Political Compass

[The Beatles]

The logic is that windy's objection, or at least on the grounds he gives, is spurious. It's silly to object to being required to buy something but not to object to taxes. If he is opposed to the healthcare bill on other grounds -- say, he doesn't want to have to pay for the care of poorer people, something Republicans often say -- then that's a valid line of argument, as are many others. His isn't.

[Shadow I]

But when you are considering a comparison between health care spending and taxes, you need to consider your taxes + your health care spending, versus our taxes alone.


Actually... no I don't. My insurance premiums and out of pocket expenses are a fixed cost. My taxes vary with the amount of money I make. I'll pay the same for healthcare regardless of whether I make 50,000 a year or 10,000 a year. The taxes that pay for Social security take a fixed percentage, of 6.2%, and I haven't made enough to actually pay income tax until this coming year.

My point was that in Canada, our healthcare cost is just another part of our taxes for the most part, so I can't really get an accurate idea for what my health care actually costs. If we compare your taxes + healthcare to my taxes, we get a comparison for the amount of money we are each spending on taxes + healthcare.

"Massachusetts' problem of overcrowded waiting rooms and overworked primary-care physicians (who were already in short supply) has been exacerbated by the influx of patients now covered. One criticism of the program is that it has done nothing to realign incentives for MDs to provide primary care."
- http://en.wikipedia.org/wiki/Massachuse ... m#Outcomes

A single state system without the backing of federal funding was always doomed to fail, as there is a lot less tax revenue going to an individual state than the US government has at its disposal.

[Freenhult]

"Massachusetts' problem of overcrowded waiting rooms and overworked primary-care physicians (who were already in short supply) has been exacerbated by the influx of patients now covered. One criticism of the program is that it has done nothing to realign incentives for MDs to provide primary care."
- http://en.wikipedia.org/wiki/Massachuse ... m#Outcomes

A single state system without the backing of federal funding was always doomed to fail, as there is a lot less tax revenue going to an individual state than the US government has at its disposal.

This logic is flawed. A state is the same as the entire union. If one state can't take care of its own people, what makes the fed able too. More people != greater buying power overall.

[Gen. Volkov]

My point was that in Canada, our healthcare cost is just another part of our taxes for the most part, so I can't really get an accurate idea for what my health care actually costs. If we compare your taxes + healthcare to my taxes, we get a comparison for the amount of money we are each spending on taxes + healthcare.

Yes, I know, but your "health care" cost is going to scale with your income. Mine won't. Unless I am forced to pay into a government system, my health care costs won't change whether I make 10,000 a year or 500,000 a year. Yours will, depending on what tax bracket you are in.

[Shadow I]

This logic is flawed. A state is the same as the entire union. If one state can't take care of its own people, what makes the fed able too. More people != greater buying power overall.

The single state system did not have very mucn (any?) federal support. The bill that affects the entire US does. There is a very big difference.

Yes, I know, but your "health care" cost is going to scale with your income. Mine won't. Unless I am forced to pay into a government system, my health care costs won't change whether I make 10,000 a year or 500,000 a year. Yours will, depending on what tax bracket you are in.

I was more interested in a comparison between people at our economic level, which is more or less similar I think.

[Nuclear Raunch]

I'm 100% positive that this claim is nowhere near the truth, before we discuss it further I want to see where your source for this is.

And you would be 100% wrong.

http://www.post-gazette.com/pg/09347/1020585-114.stm

Most relevant:

"Assembled by Carnegie Mellon University professor Paul Fischbeck, the chart shows that per capita health care spending in the United States is pretty similar to that in Germany, the United Kingdom, Sweden and Japan -- until about age 60."

All those countries have UHC. US healthcare costs skyrocket after age 60. That is why our numbers are so much higher. I was actually pegging the rise a little low.

I can't find the study anywhere, it's not on the guys website, nor it is on the RAND Corporations site (where a contributor of his name has 3 other studies) nor is it on his school's website, but when I get a chance I'll check my school's online library of scientific journals.

From the link it says we spend about the same (doubtful, but I'll play along) until age 60, where it takes off. That's roughly 77% of the average life is the same. In the remaining 23% we need to spend enough to double their output for their entire life. So basically in the last 18 years of our life we will spend as much as they will in their entire life plus what they spend in the last 20 years of their life.

No effing way. Stats that extreme are virtually never accurate, and I'm sure I can find out why once I see his actual study.

[Nuclear Raunch]

http://www.kaiserhealthnews.org/Graphic ... rison.aspx

That's actually rather funny, but I'm sure they cherrypicked the hell out of it.

[Shadow I]

cost: $871 billion over 10 years

You people have been arguing that Obama is going to cost you a trillion in a year. This health care reform is going to cost 0.6% of your GDP each year for 10 years. Compared to the 10-15% that your country pays per year for your existing health insurance. Lol. In order to break even, all this new plan has to do is reduce your health care cost by a pretty tiny amount. Which if you compare average household costs of health care in socialized systems to yours, is not such a tall order.

[Gen. Volkov]

No effing way. Stats that extreme are virtually never accurate, and I'm sure I can find out why once I see his actual study.

Find it and prove me wrong then. However, the article gives some pretty compelling reasons for why it plays out that way.

I was more interested in a comparison between people at our economic level, which is more or less similar I think.

This is all vague estimates you understand, but if we make the same and I add in all my costs for health insurance, prescription drugs, and the one or two doctor visits I make a year, my total for health care comes out to 1280 dollars a year. Taxes will be about 1500, so that's about 2780 a year total. Yours is harder to calculate, since you have my same income tax percent, but a bunch of additional sales taxes and whatnot. But just assuming that the additional taxes you pay will come straight off your income like the income tax, you'll be paying about 2800 a year. So I am paying about the same amount per year as you are, assuming we make the same amount of money. I'm guessing I'll make about 10 grand this year, assuming I don't get a new, higher paying job, which is far from unlikely. If I make 28,000 a year, as is likely if I get the job I want, I'll be paying about 900 dollars a year less than you.

[The Beatles]

I don't think you can assume that, V, as sales taxes are regressive, i.e. don't scale with income. I pay just the same sales tax as you do though here in California I pay in income taxes about twice what you make.

I think what would be a more useful comparison is health spending as percent of GDP times tax -- compare that against medical expenses directly. So assuming Canada spends 10% of its GDP on healthcare, that means Shadow's medical expenses would be the equivalent of 10% of your taxes. A direct tax-to-tax comparison is unfair, as the two governments spend their money differently.

My current health plan is largely covered by my employer and the premiums are around $500 or $600 a month, I don't remember exactly. Direct cost to me is $40. There should be no out-of-pocket medical expenses on this one, though my old plan had a deductible. Anyway, assuming I paid the same dollar amount of taxes in Canada, and 10% of those were spent on the health system, that works out to roughly $2500 yearly (I'm including my Medicare and Social Security contributions with my income taxes here, but not sales taxes). The reality is that I'm paying $480 out of pocket and my employer perhaps $6,600 (same at my previous employer). Paying for myself might cost say $4,200 at $350/month and that would be with a significant deductible and co-pay. Give me single-payer any time on economic grounds alone.

Anyway we already knew it was cheaper. The usual arguments have instead been about waiting times, etc., which frankly get bad in the US too. Health indicators tell their own story. At this point I seriously cannot see a single logical argument against UHC in the US, not even the selfish ones.

[Shadow I]

You forgot your own sales tax in that volky, as well save savings considerations etc. Average sales tax in US seems to be around 6%, which would put you well over me in spending even at 28000.

Now, is that estimate for health care costs per year to you the total, or the tip of the iceberg as with Beatles, where he pays only about 10% of the actual cost of the insurance?

Using Beatles' suggestion puts my health care spending around $250 a year. So I think we can conclude that while I do pay more tax in general, my health care costs are significnatly lower.

The usual arguments have instead been about waiting times, etc., which frankly get bad in the US too.

Again, the long witing times are a myth. What you hear about for long wait times is some fool who goes to the emergency room because their nose is stuffed up and ends up waiting 6 hours because the doctors are busy dealing with things that are actually emergencies and can't be bothered telling them to go away.

This coming from first-hand experience of the system.

[Gen. Volkov]

I don't think you can assume that, V, as sales taxes are regressive, i.e. don't scale with income. I pay just the same sales tax as you do though here in California I pay in income taxes about twice what you make.

The thing is, the sales tax and "value added tax" are how they pay for healthcare, I think. But you're right, I have no real way to work it in.

I think what would be a more useful comparison is health spending as percent of GDP times tax -- compare that against medical expenses directly. So assuming Canada spends 10% of its GDP on healthcare, that means Shadow's medical expenses would be the equivalent of 10% of your taxes. A direct tax-to-tax comparison is unfair, as the two governments spend their money differently.

First, Canada probably spends more than that on healthcare, second, 10% of GDP does not translate to 10% of government budget, which is funded by taxes.

Anyway we already knew it was cheaper. The usual arguments have instead been about waiting times, etc., which frankly get bad in the US too. Health indicators tell their own story. At this point I seriously cannot see a single logical argument against UHC in the US, not even the selfish ones.

I was never arguing against UHC, this was about the amount the average person in their mid-20s pays in a single payer vs the US system. I actually do want a single payer system in the US, my problem is more with this bill in particular. I see a lot of graft and corruption, and an increase in the deficit.

Oh, and here's this little tidbit:

"In 2007, the latest available year for data broken down by age group, health care spending by provincial and territorial governments was highest for seniors age 65 and older ($10,318 average per person) and infants younger than 1 ($8,239). In contrast, health care spending on Canadians between age 1 and 64 averaged $1,966 per person, up from $1,832 in the previous year. "

That's in a single payer system. According to my other article, the difference between young and old is even greater in the US. The extra 2000 or so spent per person in the US could easily be accounted for by the 60+ group.

Another article:

http://www.ahrq.gov/research/ria19/expendria.htm

5% of the US population is apparently spending about half the total US expenditure on health care, and the elderly spend about 36% of the total.

You forgot your own sales tax in that volky, as well save savings considerations etc. Average sales tax in US seems to be around 6%, which would put you well over me in spending even at 28000.

Actually in my state it's 7 percent. Which adds another 1900 at 28k a year, assuming it's straight off the top, which as Beatles points out is not actually reasonable. I may have also missed some taxes that you are paying. I don't really know how to figure this one.

Now, is that estimate for health care costs per year to you the total, or the tip of the iceberg as with Beatles, where he pays only about 10% of the actual cost of the insurance?

It's the total. I don't get insurance through work. I pay a 104 dollar a month premium for insurance. 1 doctor visit is about 44 bucks, and I pay 14 bucks every 3 months for generic synthroid. I generally have 1 to 2 doctor visits a year, unless I'm really sick.

Using Beatles' suggestion puts my health care spending around $250 a year. So I think we can conclude that while I do pay more tax in general, my health care costs are significnatly lower.

Beatles suggestion is flawed though.

A little quick and dirty research though gives me first that Canada's government pays about 70% of healthcare costs.

http://en.wikipedia.org/wiki/Health_care_in_Canada

Second, that Canadians spent 183 billion on healthcare in 2009. 70% of which is 128 billion.

http://www.news-medical.net/news/200911 ... -CIHI.aspx

Lastly, that Canada's budget for 2009 was 258 billion. So about half your budget went to health care, which means about half your tax dollars went to health care. I don't know how much you are actually making, but if 10% of your tax dollars is 250, then half is about 1250. So I am spending about the same as you on health care. Maybe a tad more.

[The Beatles]

Ah, thanks for the calculation correction, Volky. Yes, my way was stupid.

Let's do a bit more figuring. I don't like Canada's case because a. all the social programmes and health are counted as one in the few online sources I've just checked (coming out to 56% this year) and b. its indicators are a bit worse than the Western average. So let's look at Germany and the UK, the classic single-payer and single-provider systems, respectively. The most recent German budget on Wikipedia is 2005, coming out to 33% for health and social security. The UK's is current and is 18% on health.

Because of the funny way I pay both California and the US income taxes, I would probably pay less tax in either of those two countries, but what the hell, let's figure with what I've got.

33% of my taxes a year is about $8,300 and 18% of them is about $4,500. (Some of those go into the health system, but they don't benefit me, as I don't use Medicare/Medicaid and I pay for my emergency services.) By contrast I pay $960 out-of-pocket (my previous figure was off, because I counted only 12 deductions of $40 but they come out of pay every two weeks) and my employer a shade under $7,000. So my total healthcare costs would be slightly higher in Germany and significantly lower in the UK. Now for all this, I hardly ever use the doctor, but if we want to compare services, I believe I might have to pay for some drugs, and no medical or dental services are included. I can get treated in any hospital in the country and 70% will always be covered, but I am only fully covered in Blue Shield affiliated hospitals, which I believe can be found in every major city -- for instance, the University of Washington Medical Center is. Basically I am not getting a bad deal. In Canada I'd be paying over $14,000 for health and social services, which is almost twice what I pay now -- assuming tax rates are the same, which frankly makes this exercise more a game than a real comparison. With tax rates we would get further.

I would pay VAT in the UK, as I do here in California, don't know the exact numbers. Don't know Germany but I'd be surprised if they didn't have one.

Anyway, how do the numbers crunch out for you, Volky? I

[Shadow I]

I did a little digging - my current health care is covered by the university, for which I pay $145 per semester.

So my total health care expenses is $435/year. (CAD)

The combination of a slowdown in the economy and a continued increase in health care spending resulted in a jump in the proportion of health care expenditure from 10.8% of Canada's gross domestic product (GDP) in 2008 to an estimated 11.9% in 2009.

So there are your stats for Canadian health care spending by GDP.

[The Beatles]

As Volkov pointed out, what matters is percent of government tax revenue, which is virtually all of government revenue these days, so we may take it as the same. Just search for the Canadian budget, there's a flash app in one of the big Canadian newspapers detailing it. That indicated 56% of the most recent budget went to health and social services.

The comparable figure for the US is 40%, which is 18% on Medicare+Medicaid and 22% on Social Security. (So I actually pay more toward health bills, but since they in no way contribute to my own health, I haven't been counting them.)