>> I don't think this is relevant to this thread. The total health care
>> spending in the US is warped by the extreme costs of high-end care
>> that's simply not available in Canada. I think, for the purposes of
>> this thread, it's important to keep your eye on my claim: that for the
>> same dollars, (average) individual Canadians could (probably) do better
>> in the US.
And John Thornton replied:
> What is available in the US that is "not available in Canada"? What
> percentage of US medical expenses are made up of these "Only
> available in the USA" expenses?
___________________________________
There's more readily available high-tech equipment in the US like scanners for those able to pay for them.That's mainly due to a decade of government cutbacks in Canada, which has been strongly contested by the public and health care professionals, and has forced the federal government to begin putting more money back into the system. So it's almost certainly true that premium private coverage for the wealthy is better in the US than Canada.
But Jordan is saying that Canadians as a whole would be better off under the US system, and the core of his argument is taxation. So it's worth noting in this regard that while Canadians generally pay more income tax - especially at the high end - the gap is usually greatly exaggerated. One US study, for example, compared personal tax rates for New Yorkers and Ontarians, using 1999 tax data. Canadians paid 3.1% more than Americans at 50k and 5.6% more in the top bracket (250k plus) - not a big difference. Moeover, "after adding social security taxes, city taxes and other local taxes in the U.S., etc it appears that the average tax burden is higher in New York State when compared to that in Ontario at the lower income levels, being below $100,000. The real difference is when income levels are higher than $100,000. At these levels a larger portion of income is taxed at the highest marginal tax rate in Canada, thereby increasing the average tax burden on income." (http://www.americanlaw.com/ustxtech.html)
Americans are required to purchase private health insurance if they aren't covered by a plan at their workplace. Canadians aren't. Self-employed and other Canadians who don't have access to a company plan sometimes decide to buy supplementary private insurance to cover costs not covered by their provincial plans, notably for drugs and some chiropractic, counselling, and dental services. Because their basic health costs - physicians and hospitals - are still covered by the public insurer, their private supplementary coverage is much lower. For example, my wife and I could get a private plan to supplement our OHIP (Ontario Health Insurance Program) which would jointly cost us around 5k, which we concluded was prohibitive in relation to our needs. Extra medical expenses like drugs are written off against taxes in any case. Friends in NYC who are self-employed computer programmers told us their health care plan costs about four times that amount. Quebec, incidentally, has a comprehensive drug care plan, another indicator of why it is the most socially progressive part of the country.
The cost of medical insurance is beyond the means of most lower- and middle-income Americans. Lacking such coverage, they are often faced to forego necessary medical treatment which could prevent more serious illness in future, and when catastrophic illness does strike, they are often bankrupted. All Canadians have medical insurance - it could be better, but it is not at all bad simply having your card clicked when you check into a clinic, GP or specialists' office, or hospital - which is why any talk of possible tax advantages resulting from the introduction of a US-style health care system leaves us stone cold.
Marv G