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Statesman
 
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Post 09 Jan 2020, 9:34 am

bbauska
Perhaps I do not understand the Canadian system. Maybe you are allowed to CHOOSE if you want to be part of that program. Tell me if that is an option for a Canadian citizen to refuse payment for and participation the Provincial Health program


First: health care costs are paid largely out of general taxation. There are some provinces with specific health insurance levies but even those are very small.
So, if you refuse to participate in a Provincial plan, you aren't returned any portion of your taxes. You might only save $30 or $40 a month in some provinces.
Second: Doctors may opt out of the plan and charge for their services separately. But they can't charge separately AND participate in the plan.
Third: Private insurance for medically necessary hospital and physician services is illegal in 6 of the 10 provinces. Nonetheless, a significant private sector has not developed in any of the 4 provinces that do permit private insurance coverage. The absence of a significant private sector is probably best explained by the prohibitions on the subsidy of private practice by public plans, measures that prevent physicians from topping up their public sector incomes with private fees.

Mostly measures have been taken so that doctors can't try to set up a two tier practice, allowing those willing to pay higher fees to jump the queue.
So Doctors must choose one or the other. And since the market for private payment is almost non-existent, doctors don't pursue that angle. The handful of people who are willing to pay exorbitant fees to jump the queue become medical tourists. There aren't many.

So lets compare how free you are versus the average Canadian.
Go to any GP in the country? yes in Canada. No for most insurance plans in US

All services and fees covered for any prescribed treatments? yes in Canada. Not in US. Your insurance company decides whats covered....(usually some clerk) . And often results in convoluted and expensive debates between the doctor/patient and the insurance company.

choice to participate or not? In Canada you can choose to pay direct, but you aren't compensated for that... In the same way medical tourists aren't able to claim much for services rendered abroad.
(Emergency care abroad is paid for by the provincial fee schedule often, so most Canadians travelling in the US have private travel insurance.) In the US, many have no insurance, some by choice, or choose plans that offer little in the way of actual coverage. I believe this is choosing to risk medical bankruptcy for an immediate savings ..... Bully.

So how free are you in comparison Bbauska? Please be specific.

And importantly, this supposed freedom comes at what cost? A medical system that costs more than twice what Canada's does per ca-pita ...with far poorer average results..
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Post 09 Jan 2020, 10:54 am

It seems almost a waste of time to discuss health care because the evidence is clear from other wealthy developed countries: socialized medicine delivers health care to more people, at a much lower cost, with no negative effect on outcomes/life expectancy. As for choice, we're not shopping for cars. Most people (I think) will be happy if they can go to a competent doctor when they need to without worrying about cost All this concern that what's going to happen if I change my health care plan to being covered by the government...seems to magically go away when we turn 65 and we accept Medicare without complaint. "Choice" with regard to health plans or doctors is something that those who are economically vested in the current system--hospitals, pharmaceutical companies, insurance companies, the AMA (representing doctors)--seek to trump as being this thing we must have. It's just a political article of faith without any substance. But yeah you won't get to have a different private plan but so what it doesnt make any difference. Now, I guess if you have a PPO you can go straight to a specialist. But how many people still have that kind of health insurance? And does that change anything, really? And is it worth spending 10% more of our health care on GDP with no concrete results and having many people without access to health care?

I do find it interesting that Canada has low abortion rates after decriminalizing abortion. There are three main factors (I think) with regard to women getting abortions: (1) sex education, (2) access to contraception, and (3) economic stressors. I am betting that Canada does better than the US on all three factors. The same religious dogma that demands that women not be allowed to have abortion...impedes sex education and access to contraception. We're a wealthy country--we should have extremely low abortion rates. But the way to achieve that is not by making it illegal--it's by making sure that sexually active women are fully educated, have access to family planning/advice through their doctors and have easy access to contraceptives. And that includes sexually active teenagers. You can try and dissuade them from bring sexually active, but there is no sense to being blind to the fact that many of them are and some of them get pregnant.
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Post 09 Jan 2020, 12:35 pm

Freeman, abortion is "decriminalized".That somehow indicates that is of questionable legitimacy. Its just treated as a medical procedure who's use is a private decision between a woman and her doctor. In the last election the conservative leader wouldn't publicly commit to never raising the issue of abortion in Parliament again. That stance is credited with his party eliminated from consideration for about 65% of voters.

People tend to forget why abortion ends up being made legal in advanced nations.
Historically, women around the world have tried to end unwanted pregnancies whether abortion is legal or not, often jeopardizing their safety and health by self-inducing or seeking a dangerous illegal procedure.

While there is very little relationship between abortion legality and abortion incidence, there is a strong correlation between abortion legality and abortion safety.

The World Health Organization defines unsafe abortion as a procedure for terminating a pregnancy that is performed by an individual lacking the necessary skills, or in an environment that does not conform to minimal medical standards, or both. Unsafe abortion is common in places where abortion is illegal. Nearly half of all abortions worldwide are unsafe, and nearly all unsafe abortions occur in developing countries. In countries where abortion remains unsafe, it is a leading cause of maternal mortality.

Women who have unsafe abortions are at risk of serious medical problems, including incomplete abortion, hemorrhage (heavy bleeding), infection, uterine perforation (caused when the uterus is pierced by a sharp object), and damage to the genital tract and internal organs (by inserting dangerous objects such as sticks, knitting needles, or broken glass into the vagina or anus). Each year around 7 million women are admitted to hospitals for complications of unsafe abortion and between 4.7% – 13.2% of maternal deaths can be attributed to unsafe abortion.

Highly restrictive abortion laws are not associated with lower abortion rates. According to the Guttmacher Institute, the abortion rate is 37 per 1,000 women in countries that prohibit abortion altogether or allow it only to save a woman’s life, and 34 per 1,000 in countries that allow abortion without restriction as to reason.

Estimates of the number of illegal abortions in the United States, in the 1950s and 1960s range from 200,000 to 1.2 million per year. Today, abortion is one of the most commonly performed clinical procedures in the United States, and the death rate from abortion is extremely low: 0.6 per 100,000 procedures, according to the World Health Organization.

Legalization of abortion allows women to obtain timely abortions, thereby reducing the risk of complications. In 1970, one in four abortions in the United States took place at or after 13 weeks gestation. In 2015, 91 percent of abortions were performed within the first trimester, with 65 percent performed at or under eight weeks gestation.

Access to safe and legal abortion is vital to women’s health and well-being.
https://www.ourbodiesourselves.org/book ... -abortion/
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Post 09 Jan 2020, 2:17 pm

I do find it amusing that Ricky finds it impossible to be on the same side with anyone on an issue. No matter how much someone wants to try and agree with him...he will find a way to distinguish his position!
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Post 10 Jan 2020, 12:15 pm

Maybe, Freeman, because I see more than just 2 sides on most issues. its a difference in a lot of countries where the political environment is more than a duopoly. You learn to expect and accept nuanced argument.

It may seem like I'm splitting hairs when I distinguish between "decriminalized" and the reality of how abortion is categorized in Canada. However I think its a substantive difference.
Its the difference between saying "Its not right but we'll tolerate it ...:
and
just being another medical procedure.
There's absolutely no stigma attached. No judgement.
I think that's a pretty significant difference. perhaps i didn't explain my self so well?
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Post 10 Jan 2020, 12:37 pm

Yeah, I see it now. Maybe I should have said decriminalized and depoliticized. I am not sure I would say it's just another medical procedure for the woman, but the government is not going to distinguish it as far as paying for it. Whether it's based on the notion that regulating abortion is not effective because they are just going to happen anyway and women will die or whether (my preference because while the bad effects of prohibiting abortion are an important consideration...it may not be always true in a wealthy/heavily regulated society that women will not be deterred from getting an abortion in situations where they otherwise would have got one and I think they should have that choice) it's based in the notion that whether to get an abortion is between her and her god/beliefs...getting the government totally out of it and depoliticizing it is a very good thing.
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Post 10 Jan 2020, 1:05 pm

I am fine with de-criminalizing, and not having government funds going toward abortive clinics/services or having Medicaid/Medicare paying for it. Keep them COMPLETELY out of it.
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Post 10 Jan 2020, 1:26 pm

There are no laws prohibiting either citizen seeing any physician.

You can choose what insurance you want. If they do not give you what you want, shop around. After all, we were told that we can still have any doctor we want.

A friend of mine is 22 years old, is in fine health and sees little need for medical insurance other than a catastrophic plan. Why is he saddled with a larger payment premium when he does not see the need of it?

I am more free in the US regarding my health care for the following reasons:
1.) I can see any doctor I choose.
2.) My health care costs less than yours. ( I have a family catastrophic cap of $3000/year)
3.) I have not had ANY increase of my zero payment for this insurance for the last 17 years
4.) My medical is covered OUTSIDE of the US as well; with invoices provided (I get reimbursed)

Top that, RickyP...
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Post 10 Jan 2020, 4:59 pm

Insurance through the Coast Guard, Brad? If so, not exactly applicable to many other Americans...
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Post 10 Jan 2020, 8:43 pm

It is what it is...
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Post 11 Jan 2020, 9:43 am

bbauska
I am more free in the US regarding my health care for the following reasons:
1.) I can see any doctor I choose.
2.) My health care costs less than yours. ( I have a family catastrophic cap of $3000/year)
3.) I have not had ANY increase of my zero payment for this insurance for the last 17 years
4.) My medical is covered OUTSIDE of the US as well; with invoices provided (I get reimbursed)

You seem to be an exceptional American. Lets compare the average poor American and the average poor Canadian. The average middle class Canadian ..

Every poor or middle class Canadian, can:
1) See any doctor they choose (GP) Access to a specialist is through GP referal and your GP can access any specialist they wish for you. Hows that go for poor or middle class Americans ? Depends on your insurance no? Of failing that affordability.
2) The per capita expense for Americans is twice that of Canada... Tax rates for poor Canadians are less than Americans, middle class about the same. Rich Canadians pay more... But no one needs to buy insurance on top of their taxes. So, on the whole taxes plus insurance favors Canadians.
3) Costs are increasing in the US at twice the rate of Canada. (Drugs, and hospital charges lead the way.)
4) Canadians travelling abroad are covered at Canadian reimbursement rates. Which falls well short when travelling in the US so most need to buy travel insurance for that destination. I don't know how that works for Americans not named Bbauska who travel...

So; is your argument "Bbauska is doing fine".
And you could care less about society as a whole ?

bbauska
I am fine with de-criminalizing, and not having government funds going toward abortive clinics/services or having Medicaid/Medicare paying for it. Keep them COMPLETELY out of it.

So access to legalized abortion than comes down to affordability. And poor women, as they did for centuries, are forced to illegal practitioners .... And so they often they are injured or die as a result.
Do you think that just?

There a lot of things my taxes pay for that I don't agree with ...but that's the bargain we've made in most societies. We allow our representatives to govern for us and represent our wishes.
In Canada and most other modern nations we've discovered it is more cost effective, more medically effective, simpler, more just and freer than Americans have it . Well, for people who are NOT named Bbauska.

But I gotta admit that Bbauska seems to have it made in the shade,.
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Post 12 Jan 2020, 5:29 am

Ricky:

Tax rates for poor Canadians are less than Americans


No way. Source?

middle class about the same


source?
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Post 12 Jan 2020, 2:19 pm

RickyP, You are right. I WORKED hard to become so.
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Post 13 Jan 2020, 2:24 pm

Here's a couple of sources RayJay. .There aren't significant differences except that, as quoted from Vice, Canadian taxes cover every ones health care. Americans under 65 still need to pay for that.


The answer is more complex than you might think. Statistical gathering agencies in both countries publish averages of income taxes paid, but comparing the two numbers is like comparing the stats of a hockey player with those of a basketball player. The numbers are based on different premises and include different pieces.
Using an average is also problematic as the very poor and the very rich skew it on both ends. In general, lower income Canadians pay less in tax for the services they receive and rich Americans are better off than rich Canadians.


https://www.investopedia.com/financial- ... icans.aspx

The OECD analyzes the tax burdens of 35 countries, including the United States and Canada. According to its data, in terms of total tax revenue as a percentage of GDP, in 2010, the U.S. collected a slightly lower than average amount of taxes from its citizens ($11,365 USD per capita). Canada collected a slightly higher than average amount ($14,693 USD)
That total tax revenue figure includes not merely federal income taxes, but all taxes, including “taxes on income and profits, social security contributions, taxes levied on goods and services, payroll taxes, taxes on the ownership and transfer of property, and other taxes.”
As Vice Money puts it, “American marginal tax brackets aren’t too different from Canadians’, yet [Canadians] get universal health care and [Americans] don’t.” Currently, Americans pay $3.4 trillion a year for medical care and, unfortunately, don’t : “The U.S. life expectancy of 78.8 years ranks 27th. It has the fourth highest infant mortality rate in the OECD, the sixth highest maternal mortality rate and the ninth highest likelihood of dying at a younger age from a host of ailments, including cardiovascular disease and cancer,” reports Bloomberg.
https://www.cnbc.com/2017/08/07/canadia ... catch.html
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Post 13 Jan 2020, 4:11 pm

Ricky:

Here's a couple of sources RayJay. .There aren't significant differences except that, as quoted from Vice, Canadian taxes cover every ones health care. Americans under 65 still need to pay for that.


The answer is more complex than you might think. Statistical gathering agencies in both countries publish averages of income taxes paid, but comparing the two numbers is like comparing the stats of a hockey player with those of a basketball player. The numbers are based on different premises and include different pieces.
Using an average is also problematic as the very poor and the very rich skew it on both ends. In general, lower income Canadians pay less in tax for the services they receive and rich Americans are better off than rich Canadians.


https://www.investopedia.com/financial- ... icans.aspx


Your source does not confirm your statement. Also it is from 2011 which ignores a major US tax overhaul and I think some Canadian activity as well. If you compare rates of all the tax categories for low income Americans and low income Canadians, you will see that low income Americans pay less.

Income tax … 15% in Canada vs. 10% in US and then 12% up to $40,000 of income.
Canadian provinces also tax 5 to 10% on the first bit of income whereas in the US it is 0% to 5% depending on the state for low income people. Our standard deduction for married people is $24,400. Your basic personal deduction is about $12,000.

Our sales tax ranges from about 0 to about 8% whereas in Canada it is 5% to 15% in some provinces.

For Canada social security individuals pay close to 7%. In the US social security is 6.2%.

In Canada, employees pay for unemployment insurance which is 1.62% and employers pay over 2%. In the US it is all paid for by employers.

Just on this narrow point you were providing misinformation. Low income US taxpayers pay very little, less than those in Canada.