Public Opinion and Health Care

 Getting to another point made by Dr. Murdoch:

Private insurance is banned in Canada.  So that pretty much dries up your market.

I ran across this from the CBC website.  Here are a few quotes:

On June 9, 2005, the high court struck down a Quebec law that prohibited people from buying private health insurance to cover procedures already offered by the public system.

"Access to a waiting list is not access to health care," two of the justices wrote in their decision.

High court?  Private Insurance??  Waiting lists?!?!?  All this sounds like a far cry from the Canadian Healthcare System we all know and love.

There must be something amiss, here.  While our resident expert, Dr. Murdoch, sorts all this out and sets us straight, here is the full length to the article:

http://www.cbc.ca/news/background/healthcare/

JamesNT

 First of all: capitalism and free markets are good. 

Having said that, there is a place where they do not work- which was alluded to earlier.  When the transaction, who gets the good, vs. who pays for the good are not the same person.  Everytime you split that transaction, you undermine market forces and the integrity of the system. Efficient markets also assume that the buyer has complete information about what they are getting.  In health care this is very hard for the lay consumer- and they have ceded their decision and review process to the folks that have their premiums. 

So in health care, in the US, it is a flawed market/ not functioning ideally.  (But I still think providers should be paid fee for service- the more you work, the more you get paid: healthy capitalist)..

I would like the age of Medicare eligibility to be lowered to 0 and the plan to be offered throughout the US at every business as an alternative plan that  employees can chose.  In terms of infrastructure- it already exists.  There is a mechanism to collect premiums (we all pay now, we would just pay more). And there is a mechanism to pay providers: almost everyone takes Medicare (or pediatiricians SSDI) now and generally knows the rules and has the forms. KEY:  Then we set the premium at a flat fee but lower than current Medicare rates at around $5000/ per person per year.  No family subsidy- each person- same premium.  That will bring all kinds of folks into the system.

Us young health folks will float the pool. There are a lot of other benefits that will make the Health Insurance Companies upset so I won't go into them here.

--James

 And with Mr. Hatheway's reply, we now see the great train wreck I spoke of earlier. 

I would like the age of Medicare eligibility to be lowered to 0 and the plan to be offered throughout the US at every business as an alternative plan that  employees can chose.  In terms of infrastructure- it already exists.  There is a mechanism to collect premiums (we all pay now, we would just pay more). And there is a mechanism to pay providers: almost everyone takes Medicare (or pediatiricians SSDI) now and generally knows the rules and has the forms. KEY:  Then we set the premium at a flat fee but lower than current Medicare rates at around $5000/ per person per year.  No family subsidy- each person- same premium.  That will bring all kinds of folks into the system.

Us young health folks will float the pool. There are a lot of other benefits that will make the Health Insurance Companies upset so I won't go into them here.

Emphasis mine.

Pay more, Mr. Hatheway?  $5000 per person per year?  That's considerably more than I pay for healthcare now.

I don't think so, my friend.  I have $10,000 in studen loans to repay now.  I have a 2 year old child and day care to pay for.  My wife and I will both need new cars in the next 18 months (both of our cars are almost 7 years old).  Gas and food prices are at an all time high.

And you want to raise my prices even more.  No thank you, sir.  I will be writing my congressmen and my President and I will be VOTING AGAINST YOU.

Explain to me, sir, why I should be footing the bill for someone else's healthcare when I have problems of my own to deal with?

Do we see the train wreck now?

JamesNT

Just some quick facts:  The USA family premium in 2005  was between $8000 and $12000 according to the Public Policy Institute of NYState. The average Nationwide was $10,728.  The average individual premium (employee plus employer contribution) nationwide in 2006 was $4,400 and actual heatlh expenditures per person in the US was $7600 according to the National Coalition on Healthcare's WEb site.

So you may be doing better than the average family for 2008- or your employer may have a young workforce, or you may have high deductibles, or no/ limited drug coverage.  Or, like most companies, the two person families subsidize the 4 person families. 

What you may not realize is that you already pay into Medicare- and it is likely pre-tax.  The bureaucracy already exists.  You are currently buying health insurance for when you are over 65 --and your health is declining- on average.  And the Medicare overhead cost (direct claims subtracted from. collected premiums) is far lower than any commercial insurer.  My grandparents (now deceased) had far better health insurance coverage under Medicare that I have been able to get most of my life.  Medicare is not as bad as some insurances with huge gaps, at least it has universally recognized forms (HCFA1500, UB82 etc.) and standards and published rules.

PS.  No need to vote against me- I'm not running for anything, just expressing an opinion of a modern fiscally conservative republican.

--James

JamesNT:

I ran across this from the CBC website.  Here are a few quotes:

 

On June 9, 2005, the high court struck down a Quebec law that prohibited people from buying private health insurance to cover procedures already offered by the public system.

"Access to a waiting list is not access to health care," two of the justices wrote in their decision.

High court?  Private Insurance??  Waiting lists?!?!?  All this sounds like a far cry from the Canadian Healthcare System we all know and love.

There must be something amiss, here.  While our resident expert, Dr. Murdoch, sorts all this out and sets us straight, here is the full length to the article:

http://www.cbc.ca/news/background/healthcare/

JamesNT

Good Googling.

:)

Let me get you up to speed on internal Canadian politics.

Quebec is a predominately French speaking province in which the ruling party often wants to separate from Canada.  Quebec seems to get their way alot in Canada because the Federal Government tries to appease them.  Keep 'em happy and so they won't try and separate is the trend du jour.  Sad but true.

In Canada, healthcare is mostly a provincial matter, so Quebec delivers it's own healthcare.   The Federal government does chip in a bit but it is a smaller share every year.  Provinces that are in contravention to the Canada Health Act can be denied "Federal transfer payments" from the Canadian government, but that really hasn't happened yet, despite Quebec's clear ongoing violations.  Essentially Quebec is in contravention to the Canada Health Act and risks a cut in funding at any time.

So in some respects, the rules for Quebec are different than any other province as they are often allowed to "do what they want".  I think if private insurance took off in Quebec, you might see the Canadian Government attempt to get Quebec to follow the Canada Health Act more closely.

I'm sure that is clear as mud.  Mais Oui !

JamesNT:

Do we see the train wreck now?

 

The real train wreck would be is if you are between jobs and you get a major illness.

Now your surgery and 3 week hospital stay will bankrupt you.

That's not to say that the general unaffordability of healthcare is the #1 most important issue.