How many jobs depend on the Detroit Three?

It's amazing how discussions of socialized medicine always turn into a
shell game where the discussion goes around in continuous circles. You
are correct - people in favor of socialized medicine talk as if it is
free when it is obvious to the thinking person that the costs have to
come from somewhere.

Someone mentioned medicines are cheaper in Canada. Hopefully that
problem will be fixed in the U.S. where we are subsidizing all the other
countries by the difference that we pay for the same medicines by the
price structures for U.S. vs. non-U.S.

 

But health care is still 1/3 cheaper by % of GDP in Canada.

 

Is that an honest figure? Is that the *total* health care cost? Does
everyone agree on that figure, or is it calculated using some Al
Gore-type method that ignores certain inconvenient things and
exaggerates others or includes some "savings" that should not be
included? How much of that cost is the cost of medicines subsidized by
the U.S. consumer and health care industry? What quality level has been
lost to hit whatever the cost level is?

 

Thanks. These supplement plans generally aren't viewed as insurance in
the US, thus the question. Just a difference in nomenclature.
As for something like that:
Chief
Justice Beverly McLachlin. "The evidence in this case shows that delays
in the public health-care system are widespread, and that, in some
serious cases, patients die as a result of waiting lists for public
health care. The evidence also demonstrates that the prohibition against
private health insurance and its consequence of denying people vital
health care result in physical and psychological suffering that meets a
threshold test of seriousness.²

 

Instead you worry about whether the line will too long and the
disease will progress. At one time, although this has recently been
corrected, you were 3 times more likely to die on queue waiting for a
"nonemergent" heart bypass than you were to die on the table during the
surgery. There is also a lag time (at least compared to the US) where
many new drugs and procedures aren't available. Studies from the
cardiologists, for example, show Canadians consisently have lower use
of cutting edge medications, have higher incidence of handicaps and
lower standardized quality of life scores.

Depends. Only the brand name medications are price-controlled. Many
studies show Canadians pay more for generics because they aren't.

But there is also no way you would get the same coverage. The US
rations care by ability to pay. Other ration by access (as noted above
for example).
In Canada, you guys have a heavily subsidized system (with all of the
demand dislocations that incurs), but government-run price controls. In
the US we managed to also get a highly subsidized system, but since we
don't have the control mechanisms supply and demand forces run rampant.
Especially in a situation where there are high barriers to entry to the
industry (you don't decide in 6 months to be a doc.)

The other big cost is back office with so many different forms. Although
many docs are most pissed off about the high levels of paperwork
associated with government run programs.

 

In a recent radio discussion of health care schemes, someone claimed
that Canadian hospitals do *not* have the enormous billing staff that
one finds in the USA: they may have one or two just to deal with the
Americans who come across the border and pay "full price" because it's
still cheaper than in the USA.

And don't imagine that the US and Canadian schemes are the only two ways
to do things. Look at Australia, Taiwan, Japan, Switzerland, the UK and
Germany, to name just a few.

This whole discussion reminds me of a conversation with a friend who had
worked in Chile under both the "socialist" (I mean *really* socialist,
not what the Democrats get accused of) and the anti-socialist regimes:
under socialism the basic necessities of life were affordable but in
short supply; under the anti-socialist regime everything was plentiful,
but few people could afford it.

Perce

 

What is interesting in this debate is how we have blue collar people
sniping at other blue collar workers because they make more than them.
Instead of saying "I want to be paid as much as them" they say "they
make too much".
How does this even make sense? Seems like big business has everyone
convinced that blue collar people should be living sub-middle class
lives, living paycheque to paycheque.
These other blue collar workers should be trying to get their wages
increased rather than someone else's wages decreased.

What should be looked at is why blue collar wages are so low. How is it
that people in the developed world accept having to compete for jobs
with people in China and India not to mention Mexico? Is their cost of
living the same?

We should be addressing globalization and free trade and whether it
makes sense to compete directly in all areas of trade. Maybe we should
only trade in areas that are beneficial to all considered rather than
just the corporations.

 

I don't see where union blue collar wages are all that low. But that's
neither here nor there. The American way of life in recent years is to live
at a level 15-25% higher than what is earned. That's why there is so much
market volatility now. When people are earning $25/hour, they try to live
like they're making $35/hour. Never mind the taxes that are taken out; I
want what I want and I want it NOW! Not everybody has this way of thinking,
but enough do to make a difference. I have never had more than 1 credit card
in my life, and I pay it off as soon as I get the bill because I don't want
to pay the interest. The only reason I kept one is for credit rating
purposes. For most purchases, I use my debit card, or wait until I can
afford it. I'm retired now, living off my checking account until my SSI
kicks in. I didn't make a lot of money in my 45 years of working, but I
didn't let myself get deep into debt, which explains why I could retire a
little early.

Of course, that's just me- your lifestyle may vary greatly.

 

Actually, I said blue collar, not union blue collar. I see some people
writing into various blogs saying that they only make $18/hour and
people who make $28/hour are overpaid. One guy said he couldn't afford a
new car and so he resented that auto workers could. He should be asking
why he is making so little that he can't afford a new car rather than
ask why others can.

The American way of life in recent years is to live

 

http://www.chsrf.ca/mythbusters/html/myth28_e.php

--------------
in the U.S., healthcare spending as a proportion of GDP increased from
7% in 1975 to 15.3% in 2005. In Canada, the figures rose from 7% to 9.8%
over the same time period, remaining constant at about 8 to 10% of the
nation’s GDP for the last 20 years.
-------------

10% is 1/3 less than 15%.

And just to be clear, some reports assign the name "medicare" to
Canada's health care system. All readers should note that there is no
such single pan-Canadian health care system. Each province operates
it's own health insurance system, none of which go by the name
"medicare". For example, health care in Ontario is funded by OHIP
(Ontario Health Insurance Plan).

And there are complications when a resident of one province is treated
in another province. If a resident of Toronto is diagnosed with some
rare disease, he simply can't travel to a specialist in Vancouver (BC)
and be treated and expect OHIP to pay for it without prior approval.
And if there is no such approval, then he'll have to pay out-of-pocket
for the treatment, or fight OHIP in court after the fact.

This document:

http://www.aims.ca/library/MPPI_pharma-revised_.pdf

explains why drugs are cheaper in Canada. I think it over-emphasizes
the "market separation" theory, which claims that the Canadian and US
drug markets are sufficiently partitioned from each other so that the
drug companies can charge different prices in each market according to
what each market can afford, and since (according to the article)
Canadians are "poorer" than Americans, then the drug companies must
charge proportionately less for drugs in Canada to maximize sales and
net-profits.

The above document does not fully explain the effect on Canadian drug
prices by the "Patented Medicine Prices Review Board (PMPRB)". The
PMPRB uses international price benchmarking to regulate Canadian prices,
in effect creating price ceilings. The Canadian price for new products
cannot be more than the average price of the seven international peers
the PMPRB uses as the reference group.

When it comes to health care in Canada, the PMPRB is the only federal
agency or legal body that affects health care costs (specifically, drug
costs) across all of Canada. But even with the PMPRB, the individual
provinces themselves can (and do) negotiate their own drug prices
directly with the drug makers, which usually results in prices that are
less than what is dictated by the PMPRB.

Back in the USA, just as malpractice insurance and court awards drive up
healthcare costs, so too does law suits against drug companies drive up
drug costs. To quote the article:

"The US legal system in effect imposes a huge tax on pharmaceuticals
that Canadians do not have to pay."

One other thing makes US health care costs high (not mentioned in the
above document) is that it's common in various state laws that health
insurance purchasers (individual companies, municiple gov'ts, other
entities, etc) can't band together into large groups and negotiate their
own health insurance and drug plans. By being prevented by law from
forming large purchasing groups, they can't enjoy the bargaining power
that the Canadian provinces have.

What has been lost in the Canadian healthcare systems are the costs
associated with lawsuits and malpractice insurance, and the costs
associated with thousands (and even millions) of white-collar
administrative jobs in both the health insurance companies and the
healthcare delivery side (hospitals, private clinics, etc) that are
involved with record keeping, billing, reimbursement tracking, and in
general fighting over payments. All those back-office, paper-pushing
jobs play absolutely no role in health care delivery to the patient, but
yet are necessary to make the US health care system work.

 

It seems thats the current trend in American thinking. Bring down the
top as a way to help the bottom. Punish those who worked hard to get to
the top. Trouble is, you can't raise the bottom by bringing down the top.

 

And there are differences in what the different plans pay for and the
costs they get in both premiums and taxes.
a

But for prescription drugs the prices that will be paid are set by
the plans. While it is based on the average of a basket of different
country's prices, all but the US also have government price controls. So
the pharms have the choice of either taking what the Canadian's will pay
or not selling the medications at all.
So, they are PAID proportionally less because that is all the Plans
will allow. In fact, if a company produces a new medication and decides
not to wait for the allowable price to decided upon by the bureaucracy,
if the allowable price is less than what the pharm thought it was going
to be, then the pharm has to return the difference. The drug companies
must charge less to get ANY sales and profits.
One interesting stat that argues for the idea that they are not
really different markets if let alone is that Canadians pay more for
generics than in the US. One of the (relative) cost savings for the US
is actually more expensive in the Great White North.
Another interesting stat is the the Western Countries and Japan all
are comparable to the US in the PERCENTAGE of total healthcare
expenditures go to drugs. This would tend to argue that if everybody
spent the same total as the US, drug prices would be pretty much the
same.

Which I just spent a whole bunch of time above explaining how it
fits in, so I won't bother again (g)>

But again, it is a take it or leave it. Sorta hard to "negotiate"
under those circumstances.

Governments often exempt themselves from troublesome things like
anti-trust laws (g).

But there are still rationing methods included in the CDN system.
Otherwise you couldn't control prices any better than we can. You ration
by the queue and by budgets that can mean some hospital shut down except
for emergencies toward the end of the year.

 

Not to mention the profits the private companies make and refuse to
divulge. People talk about how much less efficient public companies are
(don't agree for the reasons stated by MoPar) but don't mention that
private companies take out huge amounts in profits.
We have to pay for that too but it is probably never mentioned as a cost
by people advocating private over public because it is not considered a
cost from the companies perspective.

 

And now competing with Mexican or Asian workers is just another way to
bring down the top.
These corporate big wigs are probably laughing in their sleep at the way
they put us in this position (I'm not blue collar incidentally).

 

I remember this being negotiated during Mulroney's terms in office.

 

And it carries over into all aspects of life. Look at the education system-
X% of students don't attend class, do homework, or pass tests, so instead of
holding them back a year, let's just make the curricula easier. So now, 10th
grade math is taught in the 12th grade. If you want to have some fun, go to
any store, make a purchase (say the total is $3.72), and give them a $5
bill. After they've punched that in, tell them you've got the change and
hand them 3 quarters. Oh boy! You can see the smoke coming from their ears!

 

Absolutely not true.

The only thing we have a waiting line for is elective orthopedic
surgery. That's because our othopedic surgeons are very busy performing
emergency hip surgery on EVERY senior citizen that slips and falls in
their bathtub and breaks their hip.

Quite the opposite.

Many new drugs and proceedures are available first in Canada (and
Europe) before they become FDA approved.

Robotic surgery systems were first used in Ontario before they became
widely deployed in the USA.

Translation: There is more use of generic drugs in Canada vs the usage
of the exact same (and more expensive) branded-label drug.

"For almost a decade (up to the year 2001), Canada was ranked number
one among 175 countries in the United Nation's Quality of Life survey."

http://www.english-vancouver.com/canada-human-development/

Most and Least Livable Countries: UN Human Development Index, 2006:

lhttp:/www.infoplease.com/ipa/A0778562.html

Canada rank: 6
USA rank: 8

The criteria for calculating rankings include life expectancy,
educational attainment, and adjusted real income. The 2006 index is
based on 2004 figures.

http://www.ingentaconnect.com/content/adis/ahe/2008/00000006/00000001/art00002

Differences in Generic Drug Prices between the US and Canada
Authors: Gooi, Malcolm1; Bell, Chaim M.
Source: Applied Health Economics and Health Policy,
Volume 6, Number 1, 2008 , pp. 19-26(8)

Results: Using the lowest quote for each selected drug, 12 of the 19
(63%) generic medications were least expensive in the US, with an
average saving of 47% per drug for these 12 drugs. Seven of the 19 (37%)
drugs were least expensive in Canada, with an average saving of 29% per
drug for these seven drugs. Overall, there was a sizable variation in
prices for the same generic medications within and between the US and
Canada.

Conclusions: The lowest priced generic medications were not consistently
found in either the US or Canada. The price controls and ensuing savings
applied in Canada to prescription patented medications do not fully
extend to generic medications.

Americans would like to believe that, but it's not true. Canadian
doctors use the same drugs, devices, and proceedures, and have access to
the same diagnostic devices (ultrasound, MRI, CT) that US doctors have.

In Canada, health care is rationed by need. If a Canadian doesn't need
an MRI scan, he won't get one. If an American doesn't need an MRI scan,
but he wants one, and is willing to pay for it, then he can buy one.

Use of the term "subsidized" is strange in that context.

I could say that the US gov't is heavily subsidized (by taxpayers). Is
that a useful statement to make? No.

In both the US and Canadian healthcare systems, doctors are paid for
their services. Companies that supply medical devices, hospital
supplies, and drugs are paid for their products. Everyone is paid a
negotiated price for what they provide. The difference is who the payer
is (or how many payers there are), and how the payer(s) is/are funded.

Yes, in the US you have to deal with the federal programs of medicare
and medicade.

In Canada, we have no such federal programs that are involved in the
payment of costs associated with medical services directly to either
patients, or hosptials, or doctors. Instead, federal money that is
"earmarked" for healthcare is transfered directly to provincial
treasuries in bulk, and that money is combined with provincial income
tax and provincial sales tax and all 3 sources of money are combined and
form the pool of money that a province will draw from to fund (among
other things) the health care system in that province.

 

How much is too much? Wages are generally (but not always) paid in
accordance with skills and responsibility. Machinists and electricians
usually make more than assemblers, who usually make more than janitors.

I don't know that business has the blue collar worker convinced of anything.
They have work available, The worker can accept the wage or move on to some
other place. If not enough workers apply, the business will offer a higher
wage. As long as people accept what is offered, it must be acceptable to
enough people.

You state that blue collar wages are so low. Give some specifics please. I
know plenty of blue collar workers that make $25 to $45 an hour. What they
have in common is that they possess more skill, have more education and
training, than those that do not make that much. In my company, blue collar
workers make from $10 to $28. Wide range of wages, wide range of skills.

Wages, of course, are just one portion of the cost of having an employee.
Insurance, pension, healthcare, vacation time, and all the other benefits
are added to the base cost.

Your last sentence is interesting. How about some examples? If the
corporation benefits, do others benefit also? Here is one example.
Corporation A makes televisions. They pay their workers a good wage and
sell the TV for $3500. The company makes a small profit, they sell about
500 units a week. Corporation B designs televisions, but has them
manufactured in some far off land. They employ a few skilled people, but
only have a low paid warehouse staff to move the cheap TV from import
container to the shipping dock. They sell the identical featured TV for
$500, they sell 5000 of them a week, make a good profit, and you and I can
afford one. Maybe even two of them. Who benefits? Look around your house
and see how many items we have that are not affordable if made here by
highly paid workers.

I don't know the answer but it is just as much a moral dilemma as a business
decision. The same guy that complains of imports, complains of making low
wages, will scour the town to find the lowest possible price on his TV, turn
of the ball game and take about the star that is making $10 million a season
and think he is not paid enough because his ERA is better than the guy on
the other team that makes $15 million a year.

Pogo was right.

 

That's not even funny. You'd think a cashier would be anticipating this
after, oh, I don't know, the second or third day on the job. But
there's either a lot of noobs running the registers, or they just can't
be arsed to even put a minimal amount of thought into their job.

nate

 

Within a company yes, but not throughout the economy as a whole. Are
people working on a factory line that much more skilled than a janitor?
Is a janitor more skilled in a GM factory than one in a factory that
makes dryers and is non unionized?
Do you think people should be able to raise their family on $18/hr? In
what locations is that enough to pay for a house and car and raise a family?

Well obviously so many people are attacking these line workers for being
overpaid. Who do you think puts that idea out? Certainly not unions. Do
all of these people just come to that idea on there own?

Yes, but when these companies can threaten to move the work to China,
what option do these people have. That is why I say that the workers are
not benefiting from globalization. The corporations are by being able to
sell things here and make them somewhere else.
Of course, when people are no longer able to buy the products, then the
problem with the approach begins to show as it is now throughout the
retail industry.

I gave an example of some people making $18/hour. Some people say
minimum wage is acceptable for some of these people. Do you think no one
is making minimum wage? So there you go. Everyone making minimum wage is
an example. The fact that you have to ask indicates you are arguing from
an ideological perspective rather than actually thinking things through.

What they