USA. Health and Overwork

[Synobun]

Life and healthcare in America are good if you're well-off. If not, you're going to have a pretty rough time.

Sounds like Canada is much better for most people but not as good if you're making quite a lot.

As Warpus said, we still have private coverage. The rich can also get healthcare across the border or overseas very easily.

For example, getting biopsies done for rare conditions is incredibly difficult in Canada. We only have two test centres in the entire country, and samples have to be frozen to be sent for testing. Because capacity and capability is so limited, there are extremely strict requirements for getting approval for the biopsy.

In those cases, you can head on down to a place like Seattle and just pay 50k out of pocket for the biopsy and test. Done.

But good luck dishing out 50k if you're poor or middle class.

 

[MaryKB]

We have serious racism issues in the US that definitely need to be addressed. If you look into numbers further, you'll find there's a huge disparity between health for white and black people.

Our hospitals are among the best in the world. The problem is that we don't treat everyone the same, which is a horrible crime.

Well of course, most countries are racist, but the US has a significantly larger African-descended population and our prejudicial attitudes really show an effect through data.

 

[Hrothbern]

No, it really isn't.
Here is one health outcome statistic that might make an impression on you:
View attachment 569484
And here is per capita health spending:


There is no way to spin these numbers as a good thing. Just because your personal healthcare is good, does not mean healthcare is good in the US as a whole.

And let me just note that the aggregate maternal mortality rate in the US disguises some shocking levels of inequality. As just one example:


Note that maternal mortality is trending upward; not exactly consistent with the claim that the US has great healthcare.

Time for Trump to stop funding the OECD and forbid data transfer to the OECD.

 

[El_Machinae]

The $6,600 you cite seems to be what Canada spends on healthcare per capita. I am not so sure that's comparable to what you pay out of pocket. But I'd love to see a citation. Even if that's what the average Canadian pays for healthcare, this would imply that the rich (who can afford to pay out of pocket for specialists or what have you) drive this average up for the rest of us peasants.

Our system is progressive, but the average Canadian family mostly spends the per capita average on healthcare. Google this for a First-Order economic analysis (which is good enough for the discussion we're having) The Price of Public Health Care Insurance 2019 - Fraser Institute

Mary is cheating a bit, because she's not including the tax portion of the American healthcare system. The Federal government spends over $1 trillion on healthcare which is about $9k per worker. Now, with the American system it's easier to say "oh, I'm paying that for other people my insurance is paying for mine", but the outcome is the same. If I don't consume $6600 of healthcare per year, I'm paying 'for other people' too. At the very least, someone should include their Medicare (plus employer topup) when talking about how much their insurance costs.

This doesn't say anything about how she thinks things are better for her down there. If that true for her, it's true for her and no razzle-dazzle statistics discussion changes that.

 

[warpus]

Just so you know Fraser Institute is a right-leaning group that has a significant enough anti-left-leaning bias. Their studies usually find issues with progressive initiatives and vice versa with conservative ones. i.e. they have an agenda

But does that mean that I spend $6,600 on healthcare a year? That just seems way too high at first glance. I would have to check my pay stubs and such and see where all the deductions go.

 

[El_Machinae]

Just so you know Fraser Institute is a right-leaning group that has a significant enough anti-left-leaning bias. Their studies usually find issues with progressive initiatives and vice versa with conservative ones. i.e. they have an agenda

I'm aware of their bias, but it won't matter so much for such a simple analysis for the discussion we're having. At the average income, we pay the average for the total healthcare costs. At lower income, you pay less of the total. At higher, you pay more. It's a progressive system.

 

[warpus]

I wouldn't trust their conclusions at all, due to their bias. It's easy to cherrypick data to lead to whatever conclusion you want.

I wonder if that $6,600 seems high due to the fact that dental is not covered under public healthcare here. So if somebody doesn't get dental coverage via their work, and they need a root canal, it can get expensive. Together with what you're saying - "the rich pay more", it could explain why the amount seems so high to me.

 

[El_Machinae]

I wouldn't trust their conclusions at all, due to their bias. It's easy to cherrypick data to lead to whatever conclusion you want.

I wonder if that $6,600 seems high due to the fact that dental is not covered under public healthcare here. So if somebody doesn't get dental coverage via their work, and they need a root canal, it can get expensive. Together with what you're saying - "the rich pay more", it could explain why the amount seems so high to me.

This is just being overly skeptical, they are a respected think tank with a known bias. If you were looking for policy explanations or deeper analysis, then yeah, they have a bias. This is just first order, back-of-the-envelope stuff.

I don't know why $6,600 seems high to you. Canada spends about 11% of its GDP on Healthcare. Our middle income household makes about $60,000.

 

[Estebonrober]

I posted a brookings institute aggregation of information and review. It’s enlightening. We are way over paying. Especially compared to other developed nations.

 

[warpus]

This is just being overly skeptical, they are a respected think tank with a known bias. If you were looking for policy explanations or deeper analysis, then yeah, they have a bias. This is just first order, back-of-the-envelope stuff.

I don't know why $6,600 seems high to you. Canada spends about 11% of its GDP on Healthcare. Our middle income household makes about $60,000.

I completely disagree that the Frasier Institute is "respected". Unless you mean respected by right-leaning politicians. Everybody else who knows who they are ignores them. All they ever do is pump out studies that can be used by right-leaning politicians to push forward some agenda or other.

$6,600 seems high to me because I do not think I spend nearly this much on healthcare myself, all sources considered. I should be somewhere near the median in terms of income, so I'd assume that my healthcare contribution should be near the median as well, although that could be a faulty line of thinking.

 

[MaryKB]

I completely disagree that the Frasier Institute is "respected". Unless you mean respected by right-leaning politicians. Everybody else who knows who they are ignores them. All they ever do is pump out studies that can be used by right-leaning politicians to push forward some agenda or other.

$6,600 seems high to me because I do not think I spend nearly this much on healthcare myself, all sources considered. I should be somewhere near the median in terms of income, so I'd assume that my healthcare contribution should be near the median as well, although that could be a faulty line of thinking.

According to mediabiasfactcheck, the Fraser Institute is reliable for data but has a bias towards conclusions. So like what @El_Machinae is saying, you can probably safely take their research numbers, but don't read into what they want you to believe from it.

 

[El_Machinae]

Most healthcare in Canada is paid for by taxes. So it's going to be the taxpayer that funds the brunt of it. As I said, our system is pretty progressive overall, so there is going to be an income level that happens to match the per capita cost. And that's just the way math works when some people are paying less than the per capita cost and some people are paying more.

Since you're an expert on bias, I guess we're done that conversation, because you should be able to find your own reputable sources. It's literally back-of-the-envelope calculation, where you match your total tax burden to the percentage of tax that is spent on healthcare

 

[warpus]

I don't doubt that their numbers are accurate, but I wonder which numbers they are excluding. Like I said, it's easy to cherrypick data to pull out what you want.

Either way, let me just move on and say that I wish that dental was included in our universal healthcare. Our dentists of course lobby against such things. I am lucky enough to get decent dental coverage via work, but I still have to pay 20%. I have friends who work for smaller companies are are not so lucky. It's the one thing our healthcare does not address and is lacking in.

On the other side of things, I am very happy about the cost of drugs for instance. When I pick up my high blood pressure medication I pay like $2.17 for a 3 month supply or something like that. The actual cost? More like $40, but most of it is covered. If we had middlemen in the picture like in the U.S., I bet these prices would be a lot higher still.

It's also great to just be able to walk into an emergency room, get triaged, seen by doctors, blood samples taken, chest attached to a machine that goes "ping", and 5 hours later you are given a diagnosis. I have an irregular heartbeat and significant blood pressure issues. This was back in 2017, basically 48 hours before my flight to Nepal. I ended up getting new medications prescribed, I got expert advice, and I could breathe a bit easier knowing that there is nothing significantly wrong with me. The doctor assigned to me had done high altitude hiking in Peru, and actually knew the villages along the way on the Everest Basecamp Trek. He quizzed me! Asked me what to do in certain situations, asked about the itinerary and the plan, and in the end made me feel a lot better about the whole thing. He did not quite give me the go-ahead, but said I would "probably" be fine if I followed his instructions and properly acclimatized and so on..

I left that hospital not having to pay anything. Then I ran back to work, after having missed most of the day being stuck at a walk in clinic and then at the hospital. Paid absolutely nothing at any point, aside from the new high blood pressure medication I suppose, which was very cheap. Work could not fire me for missing the whole day either. I did not have to stress or worry about anything aside from my actual medical condition. Everything else was taken care of. And that's the beauty of not only a universal healthcare system but also having federal and provincial employee protections in place. I can't imagine working in a place where I can be fired at any time for almost any reason and where I have to consider not going to the hospital because it might cost me.

 

[Estebonrober]

Most healthcare in Canada is paid for by taxes. So it's going to be the taxpayer that funds the brunt of it. As I said, our system is pretty progressive overall, so there is going to be an income level that happens to match the per capita cost. And that's just the way math works when some people are paying less than the per capita cost and some people are paying more.

Since you're an expert on bias, I guess we're done that conversation, because you should be able to find your own reputable sources. It's literally back-of-the-envelope calculation, where you match your total tax burden to the percentage of tax that is spent on healthcare

not doesn’t matter that much since no matter whose making conclusions they all conclude we spend waaaay too much.

 

[Zardnaar]

I think America spends almost triple what we do per person and gets worse results.

It's main advantage is some obscure drugs and procedures are available.

You can still get health insurance. You're effectively paying to skip to the front of the line. Starts at $7 a week and depends on what plan.

If you're rich you can still use overseas facilities.

When mum needed cancer treatment she was in the following week. Didn't work but can't complain about the effort.

 

[Socrates99]

Our system is progressive, but the average Canadian family mostly spends the per capita average on healthcare. Google this for a First-Order economic analysis (which is good enough for the discussion we're having) The Price of Public Health Care Insurance 2019 - Fraser Institute

Mary is cheating a bit, because she's not including the tax portion of the American healthcare system. The Federal government spends over $1 trillion on healthcare which is about $9k per worker. Now, with the American system it's easier to say "oh, I'm paying that for other people my insurance is paying for mine", but the outcome is the same. If I don't consume $6600 of healthcare per year, I'm paying 'for other people' too. At the very least, someone should include their Medicare (plus employer topup) when talking about how much their insurance costs.

This doesn't say anything about how she thinks things are better for her down there. If that true for her, it's true for her and no razzle-dazzle statistics discussion changes that.

I was reading through the tread shocked no one had mentioned the taxes we pay on top of premiums, copays and deductibles. Thank you. The best anecdotal story came out about even with Canada without counting taxes, add in the employer's contribution that in another country would be part of your salary and we're getting hosed, period.

I wouldn't trust their conclusions at all, due to their bias. It's easy to cherrypick data to lead to whatever conclusion you want.

I wonder if that $6,600 seems high due to the fact that dental is not covered under public healthcare here. So if somebody doesn't get dental coverage via their work, and they need a root canal, it can get expensive. Together with what you're saying - "the rich pay more", it could explain why the amount seems so high to me.

I doubt many Americans tallying up their expenses here are counting dental either. Its separate here as well.

 

[hobbsyoyo]

I am now salaried, so I have the pleasure of working as many hours as I want, and have on occasion pulled my share of long days (for example, today started at 6 a.m. and I just logged off at 5:30). However, being salaried also has perks in that I don't technically have "hours" and if I needed to only work 5 hours tomorrow, I could, so long as I was meeting my objectives and job duties. So it's give and take. Having done both, I definitely prefer the flexibility that a salaried position offers.

In my experience, the expectation for salaried positions rarely allow you to work less than 40 hours a week, regardless of your ability to hit productivity goals. On the other hand, there is almost always an expectation that you will work more than 40 hours a week when required even if that is not very frequent.

I also agree with @Truthy's take that @warpus's Valley friends are an anomaly. 80 hour weeks is not anywhere close to normal in technology - I personally worked at one of the most notorious sweatshop environments in technology and even they did not require or expect 80 hours. There it was closer to 50-60 hour work weeks and even then, those that 'worked' 60 hour weeks typically wasted a ton of that time with 2 hour lunches, playing with nerf guns in the office and other stupid crap. That doesn't really make it better as the company overall did have an expectation that everyone would put in lots of time at the office even if they weren't productive, but even at its worst it was still not an 80 hour week.

 

[JPetroski]

In my experience, the expectation for salaried positions rarely allow you to work less than 40 hours a week, regardless of your ability to hit productivity goals. On the other hand, there is almost always an expectation that you will work more than 40 hours a week when required even if that is not very frequent.

If you need to take an hour to go to the dentist, does your employer make you take PTO?

 

[Timsup2nothin]

So I was reading somewhere (yeah, I know, why do I never bring links...get over it) about a company that in the wake of finding out that a whole bunch of their employees can work from home just as well as they did in the office has come up with a plan. They are offering cash up front to any such employees that will take a pay cut to move to somewhere with a lower cost of living. Like, if you will ditch your $2000 a month rent in the city and move out to the surrounding rurality where you can have twice the space for $800 a month they split the savings. You make $600 a month less, but you have $600 a month more...and more than enough cash up front to cover moving costs plus.

Is this viable?

 

[Synobun]

So I was reading somewhere (yeah, I know, why do I never bring links...get over it) about a company that in the wake of finding out that a whole bunch of their employees can work from home just as well as they did in the office has come up with a plan. They are offering cash up front to any such employees that will take a pay cut to move to somewhere with a lower cost of living. Like, if you will ditch your $2000 a month rent in the city and move out to the surrounding rurality where you can have twice the space for $800 a month they split the savings. You make $600 a month less, but you have $600 a month more...and more than enough cash up front to cover moving costs plus.

Is this viable?

Wages are too low to begin with, so no. Keep the pay the same.