Sen. Rand Paul going to Canada for hernia surgery

[TU Curmudgeon]

The beef is that some are trying to make conservative Rand out to be a hypocrite but he chose a private hospital which is not a part of the publicly funded gov. healthcare system so they have failed miserably to make their case.
Just laugh... :lol:

To say that a hospital that derives a great deal of its income from the publicly funded government healthcare INSURANCE system is NOT a part of the system is beyond ludicrous.

 

[TU Curmudgeon]

If you had every physicians salary, it would not be hard to compare. It would also not be difficult to compare the cost of the various procedures that are done there with the same procedures at other hospitals--assuming that they are comparable. Presumably the people who decide to work there make some kind of analysis that factors in salary and costs.

It's been a long time since this happened, but I personally was present for the final discussions.

A reporter came up from The States to Thunder Bay, Ontario. One night, the reporter was sleepwalking and pushed both arms through a window. The glass pane slid down and the reporter has "guillotine wounds" that practically encircled both arms. He was rushed to the hospital by ambulance, admitted via the ER, had surgery performed immediately (surgery which requires copious amounts of blood transfusion), whisked off the the PARR, transferred to a surgical bed, and released from hospital about a week later. [That's just the background.] When he was being discharged he received his hospital bill and expresses surprise at the size of the bill. The surprise was NOT at how large it was, but at how small it was. When asked why he thought that the bill was small his reply was (I'll paraphrase because, even though I was there at the time, 50 years is a long time to recall a conversation verbatim) "Because my ER bill alone at home would have been bigger than this.".

You might also find it interesting that the cost of an ER visit at Vancouver General Hospital is

1. Insured BC Resident $0.00 - (approximately US$0.00)
2. Uninsured BC Resident CDN$335 - (approximately US$251.25)
3. Non-Resident CDN$750 - (approximately US$562.50)

For a day in a "Standard" bed at VGH, the costs are:

1. Insured BC Resident $0.00 - (approximately US$0.00)
2. Uninsured BC Resident CDN$1,456 - (approximately US$1,092.00)
3. Non-Resident CDN$3,530 - (approximately US$2,625.00)

and for a day in ICU the costs are

1. Insured BC Resident $0.00 - (approximately US$0.00)
2. Uninsured BC Resident CDN$5,247 - (approximately US$3,935.25)
3. Non-Resident CDN$13,665 - (approximately US$10,248.75)

The above are the 2019 rates. In 2016, the average cost of an ER visit in the US was US$1,917 (so if you live in Balne WA, have no medical insurance, and your kid breaks his arm, just boot on up to White Rock, get it fixed and save yourself around $1,400.

How do those rates compare with the rates at an equivalent hospital in the US. How do they compare with the rates at an equivalent hospital near you?

As far as differentials in incomes are concerned, simply comparing gross earnings isn't going to be all that useful. You have to include the differential in "malpractice insurance premiums" (American doctors would think that they'd died and gone to heaven if they had to pay the same premiums as Canadian doctors do) and also "debt servicing costs" (primarily due to the fact that those lazy socialist leechs in Canada subsidize their medical schools much more highly than the good, honest, hard-working, American entrepreneurs do).

Just for illustrative purposes I'll invent two doctors "Dr. Kay. Nuck" and "Dr. Yan Kee"

Dr. Nuck has a net taxable income of $100,000 out of which she has to pay $8,000 a year to service her student loans and another $2,000 to pay for her malpractice insurance.

Dr. Kee has a net taxable income of $200,000 out of which he has to pay $80,000 a year to service her student loans and another $30,000 to pay for her malpractice insurance.

Assuming that all figures above are in the same currency, who ACTUALLY makes more money, Dr. Kay Nuck, or Dr. Yan Kee?

 

[Helix]

Yeah...I mean...I personally know zero people who have gone bankrupt, or have wiped out their life savings, trying to stay alive. Or died because they couldn't afford a visit to the doctor. I have American friends who balk when I tell them I don't think about medical bills at all.

As I said above, it's not perfect, nothing is. But I'd still rather this than anything else out there, when everything is added up.

it varies wildly here. you have some people who are a heart attack or cancer diagnosis away from going bankrupt, and then there are some who have had great insurance for the last few decades and are insulated from the chaotic system that younger workers experience. you have some people who are poor and get great Medicaid coverage, and some who are struggling but who are not poor enough to qualify. it's a hodgepodge system with massive, expensive holes to fall into all over the place.

 

[AliHajiSheik]

It's been a long time since this happened, but I personally was present for the final discussions.

A reporter came up from The States to Thunder Bay, Ontario. One night, the reporter was sleepwalking and pushed both arms through a window. The glass pane slid down and the reporter has "guillotine wounds" that practically encircled both arms. He was rushed to the hospital by ambulance, admitted via the ER, had surgery performed immediately (surgery which requires copious amounts of blood transfusion), whisked off the the PARR, transferred to a surgical bed, and released from hospital about a week later. [That's just the background.] When he was being discharged he received his hospital bill and expresses surprise at the size of the bill. The surprise was NOT at how large it was, but at how small it was. When asked why he thought that the bill was small his reply was (I'll paraphrase because, even though I was there at the time, 50 years is a long time to recall a conversation verbatim) "Because my ER bill alone at home would have been bigger than this.".

You might also find it interesting that the cost of an ER visit at Vancouver General Hospital is

1. Insured BC Resident $0.00 - (approximately US$0.00)
2. Uninsured BC Resident CDN$335 - (approximately US$251.25)
3. Non-Resident CDN$750 - (approximately US$562.50)

For a day in a "Standard" bed at VGH, the costs are:

1. Insured BC Resident $0.00 - (approximately US$0.00)
2. Uninsured BC Resident CDN$1,456 - (approximately US$1,092.00)
3. Non-Resident CDN$3,530 - (approximately US$2,625.00)

and for a day in ICU the costs are

1. Insured BC Resident $0.00 - (approximately US$0.00)
2. Uninsured BC Resident CDN$5,247 - (approximately US$3,935.25)
3. Non-Resident CDN$13,665 - (approximately US$10,248.75)

The above are the 2019 rates. In 2016, the average cost of an ER visit in the US was US$1,917 (so if you live in Balne WA, have no medical insurance, and your kid breaks his arm, just boot on up to White Rock, get it fixed and save yourself around $1,400.

How do those rates compare with the rates at an equivalent hospital in the US. How do they compare with the rates at an equivalent hospital near you?

As far as differentials in incomes are concerned, simply comparing gross earnings isn't going to be all that useful. You have to include the differential in "malpractice insurance premiums" (American doctors would think that they'd died and gone to heaven if they had to pay the same premiums as Canadian doctors do) and also "debt servicing costs" (primarily due to the fact that those lazy socialist leechs in Canada subsidize their medical schools much more highly than the good, honest, hard-working, American entrepreneurs do).

Just for illustrative purposes I'll invent two doctors "Dr. Kay. Nuck" and "Dr. Yan Kee"

Dr. Nuck has a net taxable income of $100,000 out of which she has to pay $8,000 a year to service her student loans and another $2,000 to pay for her malpractice insurance.

Dr. Kee has a net taxable income of $200,000 out of which he has to pay $80,000 a year to service her student loans and another $30,000 to pay for her malpractice insurance.

Assuming that all figures above are in the same currency, who ACTUALLY makes more money, Dr. Kay Nuck, or Dr. Yan Kee?

Please source your "illustrative" numbers. There is no student in the US that pays $80,000/yr to service a student loan. You also didn't include taxes. Assuming $2,000 month for $200,000 debt for 10 years, your Dr Kee is better compensated. Factor in the exchange rate, it could be nearly double depending on the state which you omitted.



Your focus is on end user costs, my question is around physician compensation.

 

[Xelor]

Sen. Rand Paul going to Canada for hernia surgery

Is there a good reason one should give a wet rat's ass where Rand Paul has hernia surgery?

OP-er, please explain how the two red highlighted statements can be concurrently true for a given health care recipient.

No one should be surprised by this, American insurance companies have had arrangements with Canadian medical service providers so that the American policy holders would receive medical services in Canada and the American insurance companies would pay 100% of the bills of the Canadian medical service providers.

The way that this works, is that the American insurance company bases its premiums on what it would cost to provide the services in the United States of America, but bases its expenses on what it actually costs.

This is a win-win situation for both the American insurance companies and the Canadian medical service providers. It's also a win for the Canadian medical insurance premium payers (it actually cuts the costs of providing services). The only ones who "lose out" on the arrangement are the American medical insurance premium payers.​

Seems to me Paul, the premium payer, is "winning" if his insurer is paying 100% of his care provider's fees.

 

[OlNate]

it varies wildly here. you have some people who are a heart attack or cancer diagnosis away from going bankrupt, and then there are some who have had great insurance for the last few decades and are insulated from the chaotic system that younger workers experience. you have some people who are poor and get great Medicaid coverage, and some who are struggling but who are not poor enough to qualify. it's a hodgepodge system with massive, expensive holes to fall into all over the place.

I'm so sorry... I read somewhere that there are 27 million Americans (well, not somewhere, link below), and that number has risen since Trump has been in power. Something's broken...and I know this sounds condescending AF, but how is that possible for the most powerful nation in the world? I guess there are sacrifices to be made...

https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/

 

[Helix]

I'm so sorry... I read somewhere that there are 27 million Americans (well, not somewhere, link below), and that number has risen since Trump has been in power. Something's broken...and I know this sounds condescending AF, but how is that possible for the most powerful nation in the world? I guess there are sacrifices to be made...

https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/

basically, part of the country threatens to secede if we enact the sensible health care solutions that the rest of the first world enacted many decades ago even though we have also done that for older people since the 1960s.

 

[Nickyjo]

Yeah...I mean...I personally know zero people who have gone bankrupt, or have wiped out their life savings, trying to stay alive. Or died because they couldn't afford a visit to the doctor. I have American friends who balk when I tell them I don't think about medical bills at all.

As I said above, it's not perfect, nothing is. But I'd still rather this than anything else out there, when everything is added up.

True, sort of. I would have gone bankrupt from medical bills, but government medicine saved me cause I'm old. Would have saved me if I was poor, or a veteran. We in the US already have national health care for tens of millions, but for some strange reason we've decided to only apply it to certain categories of people, most of them more at risk than the average (brilliant!) with three (or more) systems instead of one. Still, socialism has been bery, bery, good to me.

 

[can2man]

Err...this hospital is entirely covered for Ontario citizens (this hospital is on Ontario). I know because I just used their online chat to inquire.

I encourage you to do the same, if you don't believe me:

https://www.shouldice.com/

I will take you up on your offer to laugh, though...well, maybe chuckle, anyway.

That is correct - I went there for surgery under OHIP.
I prefer public hospitals

 

[Blackbart]

It's HIS dime, don't sweat the small stuff.

 

[Blackbart]

True, sort of. I would have gone bankrupt from medical bills, but government medicine saved me cause I'm old. Would have saved me if I was poor, or a veteran. We in the US already have national health care for tens of millions, but for some strange reason we've decided to only apply it to certain categories of people, most of them more at risk than the average (brilliant!) with three (or more) systems instead of one. Still, socialism has been bery, bery, good to me.

Should one want it, earn it or wait in line.

 

[Nickyjo]

Should one want it, earn it or wait in line.

Don't understand,

 

[Ahlevah]

Thanks Senator Paul for reminding us all that our healthcare is not all that great for a supposed 1st world country (most expensive with very subpar outcomes).

Then there's the Zuckerberg San Francisco General Hospital way: Soak it to the people with private insurance in order to subsidize those on public insurance or who aren't insured:

After getting hit by a car on her bike, Nina Dang was taken to Zuckerberg San Francisco General and was treated for a broken arm. Doctors also took a CT scan of her brain and spine. Her bill: $24,074, with her insurance agreeing to cover only $3,830.

Five other bills reviewed by Vox revealed a similar pattern, with privately insured patients sent massive bills for treatments, without any recourse to their insurance coverage that was meant to protect them.

Zuckerberg San Francisco General, unlike most hospitals, doesn’t negotiate prices with health insurance providers. It is considered “out-of-network” for all private insurance plans. The hospital instead focuses on patients with public health plans, such as Medicare and Medicaid, recouping from patients with private insurance what the hospital loses treating the uninsured and underinsured. In Dang’s case, Zuckerberg San Francisco General billed 12 times the Medicare rate for her treatment. :shock:

https://www.newsweek.com/zuckerberg...e-medicare-medicaid-mark-facebook-san-1282274

 

[Blackbart]

Don't understand,

The US national health care you speak of. Earn it in the military or wait till one is old and they pay the $104.00 or so a month.

 

[Casca XV]

From United Press International

Sen. Rand Paul going to Canada for hernia surgery
​

Jan. 14 (UPI) -- U.S. Sen. Rand Paul, a Kentucky libertarian known for his opposition to socialized medicine, is going to Canada for hernia surgery next week, according to court papers he filed in a civil case.

The Louisville Courier-Journal reported that Paul, a onetime Republican presidential candidate, will have outpatient surgery performed at the Shouldice Hernia Hospital in Thornhill, Ontario, next week.

The information appeared in documents filed in the senator's civil lawsuit against neighbor Rene Boucher, who pleaded guilty to assaulting Paul in 2017. Paul suffered six broken ribs and a bruised lung in the dispute over lawn maintenance.

Paul has been a longtime critic of socialized healthcare systems like Canada. During Republican efforts to replace the Affordable Care Act, Paul derided what he called socialized medicine and the need for the marketplace in healthcare. In Canada, healthcare is nationalized.

COMMENT:-

No one should be surprised by this, American insurance companies have had arrangements with Canadian medical service providers so that the American policy holders would receive medical services in Canada and the American insurance companies would pay 100% of the bills of the Canadian medical service providers.

The way that this works, is that the American insurance company bases its premiums on what it would cost to provide the services in the United States of America, but bases its expenses on what it actually costs.

This is a win-win situation for both the American insurance companies and the Canadian medical service providers. It's also a win for the Canadian medical insurance premium payers (it actually cuts the costs of providing services). The only ones who "lose out" on the arrangement are the American medical insurance premium payers.
​

Nice try. You and your fraudulent source left out the fact that Shouldice is a private for profit clinic outside the Canadian socialized system. Proposed sale of Shouldice Clinic triggers privatization concerns | Apix Performance

Such clinics are common in Europe and Canada. They are in addition to the U.S. where every European or Canadian who can goes for all their healthcare to avoid Socialized Medicine

 

[Nap]

One of my best friends from Chicago has been living in Toronto for past 13 years as a legal resident. He's a hypochondriac IMO and goes to the doctor frequently for the smallest issue, real or imagined. He has nothing but positive things to say about Canadian healthcare compared to American.

Given your friend is a hypochondriac, of course he is going to prefer the Canadian system over the American as he isn't shouldering the burden of his decisions, then again neither are Americans as we have the worst possible system that is caught between free market and socialized ideals payed for by a 3rd party.

 

[TU Curmudgeon]

Please source your "illustrative" numbers.

Please note the word "invent".

I will grant you that the average medical school student debt is $192,000.

According to my amortization calculator that would run to about $13,000 per year over a 20 year term.

Canadian Doctors Say They're Paid Too Much, and Are Protesting to Lower Their Own Salaries. It's an Incredible Act of Leadership

There is no student in the US that pays $80,000/yr to service a student loan.

I did say "invented" - didn't I?

You also didn't include taxes.

Calculating taxes isn't quite as easy as it sounds because what you get for your tax dollar varies between the two countries.

On the other hand, if you want to take a look at comparing "Total Tax Load + Direct Payments for Medical Insurance" between the two countries the results are even less favourable to the US than the simple comparison of "Income Tax Rates" that most people like to indulge in.

Your focus is on end user costs, my question is around physician compensation.

In short, we are each trying to convince the other of something different than the other one is talking about.

Time to fall back and punt.

 

[TU Curmudgeon]

Is there a good reason one should give a wet rat's ass where Rand Paul has hernia surgery?

OP-er, please explain how the two red highlighted statements can be concurrently true for a given health care recipient.

No one should be surprised by this, American insurance companies have had arrangements with Canadian medical service providers so that the American policy holders would receive medical services in Canada and the American insurance companies would pay 100% of the bills of the Canadian medical service providers.

The way that this works, is that the American insurance company bases its premiums on what it would cost to provide the services in the United States of America, but bases its expenses on what it actually costs.

This is a win-win situation for both the American insurance companies and the Canadian medical service providers. It's also a win for the Canadian medical insurance premium payers (it actually cuts the costs of providing services). The only ones who "lose out" on the arrangement are the American medical insurance premium payers.​

Seems to me Paul, the premium payer, is "winning" if his insurer is paying 100% of his care provider's fees.

Very simply.

The American insurance companies base their premiums on what it would cost to provide the service IN THE UNITED STATES OF AMERICA. If the services actually cost less (let's say by putting a patient in a Canadian Hospital where all hospital services are included in the per diem rate rather than by putting them in an American hospital where every service and product is billed separately) than that then the "profit base" for the insurance company is "enhanced". The people who pay the premiums to the American insurance companies are the American medical insurance premium payers.

 

[Xelor]

Very simply.

The American insurance companies base their premiums on what it would cost to provide the service IN THE UNITED STATES OF AMERICA. If the services actually cost less (let's say by putting a patient in a Canadian Hospital where all hospital services are included in the per diem rate rather than by putting them in an American hospital where every service and product is billed separately) than that then the "profit base" for the insurance company is "enhanced". The people who pay the premiums to the American insurance companies are the American medical insurance premium payers.

Okaaaaaay....

 

[AliHajiSheik]

Please note the word "invent".

I will grant you that the average medical school student debt is $192,000.

According to my amortization calculator that would run to about $13,000 per year over a 20 year term.

Canadian Doctors Say They're Paid Too Much, and Are Protesting to Lower Their Own Salaries. It's an Incredible Act of Leadership



I did say "invented" - didn't I?



Calculating taxes isn't quite as easy as it sounds because what you get for your tax dollar varies between the two countries.

On the other hand, if you want to take a look at comparing "Total Tax Load + Direct Payments for Medical Insurance" between the two countries the results are even less favourable to the US than the simple comparison of "Income Tax Rates" that most people like to indulge in.



In short, we are each trying to convince the other of something different than the other one is talking about.

Time to fall back and punt.

You invented to create a slanted picture to further your agenda. I'm not trying to convince you of anything, but as you point out, I'm not convinced by your invention. The physician's role and compensation is rarely included in a discussion of "free" healthcare, or the costs of insurance, etc. Therefore, my interest, the road less traveled.

 

[TU Curmudgeon]

Nice try. You and your fraudulent source left out the fact that Shouldice is a private for profit clinic outside the Canadian socialized system. Proposed sale of Shouldice Clinic triggers privatization concerns | Apix Performance

Shouldice accepts payments from OHIP so it is not "outside" the Canadian socialized system.

Such clinics are common in Europe and Canada. They are in addition to the U.S. where every European or Canadian who can goes for all their healthcare to avoid Socialized Medicine

There is a difference between "Single Payer - Single Provider" and "Single Payer - Multiple Provider". By and large "Single Payer - Multiple Provider" is a better system. BTW that's the way that MOST doctors operate in Canada - "Single Payer - Multiple Provider".

The US already has (the dreaded) "Socialized Medicine" - it just doesn't have enough of it to cover ALL the needs of ALL Americans the way that the more humanitarian oriented countries do.

 

[TU Curmudgeon]

You invented to create a slanted picture to further your agenda. I'm not trying to convince you of anything, but as you point out, I'm not convinced by your invention. The physician's role and compensation is rarely included in a discussion of "free" healthcare, or the costs of insurance, etc. Therefore, my interest, the road less traveled.

MOST Canadian doctors operate under the "Single Payer - Multiple Provider" system.

Personally I prefer that one to a "Single Payer - Single Provider" one.

The "excess charge" involved in the US system is NOT (directly) in the provision of SERVICES, but rather it is in the provision of INSURANCE that would enable those services to be paid for.

PS - There is no such thing as "free" anything, someone always has to pay for it somewhere. I refuse to use the term "free healthcare" because I know it isn't true and is only a result of sloppy thinking. I don't have any problem with "no direct charge healthcare" because that is an accurate description of ANY "insurance" program be it public, private, for profit, not for profit, socialist, or capitalist.

 

[TU Curmudgeon]

Okaaaaaay....

Another interesting thing that the insurance companies like to sort of overlook telling you when they are telling you how public spirited they are, is what profit they are making through the investments they make of your premium dollars.

They don't mind telling you that the premiums that they collect are just barely more than the payments that they make (which is frequently [practically] true). But they don't want you to know that they are making money on your money while waiting to make those payments. Another thing that the insurance companies like to do is to define "contingencies for future claims" as money that has actually been paid out - which it isn't.

 

[Xelor]

Another interesting thing that the insurance companies like to sort of overlook telling you when they are telling you how public spirited they are, is what profit they are making through the investments they make of your premium dollars.

They don't mind telling you that the premiums that they collect are just barely more than the payments that they make (which is frequently [practically] true). But they don't want you to know that they are making money on your money while waiting to make those payments. Another thing that the insurance companies like to do is to define "contingencies for future claims" as money that has actually been paid out - which it isn't.

Red:

​

Do you take mind altering substances prior to posting in this thread? That insurance companies invest premium receipts to make money isn't and hasn't ever been something "they don't want you to know." Moreover, one'd have to be an idiot think that's not what they do. Everyone invests "excess" cash to so it can make money for them until they have a reason to spend their cash. That anyone'd think that insurers don't or might not is incredibly naive.

• 2010 -- Analysis and Valuation of Insurance Companies
• 1989 -- Analysis of the Capital Structure of an Insurance Company
• 1992 -- Valuation Actuary Symposium Proceedings
• Any year you want --> Look at an insurance company's 10-K, 10-Q or annual reports. You'll see clearly stated their investing of premium revenues.

The fact that you don't look for information doesn't mean it wasn't disclosed or that the information owners "don't want you to know" it. Indeed, in the case of insurance companies' returns on invested premiums, keeping that behavior secret is the last things they'd want to do. They want to attract investors and showing that they prudently and profitably use and invest their cash receipts strikes current and potential investors as a good thing, for the company's raison d'etre is to make profits/money, as much as is possible given the resources at their disposal.

 

[AliHajiSheik]

MOST Canadian doctors operate under the "Single Payer - Multiple Provider" system.

Personally I prefer that one to a "Single Payer - Single Provider" one.

The "excess charge" involved in the US system is NOT (directly) in the provision of SERVICES, but rather it is in the provision of INSURANCE that would enable those services to be paid for.

PS - There is no such thing as "free" anything, someone always has to pay for it somewhere. I refuse to use the term "free healthcare" because I know it isn't true and is only a result of sloppy thinking. I don't have any problem with "no direct charge healthcare" because that is an accurate description of ANY "insurance" program be it public, private, for profit, not for profit, socialist, or capitalist.

That was my understanding of Canadian doctors as well, that is why I was curious in this instance since it was private.