# Totally missing the obvious



## Just a Guy (Mar 27, 2012)

Saw this video about British people trying to guess what Americans pay for health care. It could have been Canadians, not picking on the British. 

https://youtu.be/Kll-yYQwmuM

What people totally miss is, the costs are still the costs. It’s not “free” in Britain or Canada, it’s just paid by the taxes. 

Pharmacare and “free” dental care, two topics getting traction in politics, costs billions, but people think it’s “free”. 

If people knew how much it really costs, maybe we would use it better.


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## canew90 (Jul 13, 2016)

That's part of the problem, the word Free. It assumes there is not cost and too many take advantage by over using the system, or not understanding that every doctor visit, prescription, etc does cost, hereby raising the hidden costs and raising our taxes.


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## Longtimeago (Aug 8, 2018)

Having lived in various countries, I have observed first hand how people see their healthcare systems. Most people really have only one perspective to look at it from. It is only when living in other countries that you can see what really is good or bad about the system in your home country.

Canadians and Brits by and large, really don't know how good they have got it. And yes, as a result Just a Guy, they don't always use it well in some regards. 

In every country I have lived in, people complain about healthcare. That is of course normal human behaviour, just like complaining about all the other drivers on the road but not yourself. But without experience of other systems, how do you know if what you complain about is worth complaining about or whether you should be thankful for what you have?

When I lived in Greece for example, they have a form of government healthcare like most countries but one peculiarity I found was that in their hospitals, there are never nearly enough nurses. Now I know some Canadians will have the same complaint about our hospitals but here's the difference. The NORM in a Greek hospital is for family/friends to come and stay in the hospital to take care of the patient. ie. walk them to the toilet, etc. They also bring them their meals, what the hospital provides is simply not edible by most people. So to a great extent, the family shoulders the responsibility for care.

It is also the norm to give the doctor a 'gift' for treating you or your family member. In most countries including Canada, this would be called a BRIBE, to insure care and attention. https://www.bloomberg.com/news/arti...sis-spurs-war-on-health-fraud-rooted-in-gifts
The practice is an accepted norm in Greek medical care. Makes you (or me anyway) think about just how good we have it in Canada. It doesn't mean I can't complain about something but I also remind myself it ain't all bad either.


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## james4beach (Nov 15, 2012)

I lived in the US for the last few years.

The issue isn't it being "free" or hidden behind layers of taxes or something. The issue with US healthcare costs is

(1) the costs are outlandishly high, vs everywhere in the world AND
(2) the costs are unpredictable, complex, and insurers are very tricky

For example, I worked for a US company which provided us with health insurance. At first glance a Canadian would think the problem is solved - but that's wrong. The first surprise to a Canadian is how much the employer is still paying for the healthcare. It's an enormous cost per employee, to the point where our small company wrestled with the problem.

The other issue is that even when you have healthcare in the US, *it doesn't cover everything*. In fact I knew a couple people in our small office who have had tens of thousands of $ of medical bills that they had to pay out of pocket. One woman had pregnancy complications which weren't fully covered. The other had services in a hospital from people who turns out to NOT be in the network of coverage.

US insurers are full of surprises like that. You _cannot decipher_ what your US medical insurance will cover, and there are still co-pays and things that aren't covered at all.

So focusing on what "free" means is entirely missing the point. What Americans want are predictable and reasonable healthcare costs. Predictable means that you can't walk around with insurance and one day find yourself with a $15,000 bill to pay. And affordable means costs which don't stress out companies.

Quick example, I'm a perfectly healthy person under 40 with no dependants and no health issues. About as cheap as it gets. The actual cost of my insurance to the employer (and if I bought it myself, heavily subsidized) was around $550 per month = almost *$7,000 a year*. That's the lowest it gets in the US, and this wasn't a very good plan.

Add some dependants for family coverage, add some health problems and you're easily looking at 20 K or 30 K a year in health insurance premiums in the US. And that still doesn't cover all services. You can still end up with surprise expenses far in excess of this.

In fact, since I want to run a small business, I left the US because I can't afford those kinds of business costs. I can afford them in Canada, UK, Australia, wherever else.


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## OptsyEagle (Nov 29, 2009)

One of the underlying problems is that morally it is impossible to put a price on life. Therefore, in that world the prices will continue to rise well above normal inflationary levels. It is almost impossible to control them.


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## sags (May 15, 2010)

Everyone wants quality healthcare to be there when they when they need it.

Who would want to be told that lower taxes meant they wouldn't get the care they need ?

Maybe....and this is a novel idea or heresy to some, the money required for a good healthcare system should come from those who have the most of it...do ya think ?


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## OptsyEagle (Nov 29, 2009)

sags said:


> Maybe....and this is a novel idea or heresy to some, the money required for a good healthcare system should come from those who have the most of it...do ya think ?


It already does.


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## Topo (Aug 31, 2019)

In the US a middle class or upper middle class family can easily go bankrupt because of healthcare costs in the case of a severe disease such as cancer. That would be very unlikely in Canada, the UK, or most other developed countries. Maybe in developing countries it could happen to poor people, but since healthcare is relatively cheaper there, it is unlikely to happen to the middle class; the quality of care is lower of course.


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## james4beach (Nov 15, 2012)

Absolutely. Friends and colleagues have asked for my opinion of moving to the US. My advice is: it only makes sense to move to US if you're under 50 and healthy. There is no way you want to be living in the US and unhealthy, or in a high risk category. No way!! Unless of course you have immense wealth, like a net worth over 10M perhaps.

Even if you have a great medical plan in the US, the moment you lose your job, you'll have no insurance or start paying through the teeth for private coverage.

In fact I discussed this with the first doctor I saw in the US. Her husband practices medicine in Canada and she told me: if you ever have a serious medical problem, you should get back to Canada. That's the advice from a US doctor!

Notice she isn't saying that cancer care is superior in the US, we have world class facilities yadda yadda yadda... she knows the real story. It's fine to be in the US when healthy but you're better off in Canada if you actually have medical issues.

What's not often talked about is the additional *stress* on a patient in the US. Every time you go to a clinic or something, you get bills from them. Even with health insurance (like I had) you end up with a mountain of bills. Some of them you have to pay yourself. Now imagine you have cancer or some chronic condition... what happens? Your life revolves around managing these bills. You have mountains of paperwork, bills, etc. And you're paying out money constantly.

The reality of the US medical system is these insurers are pains in the *** to deal with. You will have to constantly review your bills, your insurance statements, fight with the insurer to argue they should cover a certain thing. All of this is time and effort, and time = money.

On top of that you start worrying about losing your job, being laid off, economic downturns, all of which would kill your insurance and ruin your life. I know a guy who's in a high diabetes risk, overweight, and he's afraid to death of losing his job.

And unemployed? Forget about it, you're absolutely screwed.

It's immensely stressful for patients. Combining money worries with health worries, just awful. This is a big reason I decided to get out of the US while I'm still healthy.


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## Rusty O'Toole (Feb 1, 2012)

The problem in the US is that the health care system was hijacked long ago by greedy people who turned it into a very profitable government protected monopoly. They are exempt from most anti trust and anti gouging laws and ignore the rest. They have so much money to spread around to politicians and for propaganda that it looks like there is no way to change the system. This is why Americans pay TEN TIMES as much for the same treatment as other first world countries. If you want more details look up a site called Market Ticker by Karl Denninger , it explains the whole thing better than anyone else I have seen.


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## james4beach (Nov 15, 2012)

That's right Rusty.

I forgot another important point, which is that Americans tend to avoid medical care due to money concerns. You don't have the same effect with a socialized medical system. Placing the costs and bills in plain view changes everything.

Take my US office for example. Yes, we had medical insurance, but what's becoming typical are high deductible health plans where you actually pay up to a couple thousand $ out of pocket, until the real insurance kicks in. So everyone in our office saw "going to the doctor" as an action which cost them real $. We're talking about fully employed, high income earners with health coverage.

The result? People at my office avoid the doctor and they come into work when sick. Who wants to go to the doctor when you're going to end up with a $300 bill, plus all the paperwork I wrote about above? Even if it's true that the employer ultimately pays for it. 

I have a friend who now works independently (as I do in Canada) and he has minimal health coverage. He absolutely avoids doctors. The guy will probably only go in if his body forces him to, otherwise he sees doctor visits as a cost he cannot afford. Again, a high income earner.

Everything I write here is the experience of upper middle class people. Now imagine how much worse it is for poorer people!

These are benefits of the state providing blanket coverage. That's the right way to do it IMO. Start showing people bills for basic doctor visits and people will avoid getting treatment. Poor people will get no treatment.


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## Just a Guy (Mar 27, 2012)

Topo said:


> In the US a middle class or upper middle class family can easily go bankrupt because of healthcare costs in the case of a severe disease such as cancer. That would be very unlikely in Canada, the UK, or most other developed countries. Maybe in developing countries it could happen to poor people, but since healthcare is relatively cheaper there, it is unlikely to happen to the middle class; the quality of care is lower of course.


Do you have any idea what cancer treatments cost? There’s a reason they could go bankrupt. The drugs easily cost over $5000/round (most treatment plans are 2 rounds/month, some drugs are much more expensive) plus the doctors, nurses, facilities, other drugs, supplies, CT scans, etc. If I were end of life, say over 60, I’d probably forgo treatment because of the cost burden I’d leave behind for my kids. Not that I’d want to die, but cancer treatment is very expensive. Instead cancer wards are full of people over 70 years old. Instead of one person being bankrupted, society is being bankrupted.


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## sags (May 15, 2010)

Trouble with that theory JAG, is that when you got too sick you would end up in the hospital and treatment would be forced on you.

Unfortunately, at a time when we should make it as comfortable, pain free and pleasant an exit from this world as possible, we have people force you to die in pain because of THEIR religious beliefs. They believe suicide is a mortal sin, so you will just have to suffer.......sorry.

We need to rethink end of life, when it becomes unbearable to live. 

Why not have places where you can be immersed in warm water, surrounded by idyllic music and aromas, pain free and just fade away with your family saying goodbye ?

It is a lot better concept than watching a loved one die a horrible death in a hospice as I have had to witness.

We should all have a choice to die with dignity, and it would save the healthcare system a huge amount of money for those who would benefit more.


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## Topo (Aug 31, 2019)

Just a Guy said:


> Do you have any idea what cancer treatments cost? There’s a reason they could go bankrupt. The drugs easily cost over $5000/round (most treatment plans are 2 rounds/month, some drugs are much more expensive) plus the doctors, nurses, facilities, other drugs, supplies, CT scans, etc. If I were end of life, say over 60, I’d probably forgo treatment because of the cost burden I’d leave behind for my kids. Not that I’d want to die, but cancer treatment is very expensive. Instead cancer wards are full of people over 70 years old. Instead of one person being bankrupted, society is being bankrupted.


That is the whole point of "insurance." Think about all the premiums paid. Wouldn't you want your insurance to kick in when your life, your livelihood, and the future of your family is on the line? Otherwise why pay $7000.00 each year? To get treatment for the flu or a nail fungus?


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## Just a Guy (Mar 27, 2012)

$7000 is a far cry from several hundred thousand a year. Where do you think that money comes from? The magical money fairy? Even insurance is paid partially by policy holders.

Sometimes there just isn’t enough money to get what you want. A reality something people tend to ignore.


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## Topo (Aug 31, 2019)

Just a Guy said:


> $7000 is a far cry from several hundred thousand a year. Where do you think that money comes from? The magical money fairy? Even insurance is paid partially by policy holders.
> 
> Sometimes there just isn’t enough money to get what you want. A reality something people tend to ignore.


Health insurance should cover all healthcare issues. No insurance company says "we only insure the appendix, but don't deal with the testicle" or something like that.

Health insurance in Canada covers all major illnesses. In the US, the cost is higher and the insurance companies can shirk their responsibility. Healthcare in US costs more than Canada or the UK. Which one is a better system?

By the way, young people could get cancer too. I know a 36 year old who died of breast cancer. She had a 4 year old child.

P.S. The 7k quoted is per year, so over 30 years, it adds up to 210k.

P.S.2 It may be true that some countries do not have the means, but the U.S. certainly does.


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## ian (Jun 18, 2016)

I read an interesting article (I think it was in the Economist) about 18 months ago regarding the cost of healthcare as a percentage of a nation's GDP. 

The gist of the article was that most western nations, including Canada, spent about 12 to 13 percent of GDP on health care. It has been a fairly steady number. US was just under 14. 

The author claimed that healthcare spending at 16/18 percent of GDP will have a severe negative impact on a nations's economy. The issue with US heath care costs is that for the past few years it has been rising at a double digit rate far in excess of the rate of inflation. IF that rate continued, the US would be well on their way to the 16/18 number.


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## Mukhang pera (Feb 26, 2016)

Just a Guy said:


> If people knew how much it really costs, maybe we would use it better.


Ahh, the "faint hope" clause. Maybe we would, but probably not. It has to be brought home in terms of cost.

I have commented on this forum before that, in a past life, I was in a position to see the workers' compensation files of a great many British Columbians. As a rule, those files contained the chart notes of the family and other physicians of those workers, often going back for years. What struck me so many times was the sheer number of medical visits revealed. Mostly for nothing. People would be attending a physician to report a sore throat, a cold, a tummy ache, a back owie from lifting a sack of cement, a tiny bit of rash, etc. 

Unfortunately, the doctors were part of it. They would tell patients to return next week. And why not? That would allow the doctor to submit another charge under their billing number. I think most people offering services of any sort would love to have a billing number. No bad debts to worry about. Assured payment, always. And then there's the double-ending involved in "referrals". Say I know I need to see a dermatologist or ophthalmologist. I cannot just book such an appointment. I must go to a family doctor for a 2-minute visit that costs the medical plan god-knows-what to get a referral. 

If we had to pay, say even $50 per visit, many might think twice. 

Canada's system is, overall, a good one, I believe. But I think we have created this "free" medical myth that has led many to think that seeing a doctor every month, and every time they sneeze, is a birthright and just the way things should be. 

I too have lived in the U.S., for 3 years, when below age 50 and with no history of health issues. Like james4beach, I still paid quite a bit for insurance. Never saw a doctor or made a claim in those years, happy to report. But It's enough to keep me from returning to live in the U.S. Not a place to grow old, sans very deep pockets.

I have also lived "greek style" like LTA. Experienced that concept of actually living with the patient in their room during the hospital stay and providing care, with other family members bringing in food every day. That helped to keep the cost of hospital stay in a large private room to about $180 for 4 days. That covered all costs except medicines. That had to be paid separately and "pay as you go". Strictly enforced. A doctor or nurse would come to me and tell me the patient needs this or that medicine and it will be given as soon as I go downstairs to the cashier and pay for it.


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## lonewolf :) (Sep 13, 2016)

To reduce medical costs practical limits should be put on the amount that doctors can be sued.


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## Mukhang pera (Feb 26, 2016)

lonewolf :) said:


> To reduce medical costs practical limits should be put on the amount that doctors can be sued.


Are judgment costs in Canada a large part of overall costs? I cannot say for sure, but from what I have seen from reading all of the judgments from the BC courts for a long time, the number of medical malpractice cases I see is small and the number that succeed even smaller. The CMPA certainly is not quick to settle and usually, to have a chance at any significant payout, means pressing on to trial, where the CMPA always funds a vigorous defence.


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## Just a Guy (Mar 27, 2012)

Topi, no insurance company, or even the Canadian system covers every condition. There are exclusions all the time. They may not ban an organ, but they will say we don’t cover this treatment, that drug or this ailment all the time. 

Yes, young people get cancer, I was pointing out people who are 70+, who are likely to die at any moment regardless of treatment. The two are not the same. 

As for your math, sure that’s 210k, less than two years of chemo treatment in terms of cost. Most chemo is longer to begin with and that hopes they never get any other sickness over those 30 years.


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## Longtimeago (Aug 8, 2018)

It would be nice to live in a perfect world where everything was 100%. Unfortunately, this is not that world. As with many things, I think what we need to ask and answer for ourselves is a 'simple' question. Is what we have to be thankful for, greater than what we do not have to be thankful for. A positive answer to that is I think as much as we can expect to get in this world.

A 100 years ago, if you had cancer, etc. you died. Simple, no issues at all. Nowadays, if you have cancer you may live thanks to improvements in treatment and yes, insurance to pay for it. If you live in Canada, you may live without going broke if you have cancer. We even pay cancer patients mileage to drive to and from their chemo appointments! Be thankful for what we have, not unthankful for what we don't have.


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## Just a Guy (Mar 27, 2012)

I’m sure the cancer patients are thankful. I’m not sure the tax payer for the next three generations will be as thankful.

It’s easy to take, not as easy to keep giving. Oh, and yes there is cancer in my family, so it’s not like I’m picking on cancer patients. I just believe in living what I preach.


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## Topo (Aug 31, 2019)

Just a Guy said:


> Topi, no insurance company, or even the Canadian system covers every condition. There are exclusions all the time. They may not ban an organ, but they will say we don’t cover this treatment, that drug or this ailment all the time.
> 
> Yes, young people get cancer, I was pointing out people who are 70+, who are likely to die at any moment regardless of treatment. The two are not the same.
> 
> As for your math, sure that’s 210k, less than two years of chemo treatment in terms of cost. Most chemo is longer to begin with and that hopes they never get any other sickness over those 30 years.


There are exclusions, but the question is whether they are reasonable or not. To deny treatment to someone who paid premiums for years due to a job loss or other superficial reason is not, in my opinion, the right thing to do. In systems like those of Canada and the UK, such decisions are not as much driven by profit as they are in the US system.


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## Just a Guy (Mar 27, 2012)

Not exactly sure what your point is...mine, and the thread’s is that people miss the fact that health care still costs society a ton of money and people have no idea what it really costs and are shocked by it. It doesn’t matter how you wrap up the payment plan (government, insurance, out of pocket) the truth is, we’re all still paying for it and it’s expensive. You putting in $7000 is still only a drop in the bucket. If you get cancer, someone else has to make up the difference. If cancer is really hitting 50% of the population there may come a point where we can’t afford to treat everyone because there is no more money.


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## Topo (Aug 31, 2019)

It is obvious that there is a cost to deliver health care. Nobody argues against that. I am arguing that systems likes ours deliver a better value per unit of cost. The YouTube video you posted was comparing the US vs UK system. People in the UK were surprised that the Americans are getting such a raw deal. Studies have shown the US gets overall worse results at higher costs. 

You have to look at health care through the prism of insurance. When you buy insurance for your house, you are paying to protect your own house, not your neighbours. If, god forbid, your neighbours house burns down and they get paid the insurance, it would not make sense for you to lament that you didn't get any money back. Maybe you should count your blessings.

The US population is getting cotton candy at the price of a steak. There is no point in saying "both cost money anyway."


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## Just a Guy (Mar 27, 2012)

I think you don’t understand the true price of healthcare in Canada. Let’s go back to chemo treatments. The cost of the drugs is the same in Canada and the USA. It’s not cheaper in Canada just because we have a public system and the Americans don’t. Americans aren’t paying $5000 and Canadian taxpayers are paying $100. The Americans may pay more for healthcare to some degree but they also sue for millions if something goes minutely wrong adding to the costs which Canadian doctors don’t have to face. We still pay out lawsuits, a lot of which comes from government insurance (taxpayers). 

Private insurance puts limits on coverage to ensure the viability of the system. The “free” healthcare provided by government doesn’t tend to do that as they just have to raise taxes if they spend too much. People like you assume everything should be covered, you don’t care about costs because you don’t see them directly and someone else is paying. That’s a bad attitude in my opinion one shared by a lot of people. It’s how we get into a financial nightmare.


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## Eclectic12 (Oct 20, 2010)

Just a Guy said:


> I think you don’t understand the true price of healthcare in Canada. Let’s go back to chemo treatments. The cost of the drugs is the same in Canada and the USA ...


Do you have some references to confirm this?

A US visitor to Canada reported that for one vial of insulin that cost $320 USD at home was purchased at a Canadian pharmacy for $30 CAD.

The US Senate Finance Committee said one vial of Eli Lilly's Humalog surged from $35 in 2001 to $234 in 2015. In two years, Novo Nordisk's Novolog jumped from $289 to $540.

US drug company CEOs say their competitors jack up prices whenever they feel like it.
https://www.cbsnews.com/news/4-pharma-ceos-admit-they-jack-up-drug-prices-for-the-hell-of-it/


Then there's the at the time, sixty two year old drug (research costs taken care of long ago) Damarim. It cost roughly $1 to make a pill and sold for $13.50 a pill. A new company bought the rights and presto, overnight the new fee was set at $750 a pill, in 2015. The stated reason for the increase was that the buying company "needed to make money". When the CEO was asked about the massive price increase, he commented he had made a mistake by *only* raising the price to $750 instead of more. 





Just a Guy said:


> ... Americans aren’t paying $5000 and Canadian taxpayers are paying $100 ...


Maybe not those specific numbers ... but the American Society of Clinical Oncology says a component of cheaper cancer treatment with similar outcomes *is* cheaper chemotherapy. 



> Common chemotherapy for advanced colorectal cancer costs twice as much in Washington state as it does a short walk across the Canadian border into British Columbia, researchers report.
> 
> A month's worth of chemotherapy cost $12,345 on the U.S. side of the border versus $6,195 just over the line into Canada, according to findings scheduled to be presented Sunday at the annual meeting of the American Society of Clinical Oncology (ASCO), in Chicago ...
> 
> ...


https://www.webmd.com/cancer/news/20180601/cancer-care-twice-as-costly-in-us-versus-canada#2


Cheers


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## Just a Guy (Mar 27, 2012)

There’s a huge debate in some provinces about bio-similar replacements. Going over like a lead balloon. I’m not against them, but others are. They have something they think works, so are unwilling to try something cheaper. Your report is comparing apples to oranges. Bio-similar is not the same treatment. If they get the same treatment, the drug costs are the same. Not all cancer treatments have bio-similar drugs available. 

As for the cost of drugs, pick a cancer treatment, google the price. It’s there for anyone to see. My daughter did it as part of a school report.


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## Topo (Aug 31, 2019)

Just a Guy said:


> Private insurance puts limits on coverage to ensure the viability of the system.


Private insurance puts limits on coverage to ensure viability of the company.


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## Just a Guy (Mar 27, 2012)

Without the company, there is no insurance.


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## Eclectic12 (Oct 20, 2010)

Just a Guy said:


> ... Your report is comparing apples to oranges. Bio-similar is not the same treatment.


Maybe ... I didn't get the impression they were talking about bio-similar treatments but the same one. I'd have to find the details of the study to be able to confirm it though.




Just a Guy said:


> ... If they get the same treatment, the drug costs are the same. Not all cancer treatments have bio-similar drugs available.


There's something that makes cancer treatments different than prescription drugs?

US sources identify that something like 80% of the prescription drugs sold in the US are manufactured overseas then imported to the US. For the same drug/brand/dose, there can be a wide discrepancy such as $34 in the US to $5 or $530 to $27.

If the US and Canada are locked into the same prices, one wonders how the Florida storefronts that help Floridians order drugs from Canada have stayed in business for fifteen plus years.
Or why multiple states like Vermont are pushing to be allowed to supply their employees/citizens drugs by importing from Canada.


Given that the FDA is not allowed to consider cost when approving a drug and Medicare is required by law to pay while Medicare is required to pay for almost all FDA approved drugs while being barred from negotiating prices or making decisions about which drugs it covers - it seems incredible restraint by the for-profit pharma companies to match what Canada negotiates.

Australia has rejected covering many of the new cancer treatments as they couldn't find an additional benefit for the the increased cost. Sloan-Kettering Memorial Hospital said essentially the same thing in their op-ed outlining why they would not be prescribing Zaltrap, which treats colorectal cancer. The existing drug at half the price had the same results. 



> In most industries something that offers no advantage of its competitors and yet sells for twice the price would never even get on the market


https://www.nytimes.com/2012/10/15/...BFDE4DE584FDEF560C&gwt=pay&assetType=REGIWALL


Cheers


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## Just a Guy (Mar 27, 2012)

Chemo therapy isn’t exactly an over the counter drug. They are actually made on the day or maybe two before, they have a very short shelf life. Also highly toxic, so much so that doctors in emergency wards are reluctant to deal with patients who have a pump.


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## l1quidfinance (Mar 17, 2017)

Just a Guy said:


> Saw this video about British people trying to guess what Americans pay for health care. It could have been Canadians, not picking on the British.
> 
> https://youtu.be/Kll-yYQwmuM
> 
> ...



Yes it's paid for in taxes and being from Britian worth every last penny I ever contributed towards it through my National Insurance contribution that make up current Approx 12% tax and covers NHS, unemployemnt, State pension etc. There is no cap to this as with the Canadian EI and CPP contributions so the higher earners do keep on giving to the system. 


It is free in the sense that no matter how rich or poor you will always be treated and never have to give a second thought to wether or not you can afford it. I do fully agree and people knowing the cost and using it better though. I feel people should be charged out of pocket for some things. For example stupidty on a drunken night out, calling an abulance for a non emergency. 

Well.... You might have to pay £9.00 for a prescription. _The standard prescription cost in England is currently £9.00 per item. That means that if you take in a prescription that lists several types of medication, you will pay £9.00 for each one. In the case of support stockings, each individual stocking is classed as a separate item._

I like the fact that with NHS profit isn't a part of it. 

To look more closely we would need to study the full levels of taxation between the various countries for whats the better deal. 

The NHS also gets a better deal on drug costs as well appraently based on this. 

https://www.businessinsider.com/lea...us-drug-firms-trump-target-nhs-brexit-2019-12


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## Butter (Nov 26, 2017)

l1quidfinance said:


> I do fully agree and people knowing the cost and using it better though. I feel people should be charged out of pocket for some things. For example stupidty on a drunken night out, calling an abulance for a non emergency.


I double doggy dare you to call an ambulance to your house... let us all know how much the bill you get is. My guess is $400 sadly my federal government job only covers $250 of this through my extended healthcare (which I pay a small amount for each cheque).


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## l1quidfinance (Mar 17, 2017)

Butter said:


> I double doggy dare you to call an ambulance to your house... let us all know how much the bill you get is. My guess is $400 sadly my federal government job only covers $250 of this through my extended healthcare (which I pay a small amount for each cheque).


I'm referring to it being free to do so in the UK. In that as a Brit I believe the NHS should charge in some situations.


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## Just a Guy (Mar 27, 2012)

I’m sure every user find value in the “free” health care. The question is, can we really afford it? Our deficit spending would indicate we can’t. You seem raptors iss that point. You can pretend everything is fine because you don’t see a bill, but it isn’t.


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## sags (May 15, 2010)

I have paid a $40 ambulance fee several times. The bill came from the hospital weeks later.


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## Joe Black (Aug 3, 2015)

Just a Guy said:


> I’m sure every user find value in the “free” health care. The question is, can we really afford it? Our deficit spending would indicate we can’t. You seem raptors iss that point. You can pretend everything is fine because you don’t see a bill, but it isn’t.


You're not saying we have deficits just because of health care, are you? We've had roughly equivalent levels of healthcare in deficit-free years. And personally I don't think of it as free, I know I'm paying for it in taxes (it's a major reason why I don't gripe about paying them) - especially when I'm doing the "Ontario Health Premium" section for Line 72 of the provincial tax section.

Recently I saw a news segment about one of the newest generation of US aircraft carriers nearing completion, crew of something like 4600 and carrying 95 aircraft. I'm fine if my tax dollars are going to making people feel better, including the terminally ill who will not be cured but just made more comfortable, instead of war machines to fight who-knows-what enemy.


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## Just a Guy (Mar 27, 2012)

It’s 40% of the budget, our largest expenditure. I personally don’t care what we spend money on as long as it’s within budget. If we’re not within budget, something has to be cut, I’m not willing to pay more, we waste enough as it is. Easiest place to save money is where we spend the most. If you can cut other places, great. Don’t promise pharmacare and dental care though.


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## Money172375 (Jun 29, 2018)

Just a Guy said:


> It’s 40% of the budget, our largest expenditure. I personally don’t care what we spend money on as long as it’s within budget. If we’re not within budget, something has to be cut, I’m not willing to pay more, we waste enough as it is. Easiest place to save money is where we spend the most. If you can cut other places, great. Don’t promise pharmacare and dental care though.


I was debating getting a couple of cavities filled as I was transitioning jobs. My dentist says tooth pain is one of the top 5 reasons for a hospital ER visit. Complex issues but I would suspect that one argument for basic dental care is that it would be cheaper in the long run to perform preventative maintenance vs reactive.


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## Just a Guy (Mar 27, 2012)

So, prioritize your spending. Bet you own a big screen tv, a cell phone, computer, internet, more than a basic car...but no money for a dentist right? I should pick up the tab instead.

Btw, not picking on you specifically, many people fall into this boat.


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## Longtimeago (Aug 8, 2018)

Money172375 said:


> I was debating getting a couple of cavities filled as I was transitioning jobs. My dentist says tooth pain is one of the top 5 reasons for a hospital ER visit. Complex issues but I would suspect that one argument for basic dental care is that it would be cheaper in the long run to perform preventative maintenance vs reactive.


Debating? Debating??? Are you joking? Only an idiot would debate whether or not to have cavities dealt with. There is no 'complex issue' when it comes to medical or dental needs being met. There is no need for 'one argument' or any argument at all. 

I can't believe anyone over age 10 with half a brain would even write something this ridiculous.


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## Money172375 (Jun 29, 2018)

Forgive the lack of clarity. I was debating the timing of getting the cavities filled...waiting for benefits to kick in on the new job. Cavities were discovered during my final days with a previous employer. 

The complex issue I was referring to was the issue of universal dental care. “Just a guy” seemed to imply that we shouldn’t be discussing universal pharma or dental care.


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## Money172375 (Jun 29, 2018)

Just a Guy said:


> So, prioritize your spending. Bet you own a big screen tv, a cell phone, computer, internet, more than a basic car...but no money for a dentist right? I should pick up the tab instead.
> 
> Btw, not picking on you specifically, many people fall into this boat.


See my other response. I was debating the timing of getting the cavity filled, not the actual act. Was in between jobs and waiting for benefits. 

On the other hand..the choice is a real one for many Canadians. The reality is that many of the things you listed are a “need” these days. Call phones, computers, internet, a car. Libraries are an option but a distance away and not open 7 days a week. Having moved to a smaller rural community....all of these things are a necessity. As you said, there is a small population that do fall into that boat of having to make tough decisions on where their income goes....and delaying medical costs is one of them. For the vast majority, yes, it is a matter of education, and personal choice to spend on luxuries, but I do believe some form of pharma and dental care is necessary...probably based on income and net worth test. I have what is likely a lower income but an excellent net worth and I’m surprised at the govt handouts I get.


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## Money172375 (Jun 29, 2018)

Longtimeago said:


> Debating? Debating??? Are you joking? Only an idiot would debate whether or not to have cavities dealt with. There is no 'complex issue' when it comes to medical or dental needs being met. There is no need for 'one argument' or any argument at all.
> 
> 
> I agree....not a complex issue when it comes to medical and dental needs being met, but I’m sure others will argue that a national dental plan is too costly. Your statement makes it clear.....dental and medical needs should be met for all Canadians.
> ...


I agree....not a complex issue when it comes to medical and dental needs being met, but I’m sure others will argue that a national dental plan is too costly. Your statement makes it clear.....dental and medical needs should be met for all Canadians.


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## like_to_retire (Oct 9, 2016)

Money172375 said:


> The complex issue I was referring to was the issue of universal dental care. “Just a guy” seemed to imply that we shouldn’t be discussing universal pharma or dental care.


I think universal dental care is the last thing we need. Dental care is generally not expensive if you take care of your teeth. Regular checkups, proper brushing and flossing go a long way. As stated already, I'm not interested in paying for people who don't take care of their teeth, yet likely have a nice phone, a big screen smart TV, and every other gadget available. The only thing they probably don't have is dental floss. 

ltr


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## Just a Guy (Mar 27, 2012)

We can’t afford the benefits we already get, but people want more... just plain stupid in my opinion. Same as waiting for benefits, just pay for the treatment you need and save everyone dodo some money for a change


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## lonewolf :) (Sep 13, 2016)

Money172375 said:


> On the other hand..the choice is a real one for many Canadians. The reality is that many of the things you listed are a “need” these days. Call phones, computers, internet, a car. Libraries are an option but a distance away and not open 7 days a week. Having moved to a smaller rural community....all of these things are a necessity.


 Is everyone that does not have a cell phone, computer, internet or a car living in a rural area dead ?


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