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While as a relatively healthy person I've been continuously disappointed at paying approximately $1500 a month in taxes[1] towards the Canadian public health ca

While as a relatively healthy person I've been continuously disappointed at paying approximately $1500 a month in taxes[1] towards the Canadian public health care system (a quick google suggests ~30% of tax revenues), I also was happy to see that my grandpa spending ~6 months in palliative care cost them very little (if anything), compared to something like $180K in the US. I think the biggest point of contention is that reasonably well kept and healthy people are receiving little to nothing for their money in the present. eg, I got tons of push back asking for simple lab tests like cRP or dermatology cancer screening which would have been less than 10% of what I contribute to the system. Another time I literally waited in a ER room until my loss of blood made me a triage priority. The amount of resources available due to the market distortions means they have to defer you until you're worse off than when you walked in. Compare that to fast (always <1 hr, even for non emergency things like a dislocated finger) and reasonable waits anytime I've been to a hospital in the US. Mind you I've also probably spent a total of $40k (not my portion) in ~8 yrs of residency between insurance costs and copays, more than half due to a heart attack scare and ER trip that ended up being myocarditis from the vaccine. So what's my point in all this rambling? I think there's a ton of unlocked value in the US system to do more preventative care, but the US is anti-paternalism and often lets people do stuff that costs them in the long run (unwittingly or knowingly). But there's a hidden truth to Canada's system appearing so rosy -- at least as the payer and consumer I feel I get more for less in the US. Whereas in Canada you have better average outcomes because you take marginal care (eg preventative tests) from those who pay, and give it to those who cannot pay but may have a marginally more improvable conditions (eg bleeding out, having a heart attack). [1]: compare to about a quarter of that in medicare on much higher earnings

dfinninger 4y ago
I’ve also sat in an ER, waiting to be seen while in a lot of pain or with someone in a lot of pain or with visible injury. The only time I’ve actually been triaged immediately was when I had so much blood running down my face that the nurses didn’t want me to scare others in the waiting room. This was all in Dallas at good hospitals. I’ve waited months to be able to see a doctor. In fact, I’ve just recently seen a dermatologist after a 9-month wait. No one else had anything sooner. I’ve learned with the US system there are a lot of hoops you have to jump through for care if you want insurance to be happy. I have to go to one or two other clinics or quick care facilities in order to get in to see the doctor that I actually need. And once I have a prescription it’s always a prior-authorization fight to actually get the meds. And all of this, knowing that I can’t ever take a sabbatical since COBRA, on top of my monthly expenses, would be prohibitive. So, it feels like the US system is the worst of all worlds. I’ve got the waiting and the pushback and the expense.
- acer589 4y ago
  Top tip. Don't go to Parkland if you don't have to.
deleted 4y ago
[deleted]
fennecfoxy 4y ago
>reasonably well kept and healthy people are receiving little to nothing for their money in the present Even if I never use public health services my entire life (I mean I obviously already have) I'd still be happy to keep paying that tax. Why? For the same reason that I don't mind as a gay man who will never have kids that my taxes also go to: welfare/benefits for families in need, helping children, building/benefiting infrastructure I will never use. All of humanity is in this together, on this tiny blue sphere. If people are focussed only on maximising things purely for themselves and not others at all, then have we really progressed at all as a species?
- maerF0x0 4y ago
  to be clear my point wasnt about maxima, but about imbalance. IMO Rejecting someone preventative care ($1k tops), when they give $18K to the system is a broken balance. The claim/demand is not $18K in, $18K out.
  - fennecfoxy 4y ago
    Oh, definitely agree with you there, then. I guess it is troublesome because the money has to come from somewhere at the end of the day. Someone like that shouldn't be denied but I guess it begs the question of what happens if in a certain year demand for medical services outstrips allocated tax. I suppose govs should really have a slush fund for that sort of thing rather than national debt/constantly feeling they have to spend all tax money, every year.

dfinninger 4y ago

I’ve also sat in an ER, waiting to be seen while in a lot of pain or with someone in a lot of pain or with visible injury. The only time I’ve actually been triaged immediately was when I had so much blood running down my face that the nurses didn’t want me to scare others in the waiting room. This was all in Dallas at good hospitals. I’ve waited months to be able to see a doctor. In fact, I’ve just recently seen a dermatologist after a 9-month wait. No one else had anything sooner. I’ve learned with the US system there are a lot of hoops you have to jump through for care if you want insurance to be happy. I have to go to one or two other clinics or quick care facilities in order to get in to see the doctor that I actually need. And once I have a prescription it’s always a prior-authorization fight to actually get the meds. And all of this, knowing that I can’t ever take a sabbatical since COBRA, on top of my monthly expenses, would be prohibitive. So, it feels like the US system is the worst of all worlds. I’ve got the waiting and the pushback and the expense.

acer589 4y ago
Top tip. Don't go to Parkland if you don't have to.

deleted 4y ago

[deleted]

fennecfoxy 4y ago

>reasonably well kept and healthy people are receiving little to nothing for their money in the present Even if I never use public health services my entire life (I mean I obviously already have) I'd still be happy to keep paying that tax. Why? For the same reason that I don't mind as a gay man who will never have kids that my taxes also go to: welfare/benefits for families in need, helping children, building/benefiting infrastructure I will never use. All of humanity is in this together, on this tiny blue sphere. If people are focussed only on maximising things purely for themselves and not others at all, then have we really progressed at all as a species?

maerF0x0 4y ago
to be clear my point wasnt about maxima, but about imbalance. IMO Rejecting someone preventative care ($1k tops), when they give $18K to the system is a broken balance. The claim/demand is not $18K in, $18K out.
- fennecfoxy 4y ago
  Oh, definitely agree with you there, then. I guess it is troublesome because the money has to come from somewhere at the end of the day. Someone like that shouldn't be denied but I guess it begs the question of what happens if in a certain year demand for medical services outstrips allocated tax. I suppose govs should really have a slush fund for that sort of thing rather than national debt/constantly feeling they have to spend all tax money, every year.