Skiers, MTBers, anybody active, beware

[Sirshredalot]

Let's include state/provincial taxes.

$203K CAD with BC as the province https://simpletax.ca/calculator
Taxes: $70K or 35% avg

$154K USD with CO as the state (single no exemptions) https://goodcalculators.com/us-salary-tax-calculator/
Taxes: $45K or 25% avg

BUT HOW MUCH IS TAKEHOME PAY DIFFERENCE?

$8K USD difference in takehome favoring the American.... except to do the numbers right you have to adjust for median income (10% higher in US) not just exchange rates, which gives the American another $11K USD after taxes.

$19K USD buys decent insurance in the US for most people most places. For reference a Silver ABCBS HMO plan for Denver for 36 y/o male nonsmoker on the exchange has an annual premium of $6k (no subsidies) with $7k max out of pocket. But if they have an equivalent Silver PPO from a decent employer, they'll have an annual premium $1k with a $3k max out of pocket.

1. You forgot the payroll tax, which is a big share of the total tax burden on US wage earners. You need to include it.

2. If you're trying to make an apples to apples comparison of a specific wage-earner, you don't get to backdoor a salary bump based on median earnings. You're discussing a hypothetical dude who doesn't make the median.

3. Show me this hypothetical PPO with a thousand dollar annual premium and a 3k out of pocket max. Where does it exist? 1992?

4. If you want to compare US and CN medical expenses without running the risk of looking like an idiot on the Internet, just use total medical expenses per capita or as a share of GDP.

[mtngirl79]

Why not just look at total quality of life indexes?

Except when driving, Canadians I encounter seem pretty stoked.

Except the guy at Fromme on an ebike that I called out...

Seriously. How much money is it worth to not worry about illness/injury related bankruptcy?

How much less would you have to save for retirement without having to worry about medical expenses?

I think that the resistance to single payer in the USA is as much about control as it is about cost.

How many people would try to start their own business or take time off to travel or retire or or or if it wasn't for health care?

[summit]

1. You forgot the payroll tax, which is a big share of the total tax burden on US wage earners. You need to include it.

2. If you're trying to make an apples to apples comparison of a specific wage-earner, you don't get to backdoor a salary bump based on median earnings. You're discussing a hypothetical dude who doesn't make the median.

3. Show me this hypothetical PPO with a thousand dollar annual premium and a 3k out of pocket max. Where does it exist? 1992?

4. If you want to compare US and CN medical expenses without running the risk of looking like an idiot on the Internet, just use total medical expenses per capita or as a share of GDP.

1. You can express "but you forgot" all day long and we can go into deductions, exemptions, etc etc etc. US has payroll taxes for medicare and social security. Guess what? Canada has payroll taxes too in addition to income taxes! For CPP (Canada's social security) and employment insurance. I don't have hours to model taxes of a hypothetical Denverite vs a hypothetical Vancouverite. I did punch the payroll tax up on a few websites and the difference is less but still about 10K USD in the American's favor in the hypothetical.

2. Absolutely it applies. You can't just pretend the salary gap between US and Canada doesn't exist at different levels.

3. I gave an expensive exchange silver HMO plan as a high end expense and compared to an above average employer PPO plan as a low end expense to establish a range of possible expenses ($1K-$13K for US and $0-??? for Canada). For reference, that PPO is about what my wife's employer offers all of their employees from the front desk clerk on up ($1.3K premium and $3.2K max out of pocket PPO, $500 deductible).

4. $/capita or %GDP are ARE USEFUL as a measure of system expenditure disregarding funding sources that can then be applied against outcomes to compare efficiencies. They are NOT USEFUL FOR WHAT I AM COMPARING: individual financial impacts. I already explained this.

Look I'm not anti-Canadian and I'm not pro-US healthcare. Both systems have pluses and minuses. I'm just analytically trying to answer the question a previous post who compared asking, "would this hypothetical person be better off financially in Canada despite the high taxes?" I used their CAD salary and then compared it for Van to Denver. I demonstrated the answer for that specific hypothetical high earner was "most likely not better off financially in Canada." That is no criticism of either system. Just an an analysis of a specific hypothetical. No need to get spun up.

[XXX-er]

If yer a Canadian making 203K a year and you don't have a tax guy making sure you didn't pay any tax, you probably aren't smart enough to have made 203K a year in the 1st place but someone making that much coin doesn't have too worry about their lot in life

universal HC is great for the person on the margins of life doesnt matter if yer a cashier at macdonalds or a ski bum or Justin Trudeau, everybody gets served ... life is less desperate

[summit]

How many people would try to start their own business ... if it wasn't for health care?

I think this is a good point. The current system really discriminates against contractors, entrepreneurs, etc, particularly if they have families... and even against small business.

Before ACA it was more feasible IF you were young and healthy. Now it is just really hard.

I know plenty of contractors and entrepreneurs, even ones who make REALLY good money, who drive a bus or similar for 20 hours a week to get employer group insurance and it actually saves them money over working 20 more hours for their own business then buying insurance on the exchange. It's almost as if the system was designed to incentive working for large companies (hmmmm) in addition to ACA being designed to push healthcare mergers and elimination of small practice (designers admitted this was the design with efficiency in mind, but now believe it was a mistake).

The US individual market is fuct due to a combination of Republican sabotage, retarded torts driving expensive defensive medicine,and severe disconnects between health promotion/preventative care incentives to drive healthy lifestyle choices that would reduce costs of care.

Now, I'm NOT for single payer, I like multi-payer, guaranteed public basic care, inclusion of health promotion and personal responsibility for health in chronic conditions and preventative care, tort reform, and option with supplemental insurance that can be purchased or offered by employers. This is something like what Germany has, as I understand it.

[BeardMech]

Hope your never get IV acetaminophen in the hospital. Its already hundreds of dollars for a single 325mg tylenol pill. According to my wife IV tylenol is like 10x more expensive.

I used to volunteer in the UNC hospital pharmacy and man some.of the drugs Id deliver was so fucking expensive even with not even looking at patient costs. Sign my paper you stupid nurse so Im not responsible for you inevitably losing it.

[old goat]

I think this is a good point. The current system really discriminates against contractors, entrepreneurs, etc, particularly if they have families... and even against small business.

Before ACA it was more feasible IF you were young and healthy. Now it is just really hard.

I know plenty of contractors and entrepreneurs, even ones who make REALLY good money, who drive a bus or similar for 20 hours a week to get employer group insurance and it actually saves them money over working 20 more hours for their own business then buying insurance on the exchange. It's almost as if the system was designed to incentive working for large companies (hmmmm) in addition to ACA being designed to push healthcare mergers and elimination of small practice (designers admitted this was the design with efficiency in mind, but now believe it was a mistake).

The US individual market is fuct due to a combination of Republican sabotage, retarded torts driving expensive defensive medicine,and severe disconnects between health promotion/preventative care incentives to drive healthy lifestyle choices that would reduce costs of care.

Now, I'm NOT for single payer, I like multi-payer, guaranteed public basic care, inclusion of health promotion and personal responsibility for health in chronic conditions and preventative care, tort reform, and option with supplemental insurance that can be purchased or offered by employers. This is something like what Germany has, as I understand it.

Germany has 100% compulsory comprehensive insurance from multiple nonprofit insurance companies, paid by employers and employees. Enrollment is automatic. People who don't work are covered by the same insurance, paid by the towns. The 1% can purchase private insurance. The public insurance only covers approved treatments based on cost effectiveness and necessity. The public insurance cost is not based on age or health and no one can be denied.

[old goat]

Hope your never get IV acetaminophen in the hospital. Its already hundreds of dollars for a single 325mg tylenol pill. According to my wife IV tylenol is like 10x more expensive.

I used to volunteer in the UNC hospital pharmacy and man some.of the drugs Id deliver was so fucking expensive even with not even looking at patient costs. Sign my paper you stupid nurse so Im not responsible for you inevitably losing it.

That cost for the tylenol includes the cost to purchase it, inventory it, have a registered nurse administer it, have a registered nurse do a half hour worth of paperwork to document it, do another half our of documentation on its effectiveness and lack of side effects, and to pay the CEO 5million a year. I'd say it's a bargain.

[mcski]

FYI, I think you meant 5M a qtr.

[carpathian]

I just remember 10 years ago I had a job in BC making $28/hr and brought home X amount of dollars. Then came back to USA and had job making $18/hr and take home was the same. Though in BC I had health covered and in USA it has been a challenge.

Last year I was working for company that offered 'Gold Plan' . Came out to $400/week literally 40% of a 40 hour week take home. 40% ! are you kidding me?! and then the deductible still in there, bullshit...

[snapt]

Hope your never get IV acetaminophen in the hospital. Its already hundreds of dollars for a single 325mg tylenol pill. According to my wife IV tylenol is like 10x more expensive.

I used to volunteer in the UNC hospital pharmacy and man some.of the drugs Id deliver was so fucking expensive even with not even looking at patient costs. Sign my paper you stupid nurse so Im not responsible for you inevitably losing it.

It's $1000 a vial. I watched an ICU nurse hang one the other day for a patient then see in her notes she was allergic to it. It went in the trash, I'm guessing it got tacked onto her bill, but that was the least of her issues.

Yurp frequently has MD's on ambulances or in chase rigs, many times anesthesiologists. Australia, Canada, and lots of Euro medics have 4 years of schooling to get there, more on par with Nursing here. Its slightly absurd that after 18 years of school I'm trusted with paralytics and intubation where as CRNA's go to school for 7 to do the same.

[summit]

That cost for the tylenol includes the cost to purchase it, inventory it, have a registered nurse administer it, have a registered nurse do a half hour worth of paperwork to document it, do another half our of documentation on its effectiveness and lack of side effects, and to pay the CEO 5million a year. I'd say it's a bargain.

you forgot the pharmacist, pharmacy tech, ordering provider, EHR, IT, etc

IV Tylenol costs actually about $45 for the actual drug in a bottle

Maybe it is more effective and reduces opioid use and pain crisis: https://www.todayshospitalist.com/to...s-perspective/

[fastfred]

fuck health insurance fuck hospitals the one near my tried to ass fuck me a couple years ago, I was able to show them whose boss, laughed my ass off
if you think a hospital is trying to screw you all you have to do is point it out to them and tell them to eat shit, it works well
I'm close as hell giving it up, going on welfare, getting all my shit subsidzed and on the gov't tit
pretty f'n easy to do, don't know what is holding me back
my premiums are $9,084.00 this year I get ass fucked every month, so some cum stain can get rich
Then they have all kinds of bullshit where I still have to pay out the ass, what kind of country is this
publicly traded companies looking to get rich off of my poor health and accidents
single payer I can't wait

[Kenny Satch]

So what happens when you have to renew or change jobs and you've been diagnosed with a lifetime or possible fatal illness ?
Do you become uninsured for that condition ?

[iceman]

The law is that you can't be dropped by insurance for getting sick, but changing jobs might be impossible because insurance companies won't cover preexisting conditions.

[jono]

What? I have a pre-existing condition and I've changed insurance twice. It's illegal to deny coverage for pre-existing conditions for anyone who has had insurance. Since HIPAA. Slightly better after ACA, but only for those with lapses.

You can change insurance upon any qualifying life event (new job, lost job, marriage, kid--diagnosis doesn't count, but a lot of life events are voluntary, so...) Or at open enrollment, about a month a year. The biggest problem for portability is going from employer plans to individual, since open enrollment periods and, more importantly, plan years are misaligned so you can wind up changing out of or into a plan halfway through and possibly doubling your out of pocket that year (since you might have to meet a deductible/out of pocket max twice, start over even though you were six months in on the last plan, etc.)

[iceman]

What? I have a pre-existing condition and I've changed insurance twice. It's illegal to deny coverage for pre-existing conditions for anyone who has had insurance. Since HIPAA.

Yeah I was wrong on that https://searchhealthit.techtarget.com/definition/HIPAA

For some reason I thought it had changed but Trump hasn't gotten that done (yet). https://money.cnn.com/2018/03/01/new...ump/index.html

[jono]

It would probably sully the victory if they repealed ACA only to discover that all the people who bought insurance under ACA would still have gained protection against pre-existing condition denial under HIPAA as long as they stayed insured.

[old goat]

I may be wrong but I believe HIPPA prohibits preexisting condition exclusion on group plans, not individual. Also, it doesn't prevent insurance companies from charging huge rates for people with preexisting conditions or unfavorable demographics--which makes insurance virtual unavailable based on cost.

[summit]

I may be wrong but I believe HIPPA prohibits preexisting condition exclusion on group plans, not individual. Also, it doesn't prevent insurance companies from charging huge rates for people with preexisting conditions or unfavorable demographics--which makes insurance virtual unavailable based on cost.

This is accurate

[BS720]

Hope your never get IV acetaminophen in the hospital. Its already hundreds of dollars for a single 325mg tylenol pill. According to my wife IV tylenol is like 10x more expensive.

I used to volunteer in the UNC hospital pharmacy and man some.of the drugs Id deliver was so fucking expensive even with not even looking at patient costs. Sign my paper you stupid nurse so Im not responsible for you inevitably losing it.

What's that make you? A stupid pharmacist or a stupid pharmacist assistant?

[Harry]

Small town Idaho hospital.

Fair Warning: this link is gross:

https://eastidaho.craigslist.org/pol...604737341.html

[Dantheman]

I'm close as hell giving it up, going on welfare, getting all my shit subsidzed and on the gov't tit
pretty f'n easy to do, don't know what is holding me back

It's really no that easy. Paging Danno....

my premiums are $9,084.00 this year I get ass fucked every month, so some cum stain can get rich

Look into what your current gross income is compared to the AGI limits for ACA subsidies. The "subsidy cliff" is huge this year, and likely will be next year. By getting an HSA-qualified plan and maxing out contributions I was able to get my AGI below the threshold and cut my out-of-pocket premium by about 85%, with basically 100% of the difference going into the HSA.

[summit]

Look into what your current gross income is compared to the AGI limits for ACA subsidies. The "subsidy cliff" is huge this year, and likely will be next year. By getting an HSA-qualified plan and maxing out contributions I was able to get my AGI below the threshold and cut my out-of-pocket premium by about 85%, with basically 100% of the difference going into the HSA.

That is smart!

[byates1]

check this shit out:

one of the things i do is look in on mom, she is fine and 76. we are helping a neighbor, who is going through a rough time(44 yr divorce, lazy husband took half her money, only sister dies at the same time, hates her job etc, rough for her)

so my mom forgets that her 15 yr old dog is outside, its 100. they get her inside barely alive, get cold towels on her. betty is trying to get water in her, the dog is barely with it and clamps

her finger has a couple nice scrapes, she heads to the local first stop, they bandage it. thankfully my mom or her did not light the neighborhood up(911 etc)

betty works at st peters in albany ny in the cath lab, heart surgery for smokers etc, a never ending assembly line of them apparently..

she goes the next day to st peters, apparently there is an infection, they give her an iv, and i would assume antibiotics

they admit her, and she has been there for 2 nights, no stitches needed. admitted for 2 nights. they may keep her longer. no stitches.

huh. huh.