Thursday, August 13, 2009

IT'S STILL A GOOD DEAL, NO, A TERRIFIC DEAL


"I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year."

– President Barack Obama, February 24, 2009



Yesterday, I wrote in this space about health care in America and Canada.

There were some wonderful responses.

Two of my friends were quick to point out that I pay much more than $168 every three months for my coverage.

Here are their comments:

From David M:

Terrific letter from your friend at Tulane University. I love his analogy to a "shady used-car dealership". Unless the Democrats undertake tort reform, and thereby help constrain the practice of unecessary medical testing, they will not be able to achieve their goals within a reasonable cost structure. Will the Democrats turn their back on the number one source of campaign funding, the trial lawyers? It's called "leadership".
Like you, I'm a supporter of the single-payer, universal access system that we have in this country. However, the cost is a lot more than you imply in today's blog entry. When one factors in the 42% or so of every provincial tax-dollar that goes to health care in this province the cost is huge. Single-payer, universal access is great but we've got to introduce private sector competition and disciplines, inside the system, or we simply will not be able to afford the level of service we have let alone that which we seek to achieve.

From Victor:

david:

You do NOT pay $168 every three months for health care. This is an
illusion born of decades of government propaganda. Here are the actual
numbers.

Health care accounts for 45% of government spending. Therefore, it
sucks up 45% of all government revenue.

So, that means if you buy a microwave oven and pay $15 sales tax, $7
of that goes right into health care. If you pay $2000 in provincial
income tax, $900 goes to health care.

Do we have a single tier cost system. Only if one is math challenged.
Consider this.

In BC, if your salary is $100,000, your provincial income tax is
$8500. About $4000 of that goes directly into health care. That's $333
a month for health care plus the $56 a month for MSP for a total of
$389 a month for health care.

If your salary is $28,000 a year you pay $1000 in provincial income
tax, meaning $450 a year goes into health care. That's $37 a month
plus $56 for MSP for a total of $93 a month for health coverage.

Thus, if these two hypothetical taxpayers are sitting in a doctor's
office awaiting exactly the same procedure, one person is paying 4
times as much as the other for the same service. Whether the rich
should pay more is a whole other debate. But the facts are (a) we have
a multi-tier system regardless of what lying politicians say (b) Our
MSP payments do not remotely cover our total contribution.




2 comments:

John Doheny said...

I'm not sure where your commenter is getting his "45% of all government revenue on health care" figures, that sounds a little high to me. A quick cast around the internet finds Paul Krugman in the NYT quoting a figure of 10% of GDP for Canadian health care expenditures.

Now admittedly GDP is not 'government spending' exclusively, but who cares. I'm more interested in what stuff actually costs, and since all 'expenditures' come from the same place, namely our collective pockets, I'm much more interested in Krugman's figure for U.S. spending on healthcare, which is 16% of GDP.

That's almost twice as much, and for lousier outcomes. It seems to me that spending almost twice as much and getting crappier outcomes is the very definition of stupidity.

This argument is, in a way, the inverse of the one used here against single payer, which is usually some variant of "well sure, your premiums were lower in Canada, but don't you guys pay a lot more taxes?" My own totally subjective experience has been that this is hooey. It's true my effective tax rate is a touch higher in the US, but if you combine it with my state tax and sales tax rates (in the state of Louisiana) I'm actually getting dinged a bit more. Throw in the fact that my health insurance premiums are about four times as high, plus co-pays, deductables, excessive risk denials of service, risk of bankruptcy through exceeding "lifetime caps" for treatment and maximum hospital stays, danger of having coverage cancelled through 'recission' the minute I actually get sick and start costing them money, plus a hold raft of other shady, unethical insurance-weasel tricky business, and my taxes would have to be less than zero for me to come out ahead.

This obsession which taxation-as-theft is perhaps the most dangerous and noxious virus wafting noth from the dear old U.S. of A. Do not buy into it. The fact is that quality of life is not measurable entirely by the amount of money in your pockets. Canadians enjoy the luxury of a sane, civilized society with relatively sturdy social safety nets, a level of gun violence that is insignificant compared to that in any American city(we had four shot dead here in New Orleans last weekend, an event so ordinary it didn't even make the front page)and a health care system that spares them worrying about personal bankruptcy in the event they become ill. This last is priceless. The ONLY Americans who have a similar luxury are the wealthy, and they are often consumed with worry about having it taken away.

Trust me, I play music in these peoples homes. They've got more guns than Rommel.

Keith said...

The figure of 45 per cent comes from Health Minister Kevin Falcon.
He says the provinces health budget has increased from 35% to 45% of the total BC budget.
That figure can be deceptive, especially considering from whom it is coming.
For example; if the overall BC budget were reduced by 22 per cent, it has the same effect as increasing the health budget's percentage of the whole.