I want to see the word "affordable" defined in the healthcare debate

[Phoebe Loosinhouse]

Here's my own definition:

No one should pay more than 5% of their gross income EVER -

INCLUDING premiums, co-pays, drug costs, etc. for ANY health insurance coverage OR out of pocket costs.

REMEMBER most of the bankruptcies are for people with insurance who do not have their personal obligations CAPPED.

The thing that needs to be capped is NOT coverage, but personal guarantees of healthcare debt*.


*************************************************************************************************************************************No, I am not including optional stuff like cosmetic surgery, etc. etc. etc.

[subterranean]

1. I don't think 5% is realistic.

Even in countries where health care costs are half what they are here, many people pay more than that, directly or indirectly.

But you're right that "affordable" means different things to different people. And I do agree that there should be a cap on annual or monthly out-of-pocket expenses.

[Phoebe Loosinhouse]

2. Well, I always remember a Canadian posting that they pay about $750

I don't remember if it was for a family or an individual, but it hardly mattered as it was SO MUCH LESS than what we pay.

Of course, there could be higher tax rates, etc. not icluded in direct out of pocket costs, but I think the point to remember is:

EUROPEANS DO NOT GO BANKRUPT DUE TO HEALTHCARE COSTS!!!

[Oregone]

3. In Canada, I pay 1.8% of my income in premiums for a family of 4

Thats just for basic medical. I could have drug insurance for under $50 dollars a month but we are relatively healthy. So that aside, Im guarenteed to never spend more than 4% of my income on drugs out of pocket.

Aside from the 1.8% in premiums, most of the costs are subsidized with taxes. My effective tax rate seems to be about the same as when I lived in the states, but there is a 15% HST (harmonized sales tax) on purchases.

[Phoebe Loosinhouse]

4. Thank you for being personal and specific.

How many Americans can only HOPE (and pray) and yet still pay, but NOT get the benefits of a system like yours?

WE PAY MORE, AND GET LESS!!!!!!

Yeah, we're number one - you doofus, ignoramus Hannity/Limbaugh/Teabagger Americans!

[midnight]

7. That is what should be fixed, pay less and get more.....

Not an insuance for the insurance co of being given customers via forced cooperation. and a fine if they don't. This sounds crazy.

[stray cat]

9. 15% sales tax is ok then? It would be for me

[etherealtruth]

13. An increase in income tax would be acceptable to me

A 15% sales tax disproportionately effects low income earners. Institute a 2-5% tax on all earnings (with no caps) and I bet the same thing could be achieved.

[Oregone]

14. But being that it is applied to health spending, it has a net progressive effect

Yes, it would be great if Canada raised it all progressively through income taxes and waived all premiums (some provinces do), but thats not the case (its not perfect). Regardless, it is WAY more progressive than the situation in the US. That is among the reasons that people born in the lower quintiles in Canada have a much greater chance of upward mobility than those in the US.

BTW, a study I read (can't find it) showed that the plurality of health spending in Canada was on the lowest quintile, and 40% of the funding came from the upper quintile. So, yes, it definitely is a progressive system, even if some of the funding is partially regressive.

[kenny blankenship]

5. I want to see figures for how much each "reform plan" will cost Insurance co.s

How can we agree on a design to fix the problem before there is any analysis of the cause of the problem?

The thing that sets our system apart from all the ones we want to be like is the role of a profit taking middle man called the insurance company. You will not succeed in fixing the system without "hurting" the interests of this middle man. His profit is pure parasitism. He does not perform surgeries, he does not invent medicine, he does not change bandages, or take temperatures, or administer physical therapy. People who empty bedpans are essential to the health care system; the insurance company is NOT.
The insurance company is 30% of our system that is pure waste fraud and abuse.

Unless your reform plan takes on the insurance company and reduces the profits they siphon out of the system it is no reform plan at all. You cannot "cover everyone" and leave the profit cancer spreading through the system. What we have is already breaking down. Trying to claim universal coverage by forcing some people to buy what they can't afford --or can't afford to use--and forcing others to subsidize criminally expensive for-profit "coverage" for others is a quick trip on the short bus to an epic failure.

[twitomy]

12. Bingo!

I have yet to find anything of value the insurance companies add to health care. During Obama's speech he said insurerers offer a "service" Im thinking, and WTF service is that?

[Juche]

6. Our system will collapse

Health costs will increase at a far higher rate than GDP growth (probably 6-9% vs 3% for GDP).

Plus most of the economic growth will likely go to the wealthy (it has the last 30 years).

So the vast majority of americans have to make due with 1/3 of the economic pie.

The system will collapse within 10 years. By then premiums will have doubled again to about $25,000 for a family of 4. Wages for a family of 4 will probably be 70-80k on average then (vs 50-60k right now).

I really don't know what we'll do. We need massive, fundamental reform. And we can barely get minor reform.

[Deja Q]

10. If it collapses, even those in congress will suffer. EVERYONE suffers.

Won't help the countries where we're giving money (and jobs) to as well.

EVERYONE suffers.

[Juche]

11. Our system is unsustainable though

Medical costs can't keep doubling every 8-10 years, and keep growing 3x faster than wages.

We will probably end up a system where basic health coverage is available to everyone that involves 'older' treatments (pre-2005) and people who want the more advanced stuff pay extra. That is my guess. Its going to be impossible to afford to give everyone cutting edge treatment soon.

[stray cat]

8. Why 5% - how does that relate to the expense to care for people.

No money for services means no care- health care has to be financed by someone - actually by all of us.