Older Americans may have to postpone retirement under New health bill

[Hyperborea]

Ok children calm down now. Health and Human Services Secretary Tom Price has told us that everything will be all right. The new plan will be cheaper and cover more people.

"I firmly believe that nobody will be worse off financially in the process that we're going through".

"In fact I believe, again, that we'll have more individuals covered."

HHS Sec. Tom Price: "Nobody Will Be Worse Off Financially" Under GOP Health Plan - NBC News

 

[Huston55]

For the most part you are correct. I do know 10+ Canucks from various provinces and some have had wait times for knee surgery, but they eventually do get it. The thing is, they pay for it in so many ways. Income tax, liquor tax...so many taxes. If you put a dollar figure on the taxes, they're paying much more than we would if we really are honest about it, IMO. BTW, many of them go to Mexico for dental as this is not covered under their plan...same for prescriptions.

I know you caveated this by noting that it's your opinion & I don't mean to be overly critical. But, most comparisons/studies do not support the characterization of Canadians "paying much more" in taxes.

A more accurate comparison of Canadian vs US taxation would be:

- Both countries pay approximately (within a few % points) the same % of GDP in taxes, with most studies showing Canadian citizens paying a bit (not a lot) more.
- 'Lower middle-income & below' families in Canada pay less tax than their US counterparts, while 'higher middle-income & above' families pay more tax in the US than their Canadian counterparts.
- Canada provides for universal health care within their tax system, while the US does not.

I think it's really academic, unless one is considering moving from one country to the other. But, I also think that: (1) there are valuable lessons to be learned by looking at what works well in health care of other developed countries, and (2) it's not at all useful for the US to hide behind "Yeah, but their taxes are so high" rhetoric.

 

[Hyperborea]

A more accurate comparison of Canadian vs US taxation would be:

- Both countries pay approximately (within a few % points) the same % of GDP in taxes, with most studies showing US citizens paying a bit (not a lot) more.
- 'Lower middle-income & below' families in Canada pay less tax than their US counterparts, while 'higher middle-income & above' families pay more tax in the US than their Canadian counterparts.
- Canada provides for universal health care within their tax system, while the US does not.

As somebody who has lived and worked under both systems I think that's an accurate representation.

there are valuable lessons to be learned by looking at what works well in health care of other developed countries.

A really interesting and accessible exercise in that comparison was an episode of FrontLine from about 10 years ago. Well worth watching and you can do so online. It's a comparison of the US, UK, Switzerland, Germany, Taiwan, and Japan. I've personally got experience and/or family experience with 3 of those systems and the show seemed accurate. Things will have changed in the time since the show though. In the case of the UK it's been a serious amount of underfunding driving by government's attempt at austerity that has slashed the National Health Service budget.

Sick Around The World | FRONTLINE | PBS

 

[Teacher Terry]

I am flying from NV to KS for some expensive dental work and will pay 1/4 the price. Sure I have to buy a plane ticket but even if some of my kids did not live there and I had to pay for a hotel/meals it would still be way cheaper. So you don't have to go to Mexico for a deal. [mod edit]

 

[Fedup]

It sounds like Japan and Germany have better systems. I also noticed that it says the diet of fish in Japan keeps people healthy. So as much as we rant about people can't control their health through diet, here is at least one example where it does.

 

[marko]

It sounds like Japan and Germany have better systems. I also noticed that it says the diet of fish in Japan keeps people healthy. So as much as we rant about people can't control their health through diet, here is at least one example where it does.

Ever been to a hospital in Japan? I have...not recommended for those with Western expectations. You're even charged by the number of pillows used per day. Most Westerners evac asap to Australia or the US.

 

[Fedup]

Ever been to a hospital in Japan? I have...not recommended for those with Western expectations. You're even charged by the number of pillows used per day. Most Westerners evac asap to Australia or the US.

Good to know, when we read these reports they do leave out small things like that.

 

[marko]

Good to know, when we read these reports they do leave out small things like that.

I'm told by Japanese friends that should you be diagnosed with, lets say, cancer your doctor makes the decision whether to tell you based on if he thinks you can take the news. Not sure if that is still an accurate claim but...

 

[Huston55]

Ever been to a hospital in Japan? I have...not recommended for those with Western expectations. You're even charged by the number of pillows used per day. Most Westerners evac asap to Australia or the US.

Interesting observation. How do you reconcile that view with the positive review in the Frontline piece? Is it a time difference or something else?

Sick Around The World | FRONTLINE | PBS

 

[marko]

Interesting observation. How do you reconcile that view with the positive review in the Frontline piece? Is it a time difference or something else?

I haven't seen the piece but tend to take these reports with a grain of salt. I only lived there for a few years but know that our long term expats there RAN out of the country at the slightest indication of a problem.

 

[Hyperborea]

I haven't seen the piece but tend to take these reports with a grain of salt. I only lived there for a few years but know that our long term expats there RAN out of the country at the slightest indication of a problem.

I wonder how much of that is a language issue? I've only used the health care system in Japan for minor things and my language skills while far from fluent are far higher than the average expat worker. I think I would have issues dealing with serious medical issues in a Japanese language environment without bilingual support. Or at least I would have worries that I'm missing subtleties and not understanding the full information correctly.

I have heard of no major problems with the system from natives that I know and from a number of long term expats who are either near-fluent or who have bilingual support.

 

[Huston55]

I wonder how much of that is a language issue? I've only used the health care system in Japan for minor things and my language skills while far from fluent are far higher than the average expat worker. I think I would have issues dealing with serious medical issues in a Japanese language environment without bilingual support. Or at least I would have worries that I'm missing subtleties and not understanding the full information correctly.

I have heard of no major problems with the system from natives that I know and from a number of long term expats who are either near-fluent or who have bilingual support.

The Frontline reporter was fluent in Japanese & had lived in Japan for a couple years so, perhaps that's part of it.

 

[Fedup]

I'm told by Japanese friends that should you be diagnosed with, lets say, cancer your doctor makes the decision whether to tell you based on if he thinks you can take the news. Not sure if that is still an accurate claim but...

Oh no, another version of death panel.

 

[ejman]

snip...

- 'Lower middle-income & below' families in Canada pay less tax than their US counterparts, while 'higher middle-income & above' families pay more tax in the US than their Canadian counterparts.

If lower & Middle income pay lower taxes in Canada and Higher middle income & Above pay higher in the US I guess taxes are lower in Canada for everybody

 

[Huston55]

If lower & Middle income pay lower taxes in Canada and Higher middle income & Above pay higher in the US I guess taxes are lower in Canada for everybody

Yep, I got that last bit backwards.

Should have read, "Higher middle income & above pay higher taxes in Canada."

 

[MichaelB]

Bruce Bartlett (tax policy expert, worked in Reagan and Bush 1 administrations) did a comparison of total taxes plus health care costs for OECD countries. You can find it here https://economix.blogs.nytimes.com/2011/06/07/health-care-costs-and-the-tax-burden/?_r=0

You can see from this chart that, based on his work, the US and Canada pay about the same % of GDP for total taxes plus health care, and the US is very close to the OECD average.

 

[exnavynuke]

Bruce Bartlett (tax policy expert, worked in Reagan and Bush 1 administrations) did a comparison of total taxes plus health care costs for OECD countries. You can find it here https://economix.blogs.nytimes.com/2011/06/07/health-care-costs-and-the-tax-burden/?_r=0

You can see from this chart that, based on his work, the US and Canada pay about the same % of GDP for total taxes plus health care, and the US is very close to the OECD average.

I wonder how those numbers look now that we've had ~9 more years (those numbers were from 2008) of health insurance and medical costs rising while tax rates around the world have been relatively stagnant.

Edit: Found the numbers it seems. The article said:
In 2008, we paid 16 percent of G.D.P. in total health care costs, public and private combined.

The number for 2015 was 17.8%. https://www.cms.gov/research-statis...enddata/nationalhealthaccountshistorical.html

 

[Fedup]

They are not stagnant. I think their healthcost goes up as well.

 

[MichaelB]

I wonder how those numbers look now that we've had ~9 more years (those numbers were from 2008) of health insurance and medical costs rising while tax rates around the world have been relatively stagnant.

I know the numbers are dated, but have not seen any other analysis like this, so I still use it. My guess would be for the period 2009 - 2015, the total cost of healthcare, measured as a % of GDP, for the US increased somewhere around 1.5% - 2.0%, and for the OECD it rose around 0.5% - 1.0%. The years 2009 - 2011 were recessionary around the world, so discretionary healthcare spending suffered, and healthcare products and services pricing is carefully (and heavily) controlled in some countries.

 

[Huston55]

I wonder how those numbers look now that we've had ~9 more years (those numbers were from 2008) of health insurance and medical costs rising while tax rates around the world have been relatively stagnant.

Edit: Founhttp://www.indexmundi.com/g/r.aspx?t=0&v=2225&l=end the numbers it seems. The article said:
In 2008, we paid 16 percent of G.D.P. in total health care costs, public and private combined.

The number for 2015 was 17.8%. https://www.cms.gov/research-statis...enddata/nationalhealthaccountshistorical.html

Here's a more updated (thru 2014) cut at it including only health expenditures.

The US is still near the top of the pack regarding expenditures, and middle of the pack regarding results.

Health expenditures - Country Comparison

Side note: lots of interesting country-by-country comparison data on this website; find by selecting metrics near top of page.

 

[TreeHugger]

Bruce Bartlett (tax policy expert, worked in Reagan and Bush 1 administrations) did a comparison of total taxes plus health care costs for OECD countries. You can find it here https://economix.blogs.nytimes.com/2011/06/07/health-care-costs-and-the-tax-burden/?_r=0

You can see from this chart that, based on his work, the US and Canada pay about the same % of GDP for total taxes plus health care, and the US is very close to the OECD average.

Michael,

This is what our Scandinavian neighbour tells us as well. But she also adds that for that taxes they get higher pensions, excelent healthcare for *everybody* and free college education for their kids.

She is a visiting University Professor.

 

[MichaelB]

Scandinavian countries clearly have much higher total rates of tax plus health care - in the range of 10% - 15% of GDP, so it's not a valid comparison.

 

[exnavynuke]

Michael,

This is what our Scandinavian neighbour tells us as well. But she also adds that for that taxes they get higher pensions, excelent healthcare for *everybody* and free college education for their kids.

She is a visiting University Professor.

Yeah, we often forget about the other things those higher taxes fund (like cheaper education), as healthcare is the primary topic that relative tax rates seem to be brought up in. IIRC, Canada's cost to go to college is quite a bit lower than what it is in the U.S.

Yeah, I think this is a bit cheaper-

Canada

Education costs: $5,974

Median income: $26,623

Affordability: 22.44%

Highest ranked university: University of Toronto (19)

Number of universities in the top 100: 5

vs

USA

Education costs: $13,856*

Median income: $26,990

Affordability: 51.34%

Highest ranked university: California Institute of Technology (1)

Number of universities in the top 100: 51

From 2012 Here's What College Education Costs Students Around The World - Business Insider

 

[TreeHugger]

Scandinavian countries clearly have much higher total rates of tax plus health care - in the range of 10% - 15% of GDP, so it's not a valid comparison.

Swedish to be specific. Not if you add in Property taxes on 1200000 house that she owns. In Sweden property taxes are negligible compared to US.

I have no reason to believe that she lies

 

[Fedup]

Are you serious about comparing Universty of Toronto to Caltech. There is only one Caltech and it should be compared to private university like MIT, not public University. Perhaps Berkeley is a better comparison.