Insomnia Log

This is what keeps me awake at night???

Who needs sleep? (well you’re never gonna get it)
Who needs sleep? (tell me what’s that for)
Who needs sleep? (be happy with what you’re getting,
There’s a guy who’s been awake since the second world war)

-- words and music by Steven Page & Ed Robertson

Location: Boulder, Colorado, United States

Everything you need to know about me can be found in my posts

Thursday, November 06, 2008

I'm Sick of Waiting for Socialized Health Care

I had the opportunity to spend a couple of days in Canada last week. While I was there I thought it would be a good chance to do a little informal research into how their health care system really works.

"Fixing" our health care system is clearly near the top of the list of things for our incoming President and Congress to work on. And everybody here seems to have an opinion. Obama wants to bring us "socialized" medicine, according to John McCain. But socialized medicine, he warns us, results in rationing of care and long waits.

Well, Canada truly does have socialized medicine. And nothing Obama has proposed comes anywhere near to what they have. But in any case, I asked three Canadians I had the chance to talk to what they thought of their system:
  • The software engineer
  • The business executive
  • The retired factory worker
The first thing to get out of the way is wait times. Every person I talked to confirmed that there are long waits for certain things. If you want to schedule non-emergency surgery you may have to wait six months. I was told that the government is working on improving this, because of the number of complaints, but it seemed to be an accepted fact.

Can you get your hip surgery quicker if you are willing to pay? Well, I heard of one man who paid out of pocket to come to the U.S. and get his new hip. It cost him $40,000, but the money was burning a hole in his pocket and being in his 80s he really valued the time more than the money. I also heard that, depending on which province you live in, you may be able to pay for improved service locally, but that in some provinces that would be illegal.

The other thing you may have a long wait for is a first appointment with a doctor or specialist. (I guess this is similar to some popular providers in the states.) Again, that could be months. Now, once you have become a client of the doctor, I was told that immediate appointments were available. The executive and the retired factory worker told me they were getting appointments the next day when needed.

Interestingly, I also heard that employers may supplement the health care plans of their employees. For example, they may add prescription coverage, or may upgrade from a ward to a semi-private room.

The retired worker's biggest complaint? When he turned 65 and switched to the Canadian equivalent of Medicare, they switched one of his drugs. Instead of taking one pill per day he had to take two.

What about the cost? The executive told me she is in the highest tax bracket, with essentially no deductions, and that she pays 47% of her paycheck in taxes. For comparison, the highest tax rate in the U.S. is 35% federal, 7.65% payroll tax, and 4.6% state income tax (here in Colorado), for a total of 47.25%. Hmm. That doesn't count the insurance costs that are also deducted from your paycheck.

So what do they think? My software engineer doesn't like it. He doesn't like the rationing, and the inability to get the care he wants when he wants it. My business executive loves it, because people can't go bankrupt because of a catastrophic medical problem. And my retired worker feels lucky compared to his brother, who lives in the U.S. and has no health care after being forced into early retirement.

So what's the bottom line? First, it will be hard to sell government run health care in the U.S. It seems like it can be done at a reasonable cost. To do so, however, will require some rationing. And given that, people in this country will not tolerate being told they can't get the care they want.

To be successful here, socialized medicine must include the ability for employers to supplement the insurance, and it must include the ability for individuals to pay for unrationed care.

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