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Old 10-06-2007, 09:49 AM   #41
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I experience the market forces with my dental and pharmacy services where I pay and then collect from my private insurance company. It does make a difference. My dental coverage only supports teeth cleaning every 9 months so that is the cycle I am on even though they recommend every 6 months for me. They started giving me a fluoride rinse which is not covered so I got them to stop. I use a fluoride mouthwash instead. The copay is growing every year so that now it is over 50%.

On pharmaceuticals, it is also a copay (80%) so I shop around for the best deal and order in large quantities to spread the dispensing fee.

I see this as the best way to control costs. If the insurer limits my choices, then I am not getting the best care. Let them set their payment schedules and then I can decide how much of it I want to pay for my own choice. This can apply to both Canada and the US.

However, the combination of the powerful insurance lobby and the politicians is a major barrier to improvment. Some companies have moved to a health savings account. This enables those with good health and habits to get 100% coverage and carry forward any balance to cover major surgery.
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Old 10-07-2007, 11:57 PM   #42
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Question: why does she not get a dirt-cheap high-deductible catastrophic plan? Better yet, get a plan like that that's HSA qualified? I had one such plan recently, that, as a single, 43yo, non-smoking male ran me about $120/mo with a $2M cap. I'm with her in saving money if you're healthy, but I want some kind of safety net if something big and very bad happens.

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My sister does not have health insurance, not because she cannot afford it, but because she chooses not to purchase it. I think she is foolish. When I attempted to find out why she opted out of purchasing it, her logic went like this: I used to work for an insurance company and they overcharge for everything. I'm not giving them money for something I can afford to pay myself. She and her family do go in for periodic check ups and they pay for it all out of pocket, normally less than $100.00 per visit. They are relatively young and if you think about it, unless you have a serious medical issue, when you are young about the only time you did go to the doctor was for emergency medicine. They really don't have much money to begin with, so I guess if something major happened they would be going to see the bankruptcy lawyer to pay their medical bills.
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Old 10-08-2007, 03:13 AM   #43
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Billy good post. So how would you suggest fixing the health care system?
Thanks, LR...

I have a fantasy plan that could be a start. I'm sure there are lots of folks that could punch holes into it, but it stresses free market forces, and is based on the premise that the US is going to have some sort of Universal Care in the future.

I am not presumptuous to think that I know all the answers or that this 'Plan" offers all the answers. And, of course, there would be a rather rocky integration time period when everyone would be screaming - patients, doctors, hospitals, and most of all, insurance companies.

For fun, here goes:

The Plan

The US government/tax payers would deposit into every US citizen’s personal account $5,000 per year for their health care needs adjusted to inflation. This money is for doctor and hospital visits, not your local drugstore, unless prescribed by the doctor. This plan would also encourage citizenship because the illegals would be ineligible for the plan. A great side benefit.

This money would be in a special liquid account unable to be used for other purposes. After the end of a 10 year period,-- for those over 30,-- and not until they reach 30 for younger folks-- the first year’s amount is available to them for any purposes they desire (like for houses or education, a boat or vacation). Another benefit of this program will be the infusion of money back into the system keeping our economy rolling.

People will be given a debit card, and when patients go to their doctor/hospital, this card will be swiped, and the amount will be taken from the balance. Your balance will be available to you online, 24/7 the same as your credit card information. Doctors would be paid immediately for their services instead of having to fill out reams of forms and wait for payment from health insurance companies, thus streamlining the system.

Because of this immediate payment, more doctors, clinics and hospitals would be attracted to this system.

This plan is going to instill competition into the market place. Now, when you go to the doctor, as a customer, you will shop for the best doctor at the price you are willing to pay. Prices will drop due to this competitive market place, just like prices have dropped in Lasik eye surgery because these procedures are not covered by insurance today.

Doctors will soon be posting a menu of their services and prices just as any other business. They will also take out ads in newspapers and on radio advertising specials as they do for Lasik in the States and as they do for all procedures in Thailand. From dental work to breast implants with prices listed, ads are in the Thai English papers daily.

Patients wouldn’t have to worry about pre-existing conditions, or being refused for coverage, because the insurance companies would no longer be in the picture. (eventually, insurance companies would phase out... - my hope!)

So what happens if you go into the hospital and you have incurred a $100,000 bill?

First of all the amount wouldn’t be that high because the prices would have dropped.

Secondly, you will have at least $50,000 in your account (plus interest) if you have had a 10 year holding period.

Also, the doctors and hospitals have a form for an additional 30% off if you promise not to sue if there’s a problem. Why pay for their liability coverage if you’re willing to go ahead without it?

This is the way to solve the health care problem and bring about world peace.

** $5,000 is an arbitrary number and if it isn’t enough, then make it $10,000.
The Plan is subject to change, but it’s a start.

Be well,
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Old 10-08-2007, 05:09 AM   #44
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Question: why does she not get a dirt-cheap high-deductible catastrophic plan? Better yet, get a plan like that that's HSA qualified? I had one such plan recently, that, as a single, 43yo, non-smoking male ran me about $120/mo with a $2M cap. I'm with her in saving money if you're healthy, but I want some kind of safety net if something big and very bad happens.
Sometimes she's not the brightest bulb in the pack. Once she gets something stuck in her mind it is almost impossible to get it out. She still insists on carrying full coverage on her car that is over ten years old. Her reasoning is if she is involved in a crash she will have some money coming back from her insurance to pay for another one. I tried to explain that if she dropped her full coverage she would be able to take her savings, put it in some type of investment and within a year have more than the insurance company will giver her.
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Old 10-11-2007, 10:10 AM   #45
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Billy,
If my calculator is correct, at $5,000 per person per year that is 1.5 Trillion dollars a year. As I said if that is the right figure, how are you going to pay for it? ($5,000X300,000,000)
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Old 10-13-2007, 08:25 PM   #46
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Billy,
If my calculator is correct, at $5,000 per person per year that is 1.5 Trillion dollars a year. As I said if that is the right figure, how are you going to pay for it? ($5,000X300,000,000)
Thanks for reading our (fantasy) plan and for waiting for a response, Rustic23. We are currently in the Philippines, and finding internet cafes is still a challenge, since we have not been here before.

First of all, I don’t believe this plan would have a snowball’s chance to be implemented - because it would require personal responsibility.

As it is, we don’t know how Medicare and Social Security for all the Boomers are going to be paid for yet it is being promised… And the idea of Universal Care is being tossed around like it is ‘the answer’ - OMG how is that going to be covered? By us, the taxpayers, right? Yet payment isn’t being questioned - the ‘government’ will cover it.

The $5,000 per person idea was so that the money eventually would be re-entered back into the system through market forces. Right now, with the guaranteed payment system that we have, the system itself is sucking up the money without hope of control.

Hillary offered $5,000 for every newborn child just the other month on some program she was trial ballooning out there, and I don’t know how she intended to pay for it except through raising taxes.

The guaranteed payment system that we have now keeps growing out of control without any hope of containment that the free market would provide.

I realize there are two camps on this line of thought. Those who want the government to provide health care so that we citizens ‘don’t have to worry about it at all’ and those who believe that personal responsibility and market forces will act as a pricing control mechanism just as any other free market.

‘Course we could always cut spending and reallocate funds… What a novel idea!

What I don't understand, is that we as a country are generally self reliant - we are self reliant when it comes to purchasing our own homes, cars, food, travel expenses, etc. but for some reason when it comes to health care we need 'help.'

Why does self-reliance go out of the window when it comes to health care? We have been told now for decades that health care is a constitutional right and that the government 'should' provide it. What about food, clothing and shelter? these are important too, but we don't have food insurance, or cothing insurance or anthing of this nature.

There was a recent Rassmussen poll that was taken where 1/2 of Americans support the notion of providing health care free to all Americans even though "they expect it will reduce the overall quality of care, increase the ovrall cost and increase their personal costs." ...

This line of thought confuses me...

Thanks again, Rustic23

Be well,
Akaisha
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Old 10-13-2007, 11:40 PM   #47
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What about food, clothing and shelter? these are important too, but we don't have food insurance, or cothing insurance or anthing of this nature.

Welfare

There was a recent Rassmussen poll that was taken where 1/2 of Americans support the notion of providing health care free to all Americans even though "they expect it will reduce the overall quality of care, increase the ovrall cost and increase their personal costs." ...

I'm one of those Canadians with "free" health care. I also get taxed at a combined provincial and federal tax rate of 39%. BTW our health care system is still short of funds, and long wait lines are the norm. Don't look north for your solution.
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Old 10-14-2007, 06:21 AM   #48
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What about food, clothing and shelter? these are important too, but we don't have food insurance, or cothing insurance or anthing of this nature.

Welfare
Welfare is only for the poor with children, similar to Medicaid. I think both those programs are good, they just need better mechanisms to enforce existing regulations and regulations implemented to lower the amount of abuse.

Having a universal health care program seems a little foolish, when you consider if a person can't eat or drink, all of the health care in the world will not do much good. Many health problems are directly related to how much and what a person eats. If the government can control what a person puts in their mouth then the population will be much healthier and the government can save a lot of money in terms of health care. I can go much further into the argument for national food provision, but in my view it is more satire than serious debate.
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Old 10-14-2007, 08:53 AM   #49
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I also get taxed at a combined provincial and federal tax rate of 39%.
Top marginal rates in Canada exceed that. Until lowered a few years ago, my top marginal; rate was 52% and is now around 48% (I think).
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Old 10-14-2007, 09:20 AM   #50
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Top marginal rates in Canada exceed that. Until lowered a few years ago, my top marginal; rate was 52% and is now around 48% (I think).
I'm taxed at the highest combined rate for my province (Alberta). To be honest I thought that you were full of it when you said that you paid 48%, but I checked the tables and most provinces really are around that level. A real jaw dropper. Any place but Alberta also has a provincial sales tax. I'm definitely not saying that Alberta is the greatest place on earth, but how do you save any money at all, and for someone who is trying to RE, why stay there?
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Old 10-14-2007, 02:46 PM   #51
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I am a Canuck and we paid no tax in 2 of the last 5 years. In the 2 years that we paid, the rate was 15%. It helps to be retired. Our province has introduced a drug plan based on income and it covers 60% because we paid tax last year. It would be 100% otherwise.

Of course, we paid "sin taxes" on consumption of alcohol and gasoline of about $10K. We send 3 months outside the country each year and save on those taxes. We are planning to increase our out-of-country time to 6 months.
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Old 10-14-2007, 05:26 PM   #52
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I'm definitely not saying that Alberta is the greatest place on earth, but how do you save any money at all, and for someone who is trying to RE, why stay there?
While taxes are high, lot's of other things, like housing (until recently), were almost free by Calgary standards. Since I am both FI & RE it's just a personal choice: friends/family here, no moving hassles, best summers anywhere with lots of undeveloped lakes to fish, many reasons. DD lives in cowtown and from what I can see I couldn't have stood it even in my w*rking daze.
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Old 10-17-2007, 08:18 PM   #53
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Grizz

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What about food, clothing and shelter? these are important too, but we don't have food insurance, or cothing insurance or anthing of this nature.
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Welfare


Welfare isn’t an insurance policy that one purchases with a premium and a list of copays, etc. It’s what is considered a safety net and has a place in society.

I was being a bit facetious about food insurance, but really, we are self reliant for most things in life except when it comes to health care…

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Don't look north for your solution.


Great wisdom. I agree.

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If the government can control what a person puts in their mouth then the population will be much healthier and the government can save a lot of money in terms of health care. I can go much further into the argument for national food provision, but in my view it is more satire than serious debate.


Oh gosh. Have the government control what we put in our mouths? Let’s Retire, I sincerely hope you are joking….

The government does sort of control what we put into our mouths through taxes (the sin taxes) and there might be a time when the government will tax beef or ‘too much fat and sugar items’ but I sincerely hope we never get there. My goodness, what a horrible thought!

Will they then soon control what we put into our minds? Ugh!

Be well,

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Old 10-18-2007, 06:19 AM   #54
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Oh gosh. Have the government control what we put in our mouths? Let’s Retire, I sincerely hope you are joking….
DEFINITELY joking. I have to get better at using the smileys.

On the serious side I could see in the very distant future where when a program doesn't work or becomes too expensive people start movements that would seem to support what we are currently calling folly. How many of the founding fathers do you think envisioned food stamps or welfare as provided by the government? They would have probably consider it folly, but it is here now.
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Old 10-18-2007, 11:12 AM   #55
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Oh gosh. Have the government control what we put in our mouths? Let’s Retire, I sincerely hope you are joking….
The US government has subsidized the production of corn for years. A direct result of this market interference is that High Fructose Corn Syrup is the cheapest sweetener and is in many products. It has been established that the pervasive use of this product has contributed to the current obesity and diabetes epidemic.

Another example of unintended side effects.
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Old 10-18-2007, 11:20 AM   #56
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The US government has subsidized the production of corn for years. A direct result of this market interference is that High Fructose Corn Syrup is the cheapest sweetener and is in many products. It has been established that the pervasive use of this product has contributed to the current obesity and diabetes epidemic.

Another example of unintended side effects.

What I was referring to actually was something on the lines of the movie Demolition Man. Where the government legislates that the only oil that can be sold is say olive oil. Beef hamburgers can only contain XX% of fat. It is never permissible to eat real bacon. I know the government already legislates food safety so they in effect say what we can eat, but not directly. Unintended side effects would be included in the later example.
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Old 10-18-2007, 12:22 PM   #57
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I'm taxed at the highest combined rate for my province (Alberta). To be honest I thought that you were full of it when you said that you paid 48%, but I checked the tables and most provinces really are around that level. A real jaw dropper. Any place but Alberta also has a provincial sales tax. I'm definitely not saying that Alberta is the greatest place on earth, but how do you save any money at all, and for someone who is trying to RE, why stay there?
This is called the Alberta Advantage, although the "advantage" appears to be shrinking when you look at the price of housing...

I read an article a couple of weeks ago where the author said it can be measured how well you're doing economically on when you bought your house. If you bought pre-2003, you're probably doing well. If you bought post-2003, chances are you are behind since salaries haven't been keeping up with the increase in house prices.
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Old 10-18-2007, 07:53 PM   #58
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DEFINITELY joking. I have to get better at using the smileys.
Oh Phew! I did take you seriously - the smileys would have clarified! Thing is, I'm sure there are people who believe the government should control these things...

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What I was referring to actually was something on the lines of the movie Demolition Man. Where the government legislates that the only oil that can be sold is say olive oil. Beef hamburgers can only contain XX% of fat. It is never permissible to eat real bacon. I know the government already legislates food safety so they in effect say what we can eat, but not directly. Unintended side effects would be included in the later example.
This was what I thought you were advancing! oh I'm so glad you clarified. Thanks.

Living the above example would be a nightmare.

Be well,
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Old 10-18-2007, 09:19 PM   #59
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This is called the Alberta Advantage, although the "advantage" appears to be shrinking when you look at the price of housing...

I read an article a couple of weeks ago where the author said it can be measured how well you're doing economically on when you bought your house. If you bought pre-2003, you're probably doing well. If you bought post-2003, chances are you are behind since salaries haven't been keeping up with the increase in house prices.
Grizz was quoting me with his quote.

Things change from year to year. We own a Calgary condo (inhabited by DW) that we bought in 1999. It's probably 'worth' about 260% of what we paid for it. Most of that jump came a couple of years ago. This year our Sask. house (or RE in Sk generally) was up 57% according to Stats. Can. while our Calgary condo remained flat (guessing from asking prices on MLS.ca). FWIW, our Sk. house, even with 60% increase this year, would only sell for about 60-70% of a similar place in cowtown.

The advantage may be growing again. Enjoy.
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