.00 by the time I finish my last maintenance chemo treatment in February of next year.

Had I have had to pay the cost of that medical sojourn from my own personal resources, it would not have happened. Simply put, there would have been a shortfall of approximately $425,000.00 after I had sold the home that I live in and depleted my savings account. I am a currently unemployed 57 year old who would never have a hope in hell of paying $425,000.00 within my remaining working days. Where would that leave me? Probably suicide.

I am thankful everyday that Canada has universal health care and that I am entitled to access it. Never once did I begrudge paying those taxes toward health care because the thought was always in the back of my mind that one day I might need those health care resources and so I did.
 Montreal_Guy
Joined: 3/8/2004
Msg: 23
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Posted: 1/31/2010 3:07:55 PM
As a Canadian, this is one area where I have a hard time understanding how Americans can tolerate this type of situation. I certainly can understand the cultural differences involved, those underlying factors that make us see things differently. There's a certain sense of the individual over the group there, and a certain feeling that anything that the government gets involved with is somewhat tainted and wrong - except military budgets.

Those things don't exist here, in anywhere near the same numbers of people believing in them.


Like most Canadians, I feel that basic health care is a right, and not a privilege. I don't think anyone should suffer simply due to the thickness of their wallet. I don't think health care should be a profit center either. It's hard for me to reconcile the increasing costs I hear with the incredible amount of profit being generated by many of those health care companies.

It's also difficult to understand how the USA can be the only major country in the world without some sort of universal health care system.

One country that I think the USA should take a good look at is the Netherlands, ironically. They've managed to integrate the private sector and universal health care in a system that might provide an interesting model to consider.


For all regular (short-term) medical treatment, there is a system of obligatory health insurance, with private health insurance companies. These insurance companies are obliged to provide a package with a defined set of insured treatments .

This system came into effect in January 2006. For those who would otherwise have insufficient income, an extra government allowance is paid to make sure everyone can pay for their health care insurance. People are free to purchase additional packages from the insurance companies to cover additional treatments such as dental procedures and physiotherapy. These additional packages are optional.

A key feature of the Dutch system is that premiums are set at a flat rate for all purchasers regardless of health status or age. Risk variances between funds due to the different risks presented by individual policy holders are compensated through risk equalization and a common risk pool, which makes it more attractive for insurers to attract risky clients. Funding for all short term health care is 50% from employers, and 45 percent from the insured person and 5% by the government. Children until age 18 are covered for free. Those on low incomes receive compensation to help them pay their insurance. Premiums paid by the insured are about 100 € per month (about US$146 in Sept. 2009) with variation of about 5% between the various competing insurers.

Prior to 2006 (and since 1941) there were two separate systems of (short-term) health insurance: public and private. The public insurance system was executed by non-profit "health funds", and financed by premiums taken directly out of the wages (together with income taxes). Everyone earning less than a certain threshold income could make use of the public insurance system. However, anyone with income over that threshold was obliged to have private insurance instead.

http://en.wikipedia.org/wiki/Health_care_in_the_Netherlands


That pooling of people in a common risk pool is exactly what's needed to offset the costs of those who are often cut off of insurance now, because they pose too great a risk of loss of profit when being a part of a much smaller group of insured people.

Here's what the Dutch model looks like in action.


RAY SUAREZ: When the Netherlands reformed its health care system four years ago, everyone over 18 was required to buy coverage from a private insurance company. In turn, the insurers were required to accept every customer and offer the same price, regardless of age or medical history.

The Netherlands faces two challenges: strong expectations of continued high-quality care and a graying population that's entering a very expensive time of life for health care at the same time. So how do you keep costs down?

One way to keep costs down: keep people healthy, particularly people who are approaching retirement, like Frans Doppegieter.

Last spring, Doppegieter was diagnosed with type-two diabetes, a condition that can lead to more serious health problems and much greater expense, if not properly controlled, conditions like heart disease, failing eyesight, and the threat of lost limbs.

To keep patients like Frans healthy, insurance companies now offer incentive lifestyle programs, even pay for gym memberships. Roger van Boxtel is CEO for Menzis Insurance.

ROGER VAN BOXTEL, chief executive officer, Menzis Insurance: We make programs for how to quit smoking, how to train your body, how to eat healthy, and we see more and more interest with our insured to deal with these programs. It's individually. Many times, you can use Internet and the doctor behind it. It's confidential. People are willing to work on their own health care, and that's something we have to promote.

Doctors finding time and savings

RAY SUAREZ: In fact, Frans is a model Menzis patient. He dropped a lot of weight after his diagnosis. He records his blood sugar level at home and sends his data by Internet to his general practitioner, saving on costly clinic visits. His doctor is part of a collective of private doctors and therapists who've set up under the same roof.

DOCTOR: We have divided it in three to four teams here.

RAY SUAREZ: This care center, in the town of Tiel, is funded in part by the insurance company, Menzis. The doctors are relieved of administrative burdens, and the insurance company says it gets better, cheaper care.

ROGER VAN BOXTEL: If you start up a center like this, we help them with the management, we help them with their I.T. organization. It's not just the euro or dollar extra. It's more how to facilitate it, to let them become really the doctor again, who is capable of all day dealing with the patient, and don't have to think of, how do I run this business here? Who's dealing with the garbage? Who is dealing with cleaning up the toilets? That's something we help them with.

RAY SUAREZ: The Tiel pharmacy uses robotics to dispense prescriptions, but the real savings comes from prescribing generic drugs. The Dutch spend half of what the United States spends on medication per person. In fact, Menzis insurance company rewards doctors for using generics.

ROGER VAN BOXTEL: We gave doctors extra money if they were strict in prescribing medicine. We said to doctors, If 70 to 80 percent is generic and only 10 percent or 15 percent, 20 percent is the more expensive medicine, then we'll give you a bonus.

We finally are now up to the point that most of the GPs are really consequently thinking about, where can I give a generic? Will the patient understand that? And last year, only in one year, we saved in the Netherlands 400 million euro in one year.

RAY SUAREZ: The G.P., or general practitioner, is the key to cost control in the Dutch system. Patients must go to their G.P. in order to get a referral to a specialist.

Jako Burgers is a general practitioner. Like most primary care doctors, Burgers makes house calls. He says the strong relationship built between a primary care doctor and a family leads to fewer trips to specialists.

DR. JAKO BURGERS, general practitioner: We know how to treat people. We know how to treat the children. We know how to treat the elderly patient. And we have a stepwise protocols which you can follow and then, after step three or step four, there's a time to consider a referral.

Guides for new parents

RAY SUAREZ: A huge cost-saver for the Dutch, which may have more to do with culture and custom than reform, starts the day you're born. The great majority of Dutch children are born at home, much cheaper than a hospital maternity ward. Only 8 percent of women here get epidurals during childbirth.

And new parents, like the Van Dijkens, are not all on their own. A maternity aide nurse must visit all new mothers and babies. Nurse aide Patricia Stift helps out in the house, teaches newborn care, and watches for health problems. She's paid by and reports back to the Van Dijkens' insurance company. The idea is to keep new parents and babies from trips to the doctor's office for minor issues.

PATRICIA STIFT, maternity aide nurse: I come in, and I listen to them, listen to their worries, help them understand their baby, help them to get a handle on how to handle the babies.

RAY SUAREZ: The Netherlands has an infant mortality rate 25 percent lower than the United States.

The reforms also allow insurance companies to negotiate prices with hospitals for services, and hospitals can aggressively market their services, and that worries some doctors, like Dr. Johannes Borgstein. Borgstein is an ear, nose and throat surgeon. He's wary that cutting costs for services could lead to cutting patient care.

DR. JOHANNES BORGSTEIN, otolaryngologist: We're in a little bit of a slippery slope with the introduction of marketing effects in the medicine, the haggling the marketplace, the haggling the discussions, the trying to reduce costs. Marketing effects in medicine generally have a detrimental effect for the patients and often for the doctors.

E.R. alternatives

RAY SUAREZ: Finally, the Dutch seem to have found an answer to one area of care which is a huge driver of costs in the United States: the emergency room.

To avoid expensive E.R. visits, every neighborhood has an after-hours care clinic, like this one in Amsterdam. The clinic gives emergency treatment after a cycling mishap, treats late-night illnesses, and the doctors, GPs who pull 20 night shifts a year, make house calls and dispense advice over the phone.

DR. JOHN KAAL, general practitioner: About half of them will be solved over the telephone.

JOURNALIST: Just advice?

DR. JOHN KAAL: Just advice. And some of them by the triage assistant, and some of them later on by the doctoral on call. I suppose about 40 percent of total would be seen on the post here. They will be invited to come and to check out. And 1 out of 10 will be a house call.

RAY SUAREZ: Of those who access care at after-hours facilities, only about 3 percent end up being sent to the hospital. But with a stream of new immigrants entering the health care system and an economy which is not as robust as it was when reforms were implemented, government and insurers here are working hard on finding new ways to save on health care costs.

http://www.pbs.org/newshour/bb/health/july-dec09/healthcare1_10-07.html


I have a few Dutch friends, and they seem to be quite happy with the overall concept there. You may have to wait a few months for elective surgery sometimes, but you are fast tracked if your health is seriously at risk.

And they can do all this for roughly one hundred and fifty dollars a month.
 Casper66
Joined: 3/2/2007
Msg: 24
view profile
History
Health Care Cost Increases
Posted: 1/31/2010 3:44:04 PM
I am so very glad that we have universal healthcare here, my Dad is alive today because of the fanastic care he received, it was still difficult because of the loss of his income coming in but we managed. I can't even imagine adding to the stress and worry of a loved one being sick, then trying to figure out how you are going to pay for that care or having to make a decision to not have the treatment because of money. Insurance is great when you don't actually need it, but get sick, become unemployed or have an car accident and you find out very quickly how many loopholes the insurance company will find to not pay out, then drop you, despite paying into the policy for years, it's all about profit not the well being of the policy holder.
 JWG86
Joined: 7/5/2008
Msg: 25
Health Care Cost Increases
Posted: 1/31/2010 4:13:24 PM
In answer to a few other people who don't have the experience that I do with these things.

WIC is abused. Yes, there is an income criteria, and I have even seen them count an unborn child as part of the family to get away with stretching that criteria. I don't know all about WIC, but I spent a day learning about it first-hand, and I was not impressed with where tax money is going in the least, with regards to it. If I see all this crap in just ONE DAY dealing with WIC, imagine what goes on over a week, a month, a year...

As to me ragging on Canada. Registered nurses work within 1 hour of the same there per pay-period as in the US. Their gross pay is within $200. Their net pay differs by over $1,000.

These are just averages.


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