[Peter Zack]

See you're drinking the Kool-Aide they feed you. Here's the Canadaian taxation scale:


* 15% on the first $40,726 of taxable income, +
* 22% on the next $40,726 of taxable income (on the portion of taxable income between $40,726 and $81,452), +
* 26% on the next $44,812 of taxable income (on the portion of taxable income between $81,452 and $126,264), +
* 29% of taxable income over $126,264.

So it tops out at 29% not 60 or 65%. What the difference is (here comes the scary part) is we allow Dr's to make a fair living Not a Michael Jordan Living. Their salaries and billing are regulated so they don't burden the system too greatly. My eye surgeon makes in excess of $300,000 a year. I figure that's fair. His education was subsidized by the Government as well. He needed the marks and ablity to get in but once there his costs and tuition were far lower than what he would pay south of the 49th. We are struggling with University costs these days but still manage to keep them somewhere affordable so most can go to school if they want. With subsities and Government programs, most can. My older son just finished and his net cost was under $5,000 a year. So that means a Dr doesn't come out of a top school owing $200,000+ to get his degree(s). He doesn't have to charge huge amounts to get rid of the education cost burden.

I see absolutely no reason why a Dr is worth more than $300,000. If he's making more than that, he's in it for the wrong reason and that is probably why your malpractice situation is out of control and ours is easily managed. You've got money hungry hacks in the system carving people up or selling drugs pushed by big pharma (Did you know it is illegal for drug companies to advertise in Canada?) and costing billions in lawsuits further driving up costs.

So here, my son's new baby was a buck or 2 shared by all.

You will never convince me and I can safely say, the majority of people that live under social health care that a for profit system is better.

See you're drinking the Kool-Aide they feed you. Here's the Canadaian taxation scale:


* 15% on the first $40,726 of taxable income, +
* 22% on the next $40,726 of taxable income (on the portion of taxable income between $40,726 and $81,452), +
* 26% on the next $44,812 of taxable income (on the portion of taxable income between $81,452 and $126,264), +
* 29% of taxable income over $126,264.

So it tops out at 29% not 60 or 65%. What the difference is (here comes the scary part) is we allow Dr's to make a fair living Not a Michael Jordan Living. Their salaries and billing are regulated so they don't burden the system too greatly. My eye surgeon makes in excess of $300,000 a year. I figure that's fair. His education was subsidized by the Government as well. He needed the marks and ablity to get in but once there his costs and tuition were far lower than what he would pay south of the 49th. We are struggling with University costs these days but still manage to keep them somewhere affordable so most can go to school if they want. With subsities and Government programs, most can. My older son just finished and his net cost was under $5,000 a year. So that means a Dr doesn't come out of a top school owing $200,000+ to get his degree(s). He doesn't have to charge huge amounts to get rid of the education cost burden.

I see absolutely no reason why a Dr is worth more than $300,000. If he's making more than that, he's in it for the wrong reason and that is probably why your malpractice situation is out of control and ours is easily managed. You've got money hungry hacks in the system carving people up or selling drugs pushed by big pharma (Did you know it is illegal for drug companies to advertise in Canada?) and costing billions in lawsuits further driving up costs.

So here, my son's new baby was a buck or 2 shared by all.

You will never convince me and I can safely say, the majority of people that live under social health care that a for profit system is better.

Hell's bells we are already taxed more than that! And I said FRENCH. Never mentioned Canadian taxes.

Peter, I think we should therefore regulate your salary. In fact you should be paid $10,000 less than what you now make. And a merit raise? Nope. Vacation? Forget about it.

He's worth every penny if he saves my life. If I'm dead I could care less what he makes. I'm dead.

Most of the Doctor's I know earn their keep. With continuing education, learning new procedures, some of them inventing to help other surgeons. and on and on.

Uhm.. South of the 49 would be mexico. And Doctor's educations aren't subsidized here. They pay for it. Could you imagine how much Obamacare would be if they did that? We're bankrupt already.

[Peter Zack]

As I said before the problem with Canadian health care is the US system. Huge amounts of money that syphon off some of our talent and cause shortages in the system. We have the hospitals and the equipment to do the job. What we have problems with is the staffing levels.

I don't blame the Doctor or nurse that can make $XX in Canada when some hospital in Cleveland or Miami says come down here, we'll pay you $XXXXXXXXXXXXXXXX. If I were faced with that, sure I'd have to give it serious consideration.

Btw Belinda Stronach is an idiot. She crossed the floor and switched parties, she only lasted 3 year in politics. That's like Ronald Regan becoming a Democrat. Prime Minister Silvio Berlusconi is no better. He's the one that was just caught in an affair with an 18 year old and also some high priced hookers. He's an embarrassment to Italy in every way.

[Gooshin]

Hell's bells we are already taxed more than that! And I said FRENCH. Never mentioned Canadian taxes.

if you are taxed more than us

and you are getting less than us (services)

and as far as we can all see, you are not liking whats coming for you

then i see no greater incentive to get the **** out of Dodge

if you are taxed more than us

and you are getting less than us

and as far as we can all see, you are not liking whats coming for you

then i see no greater incentive to get the **** out of Dodge

Only other place I think I'd want to live is Italy.

We pay more taxes for sure. But a lot of it goes to paying for overpriced lawyers in DC. A lot of it goes to entitlements such as welfare, food stamps and the like. A bit of it goes for defense. I mean Canada ain't gonna defend US. Some to NASA. Some goes for more pork. And some to literal pork. There was a report last night on the news that the government is paying something like $1.50 per pound for pork meat you can buy at the local bodega (grocery store) for about seventy nine cents. Sure must be some gooood pork.

[Peter Zack]

Peter, I think we should therefore regulate your salary. In fact you should be paid $10,000 less than what you now make. And a merit raise? Nope. Vacation? Forget about it.

He's worth every penny if he saves my life. If I'm dead I could care less what he makes. I'm dead.

Most of the Doctor's I know earn their keep. With continuing education, learning new procedures, some of them inventing to help other surgeons. and on and on.

Yes he is. But if you can't pay the bill he's not going to be there to save your life. That's the point. Canadian Dr's salaries are regulated. That doesn't mean they can't make more than the number I quoted. They get a set fee for each thing they do. So if a Dr has a good clinic and a large patient load. He'll bill out more. It's not like some bureaucrat decides that a Dr will make $XX because he does eyes, ears and throat and another makes $XXXX because he does something else. Sure a brain surgeon makes more than a GP. But the GP can do just fine if he's good and gets lots of patients. He'll bill out whatever the per patient fees are allowed for each visit. That's the difference. The system sets the fee structure and it's billed to the government. It's adjusted for regions as well. clearly it costs more to practice in a remote region or in Toronto than it might in Halifax or Winnipeg. So the Dr's fees are adjusted to a degree to offset that. It's not a free-for-all-to-bill-as-much-as-you-possibly-can-to-rape-the-system and ultimately the client.

If a Canadian dr wants to make more money, he can specialize or take on more patients etc. he's not told that no matter what he can only make $xx no matter how much he works. They get vacations and most have partners in the practice to cover for that.

Yes he is. But if you can't pay the bill he's not going to be there to save your life. That's the point. Canadian Dr's salaries are regulated. That doesn't mean they can't make more than the number I quoted. They get a set fee for each thing they do. So if a Dr has a good clinic and a large patient load. He'll bill out more. it's not like some bureaucrat decides that a Dr will make $XX because he does eyes, ears and throat and another makes $XXXX because he does something else. Sure a brian surgeon makes more than a GP. But the GP can do just fine if he's good and gets lots of patients. He'll bill out whatever the per patient fees are allowed for each visit. That's the difference. The system sets the fee structure and it's billed to the government. It's adjusted for regions as well. clearly it costs more to practice in a remote region or in Toronto than i might in Halifax or Winnipeg. So the Dr's fees are adjusted to a degree to offset that. It's not a free for all to bill as much as you possibly can to rape the system and ultimately the client.

If a Canadian dr wants to make more money, he can specialize or take on my patients etc. he's not told that no matter what he can only make $xx no matter how much he works. They get vacations and most have partners in the practice to cover for that.

But still there are only so many patients you can physically see in one day. I would rather pay a DR. more for less of a case load then expect him to see 100 people in one day. Since he has to see more people to make more than that's more stress. Also makes a GP want to go for a more lucrative field.
Again I think we should regulate your salary. 10 grand less for you. Why should you be paid so much? What's the difference between you and a doctor. Other than he needs a hell of a lot more education. Oh, and the fact that if he makes a mistake you're DEAD.

[Peter Zack]

Well we also have welfare and a similar food stamp thing. But the big difference is that since there's no middle men in the health care system, there's no lobbiests and no lawyers wasting tons of money. There's no politicians having their campaigns and pockets lined with HMO bucks for the next campaign or secret new car for the wife. With all that crap removed, the system costs less to maintain.

I'm staying out of the military issue. We are so far apart on what a military should be for and do, that this will be a fight. Right now this is a debate. It's a red herring anyway.

[Gooshin]

i would like to point out that welfare is not so bad, because ideally all the money given out is recirculated back into the economy within 30 days.

Well we also have welfare and a similar food stamp thing. But the big difference is that since there's no middle men in the health care system, there's no lobbiests and no lawyers wasting tons of money. There's no politicians having their campaigns and pockets lined with HMO bucks for the next campaign or secret new car for the wife. With all that crap removed, the system costs less to maintain.

I'm staying out of the military issue. We are so far apart on what a military should be for and do, that this will be a fight. Right now this is a debate. It's a red herring anyway.

So true and of course I realize that. People wanted to get rid of lobbyists for sure. But of course you have the Ted Kennedys of the system that want no such thing. After all how would people like him keep getting reelected? I mean he's drunk most of the time anyway.

What we need is not to get rid of the HMO's. We need to get rid of the politicians whose pockets they line. And then make lobbying illegal. ( and I don't men a sick bird)

i would like to point out that welfare is not so bad, because ideally all the money given out is recirculated back into the economy within 30 days.

Only if the drug dealers spend it on legal stuff. I can't tell you how many Lexus I've seen these people with.

[slomojoe]

What about Britain? Women can't even get the drug for breast cancer anymore. And it's a proven drug.

Just for the record on this, since this is another of the many rumors going around the echo-chamber.

The drug in question (lapatinib, by Glaxo) is a new drug, which was approved 2 years ago by the FDA to specifically treat a subgroup of breast cancer patients who a) have a specific cancer marker and b) have failed under standard therapy. The drug, used in combination with another class of anti-cancer agents, has been proven to extend the progression-free time of disease. However, there is little statistical evidence that combination treatment with this drug can actually extend survival of patients (see for instance the original, Glaxo-supported study, which people can find here). Below is a table from that paper, which basically shows that:
- about 27% of women on double therapy have any clinical benefit, vs 18% of women on single therapy (not statistically significant);
- 50% of the women on double therapy had progressed after 8 months, while that time was 4 months for single-terapy recipients;
- survival at 80 weeks was not different between thw two groups.



Now, those extra 4 months of median progression-free time and possibly higher clinical response rate should of course count for something, but considering that the treatment runs at tens of thousands of dollars, it is not completely crazy to think about costs and benefits. Of course, all UK women are still eligible to receive the standard single-drug treatment (which according to the evidence seems to afford similar survival chances), and unlike many American breast cancer patients, do not need to bankrupt their families to do so.

Finally, as I understand it Glaxo has appealed the NHS decision and asked for more time to submit supporting evidence, and the NHS has suspended the implementation of the rule. There really is little doubt that if any new studies show a statistically significant survival benefit (or even just a larger overall clinical benefit) for lapatinib treatment, it will be available to UK patients.

[Peter Zack]

I'd take the cut in pay. don't kid yourself that some dr in Cleveland isn't packing them in to get his billing hours up. If he can get 10 in a day for $100 per or 100 in a day for $100. He's doing it.

A dr can only take a finite number no matter where he is. I've actually gone to one a few times. I've never once been rushed out of the office and told my time is up. They schedule what they can handle and I know for a fact they leave a certain amount of time for walk ins and unexpected stuff. Those that want to make more will work a few evenings a week at one of the free community clinics and see whomever is in the waiting room that night. They bill those hours on top of the ones they would from their own practices.

You're swimming up stream and you know it.
I've shown you that our taxation system is fair and that we all have free coverage from those dollars. We don't have a big malpractice problem and middlemen are not bleeding the system dry. We don't have lobbyists, Big Pharma and Lawyers taking their cut.

Bottom line is this. You want to start a business and attract good workers for your company. So to be competitive, you offer a health care insurance. The program costs a bundle but you hope it keeps a stable work force and gets you the talent you want. It's 50/50 co pay and to make sure you keep those talented people, you adjust the salaries to not make the premiums seem so expensive.

I start the same business and offer the same coverage at no cost directly to the company and no salary bump to off set health coverages.

Who will survive as costs increase?

[Gooshin]

i think one of america's current faults is the general attitude of the average american. The rich have gotten used to being rich, movie stars get big paycheques, laywers get big paycheques, doctors, politicians, insurance companies, health companies, universities, and so forth.

The poor are still poor and will be poor, because they cant afford health care, they cant send their kids to school, and basically they cant climb the ladder without resorting to crime or sheer luck.

All the while the enitre nation has gotten used to cheap prices, cheap clothing, cheap alchohol, cheap cigarettes, cheap cars (with the exception of California perhaps and their crazy by-laws), cheap electronics and so on and so forth. (and the catch is that while cheap ($$$) the quality is still there!)


If the rich would start charging less (remember taxation is AFTER the fact, no need to raise taxes, just get people to charge less, so that more can afford, which would lead to a reduction in taxes in the long run),

if the government would impose restrictions on imports and produce more goods in-house, there would be more jobs, and more job security, also China wouldnt be expanding as fast...

unions needs a boot

banks need to be combined, as i mentioned in a previous post, there are FIVE banks in Canada, and as far as i understand, there can be as many as 100 different banks in each state! The whole mortgage/lending/credit system needs to be tied up and kept in check by a single system, (or atleast a single system with FEW branches)

and.. anyway those are just some ideas floating in my head

america needs a paradigm change

[Peter Zack]

Final point from me as I have work to do tonight. But this has been fun. What purpose does an HMO serve other than to bleed profit from you and the system. Here the Doctors are basically free lance. They choose the community they want to work in (some areas offer incentives to move there) and they hang a shingle. They see their patients and bill the government directly. The patients choose the doctor they want and the specialist they want. So some suit doesn't tell me who I can and can not see. I go where I want because they all get the same fees and no government agent tells me that Dr X is cheaper than Dr Y. In this set up an HMO serves no useful purpose other than to skim $$