Your missing the point a bit. It was a group plan. The agency had to pay $1600 per month for each policy regardless of the officers age/health. Of that we had to pay $35 per month. Every one paid the same amount. And I should have added, $1600 is for the family plan (employee, spouse, any number of kids). It was $1100 for a single. Officers paid the same regardless of what plan they were on.
Not yet. 2 years ago I thought they were going to but they didn’t. Like I mentioned before, officers hired after 1994 have to pay 100% of the premium when they retire. They are allowed to use accrued sick leave to pay it, but after that is exhausted they are on their own. The other change is when post '94 officers go on medicare their premiums for the agencies insurance goes down. I, on the other hand, will get booted out of the insurance plan completely when I go on medicare, with no option to continue on it even if I were willing to pay for it.
My pension is $3400 per month. Paying out $1600 would be a huge hit. I have over 500k in a 457 plan and about 100k in an IRA, but I can’t touch either of them for over 7 years.
I have also been told that the amount current officers have to contribute jumped in increments from the $35 a month to the current $200 per month. That still isn’t bad for a $1600 family plan policy.
From waht I read during the thread “all those healthy uninsured 20-yo’s will now be forced to pay, which will help make up the losses from the pre-existing-condition insurees getting care while paying well below real-world value for their plan.”
This is like the story about raising taxes on millionaires to make up the deficit. I don’t want to get into that debate, but statistics suggest there are not enough millionaires. (The people who trot this story out on TV tend to gloss over the fact the tax is on $250K and more, not $1M and more. I bet there’s a lot of $250K to $1M earners, and nobody promises that elimiantes the deficit completely either… but I digress).
So how many uninsured are well off and can afford fairly high health care premiums but choose not to buy care today? How many are simply so cash-strapped they can’t afford any plan? Unless the former is a big number, then it’s not the premium-leveller that it is touted to be.
My observation is that the rest of the first world has the same or generally higher taxes than the USA, but instead spends the money on health care rather than military.
I was going to ask this at some point and it seems to fit here, so:
My dad owns a small construction business that has been basically teetering on the edge of bankruptcy since the housing bubble burst. His company employs himself, my mom, and sometimes 1-3 other employees (generally my brother and maybe another guy or two).
He has never paid for health insurance for anybody before, except for himself and my mom (and my youngest sister, the only one of my siblings who is still a minor); however, they had to drop their health insurance a couple years ago because it became too expensive for them to afford; the rates were about $16,000 a year for the three of them.
A few days ago he was complaining that he would have to go out of business now, because Obamacare would force him to pay for healthcare for anybody he hired, plus himself and my mom, or pay a penalty, and they couldn’t afford to pay anything.
What’s the real deal here? Will he be required to pay for employee health insurance even if there are only 3-4 people at the company?
Nope. “Small businesses” are exempt from having to provide insurance or pay the penalty if their employees buy on the exchange. And it’s a pretty well publicized threshhold - 50 employees - so I suspect your dad is being willfully ignorant.
Even better, once all the provisions of the Affordable Care Act are in place, your dad can get a tax credit if he *does *decide to provide insurance. He can also use those cheaper insurance exchanges as a small business owner.
Many countries have higher taxes that the US, but it would be wrong to say that that funds higher healthcare costs. It’s an undisputed fact that the US spends more per head of the population on health care costs than any first world country. Double or triple the amount of many countries with UHC.
Yes, we can talk about whether quality of care is the same (which I would say broadly is, in most cases), but that’s a separate point.
If you have low taxes but have to pay $16,000 out of pocket for health care, what’s the difference between that and high taxes but “free” health care? (Other than the fact that health care costs in the USA are a market disadvantage for the good employers; in other countries, it’s the same cost for everyone. )
A portion of the higher costs in the USA are attributable to excessive overhead costs (and need for profit from plans). All those offices, forms to fill out, back and forth over what is allowed and not depending on the plan… that costs money somewhere. Uninsured people still get health care, cutting medicare simply means the costs are borne by the local facility (emergency room) and the hospital takes an extra cut from the paying customers to make it up.
Another point is that aside from the efficiencies of a single-payer system, yes the government makes savings by lowering the amount they pay doctors (and others); and as the only game in town, they have a lot more leeway. Your typical GP in Canada is not rolling in the dough, but I suspect GP in the USA is not the road to riches either.
The difference in taxes here is a red herring, as most of the higher taxes other first world nations pay is because of more generous social security provision.
Once again, the fact that the US pays the most of any developed country, per head for healthcare, is really not disputed.
Agreed. The amount of overhead, bureaucracy and middlemen (that all must make a profit) are key factors in why costs are so high.
What is often said at this point (I am not accusing you of this), is that such layers are good because they are employing people, putting money in their pockets that they can go spend.
But of course, by that token it would be good for the economy if we employed 20m people to hop on the spot.
It would be much better for the economy if they were doing something that had some utility.
Agreed, but in several recent threads people have implied doctors in the UK are paid peanuts, so I feel like I should say that they are well paid. It’s a tough job, but they are compensated well:
Average salary across all jobs in the UK is £26k.
The headline average salary for GPs in private practices is £100k, while in primary care trusts it’s £70k (both kinds of practice treat NHS patients, the difference is in who manages the practice).
But in addition, doctors earn significant bonuses through government targets. The average bonus per practice is £130k (I can’t find data on the average number of doctors per practice but IMO most are just 3 or 4).
Plus overtime rates can be very good; say £150 per hour (though admittedly many doctors report working some unpaid overtime).
Put all this together and few GPs have a total takehome pay less than 4x average salary and for many it’s much higher. And bear in mind that the student debt of training to be a doctor in the UK would be equivalent to about 1 year’s tuition in the US.
You have to be careful of statistics. The interesting thing, the average wage is about the same in Canada - $40,000 or so; this is the number unemployment insurance and Canada Pension Plan are based on too. The majority of social safety net spending (at least Canada federal) is on health care, then higher education.
The doctor income sometimes get cited, but keep in mind (here in Canada) that number would be gross; the doctor pays expenses, nurse, receptionist, rent, etc. They have been slow to consolidate into larger clinics, so their expenses as GP tend to be a bit high.
A system that results in higher costs for say, a broken arm or birth, is NOT productive. Just because it employs more people, because it costs more for the same result. The money would definitely be better spent increasing the value of society - building more roads, etc.
(I saw an article on productivity that expressed this - is society richer because we have more engineers or doctors? Yes. Because we have more lawyers? Debatable. It’s what people produce that matters.)
For what it’s worth, my mother was offered a PCP job in the US that paid almost exactly two-thirds more than what she was paid as a GP in the UK (68k GBP), taking the exchange rate of the time into account. This was in 1993; I think it was along the lines of $1.50:1 pound.
What about Joe Slacker, living in his 85 year old mother’s basement, whose social security check is one dollar over the poverty threshold? Does he qualify?
The rest of the world spends considerably less both in actual dollars and as % of GDP to cover 100% of its citizens than the US does to cover only some.
Yes, but as a result of the free market and other reasons, they have a greater variety of services.
For example - most provincial health care in Canada follows the Canada Health Act to stop physicians from charging patients more than Medicare pays - so basically, the doctor either accepts what Medicare pays, or the patient and doctor get nothing - strictly private health care. Effectively that means all doctors work for the same pay scale - the only exceptions, some doctors for the super wealthy, sports teams, etc. There is a specific list of what Medicare will cover, and unless it’s a research test, this does not usually include experimental treatmets or treatments of unproven value.
The USA has a wider range of doctors providing various treatments, and also a lot more experimental treatments. It is not uncommon to hear appeals for funds to send some poor child to the USA to get a treatment that is not available in Canada - either because it’s unproven, or the Medicare administration ahs not approved the treatment yet. I’m not sure how you characterize that; but then, it’s no surprise that a lot of rich people or world leaders seem to come to the USA when they need serious medical care. This sort of fancy and experimental treatment option probably adds to the “money spent on health care in the USA” statistics.
OTOH, yes, everyone in Canada is pretty much covered. For less than the USA.
It may feel “common,” but it’s not. Studies have shown that 0.5% of Canadians report having received health care in the US in a year, but many of those were because they were here already when a medical issue arose. Only a quarter of those traveled to the US expressly for health care. Since some of those do it because they think their health conditions are more urgent than their doctors do (and so they get put on a waiting list in Canada), or because they’re seeking out a doctor or hospital believed to be “the best” for their condition, the number of those seeking experimental or unapproved treatment is even smaller.
But right now my company provides a tier system. The management gets a choice of three plans. The lower level types, as myself get only the HMO option.
Sorry, no, I don’t mean it happens every day. Just that every year or so on the news, there’s some child whose parents or community are doing a fund-raiser for; that there’s some experimental or not widely approved treatment, or some treatment only some doctors can provide - because it’s not an approved treatment on the provincial health care schedule, or they need travel funds during the treatment, etc.
Much as I love the Canadian system the US medical system seems to have more of these different treatment options and advanced treatments. Partly, this could be attributable to the “benefit” of a user pay system that enables more of a free market. That market encourages competitive promotion of their procedures. Partly, it’s because the more advanced research facilities are in the USA. Also, it attracts those researchers from all over the world.
Whatever the reason, the more advanced medical work seems to happen in the USA.
Much as people say “I could get my MRI in a day rather than waiting a month”, very few regular patients make a trp to the USA and pay the American fee to do so.
I have read that income will be based on AGI.
I am going to be about $600 away from falling off the Health Care Cliff. At $47000 you all of a sudden have your rates doubled.
I am hoping that I will be able to adjust my AGI with deposits to an IRA. Does this sound like it will work?