Canadian vs. American Health Care II

Let's do more numbers on this topic...

Consider an affluent family, an older couple with dependant children forming a household, making $150,000 annually, and paying for family wide health insurance.

In the U.S. their federal tax is $34,177.5 annually. Let's say they're tax conscious so they live in Nevada making their state and local taxes $0.00. Their insurance premiums are going to be quite high being older and having a family. Still lets say just the 2000 average, of $6,772 annually. They pay about $41,000 in taxes and premiums…

In Canada, this same family pays $34,482.77 in federal taxes annually. Not as much difference there as one might expect… This same tx conscious couple now lives in Ontario. Their provincial taxes are $14,213.25 annually… A huge difference! They pay a total of almost $49,000 annually in taxes and premiums… A difference of more that $8000 above that by the U.S. family…

While I have to say, I find a difference of $8000 to be quite large, I have to admit that, like most Americans, I don't live in Nevada. On an income of $150,000, the taxes in Ohio would be $9750… The family would be about than $1750.00 in the red for living in Ohio rather than Ontario…

Most Americans do live in Ohio or a state with comparable state taxes and the wealthy families, like the median income families, pay more than their Canadian counterparts for doing so. Where's the margin here? It seems that something other than financial concerns are the motivating factors.

Whatever it is, people don't stay in the U.S. for the quality of care. Most industrialized nations use socialized medicine or socialized insurance of some form or another; the U.S., Turkey, and Mexico are the odd birds. Those nations with socialized care or some form are not itching to change on either a national or individual level. If their care were substandard to the U.S.'s care, they'd switch to our system or be trying to do so. Nobody is. That silence, that lack of effort to change is a profound indicator of satisfaction with the quality of care elsewhere.

For more quantitiative data, look at the United Nations statitstics on health care. http://unstats.un.org/unsd/cdb/cdb_simple_data_extract.asp
Pick a variable, the U.S. comes in second to Canada on any relevant metric you might choose… To be fair, there are care metrics NOT tracked by the UN in which the U.S. does score better, heart attack victim mortality being just one. http://circ.ahajournals.org/cgi/content/full/110/13/1754

Quality and cost seem to be very close to a wash for most citizens.

Private Parts

I recently made a trip to a local gun club. As one might imagine, a gun club is not a hot bed of liberal sentiment.

While I was in the club office, the range warden was holding forth on a political matter. To paraphrase his position, he stated that because he had nothing to hide, he not only didn't object to government surveillance (wiretapping); he welcomed it…

I was shocked. I had expected that a representative of an organization which had such a vested interest in gun ownership and gun freedom would have embraced political views which cleaved closer to more conservative ideals. In retrospect, I've begun to understand that there is more than a little confusion on this topic. The "I've nothing to hide" (INTH) group seems to believe that government surveillance is harmless to those with nothing to hide, is a potential aid to discovering potential bad actors, and therefore necessarily has a very high (infinitely high?) benefit to cost ratio.

The problem with this reasoning is the unusually narrow scope tacitly assigned to of the utility of privacy. It assumes that privacy is only useful for obfuscating bad/criminal actions. I submit that isn't the case at all; Americans have taken a VERY broad view of privacy, legal and otherwise, for generations. A time long enough for broad privacy to be an American legal tradition which courts of all kinds take under consideration. I've asked a few people about their attitudes toward privacy and gotten answers which reflect a broad view: privacy is valuable even if one has nothing to hide such that surveillance is a burdensome violation even for those with nothing to hide.

Example 1: I've got translucent glass in my bathroom window, that wavy glass that destroys image resolution but allows light to pass. I'm pretty sure my neighbors like it that way and so do I. Not that I have anything to hide, if they want to watch, let them. If they're really all that curious, I'll set up seats and sell them tickets and popcorn. I just prefer my privacy; I value it even though I don't really have anything to hide.

Example 2: How would you feel if merchants followed you around their store as you shopped? You wouldn't be doing anything wrong, just shopping… But being followed seems like an invasion doesn't it? Wouldn't it be worse if it were just *certain* shoppers? Wouldn't you feel like you were being flagged for wrongdoing? Wouldn't it make you uncomfortable enough to start shopping elsewhere?

Example 3: I notice a real paucity of people publishing the contents of their medicine cabinets, the contents of their wallets, their library lists, their credit cards purchases. All of the houses on my street have curtains or blinds or both… People seem to believe that their privacy is a layer of protection from people they don't trust. Even if that protection is illusory, illusory protections provide real comfort to those poor slobs clueless enough to rely upon them. If they weren't, all those TSA screeners at the airports would be unemployed. Stripping people of their comforts, seems like real harm.

Example 4: Should you have to tell everyone about every embarassing thing that has every happened to you? What about situations that you've been in which would SEEM illegal, immoral, etc. at first blush? Isn't it of real comfort to know that facts which are prone to misinterpretation or are otherwise disreputable can be kept secret?? Harm to reputation, personal, professional, or otherwise is recognized as real harm at law; stripping people of a layer of protection for their reputations seems to open them to harm.

Example 5: Information is valuable. Corporations have trade secrets (phone lists, formulae, etc.) Inventors want to keep their projects private until they patent them. Writers want to keep their latest books or movies secret until they go on sale in order to build suspense and interest. Corporations pay millions for consumer data lists. Shouldn't data about one's own self, information which has potential value to a buyer, whether of consumer data, or titillating voyeuristic information, or whatever, be something that a person should be able to protect because it has value? If I could sell the data if I chose, might it not be my intellectual property? Isn't taking (or converting) valuable information (or intellectual property) without due process a violation of the Fourth Amendment?

Privacy is a much broader collection of rights than the right to hide wrongdoing, if you give away your privacy you've opened your property, reputation, freedom, and maybe your life itself to auditing or maybe seizure by any agent who cares to take an interest. Worse, you're not just opening it to the people presently empowered; if you destroy privacy protection, you're opening it to everyone who get into power in the future...

I don't mean to jump to conclusions, but I imagine that the range warden at my local rifle club would be much more concerned about his privacy (and maybe his right to bear arms) if he knew that, in just a few short years, President Hillary Clinton might be listening in…

Canadian vs. American Health Care

You know how you always hear "Well, taxes are REALLY HIGH in Canada" in response to any argument about how their social services might fare better than U.S. services?? Is this really the case for the average person? That is, would the average U.S. couple be better off under the U.S. system or the Canadian system in terms of money left over after taxes and insurance??

Let's make some estimates with actual data…


It looks like the highest combined Canadian Federal and Provincial tax brackets is not quite 46.95%. That's 29% Canadian Federal plus 17.95% New Brunswick Provincal. http://www.cra-arc.gc.ca/tax/individuals/faq/taxrates-e.html

By comparison in the U.S., the highest federal bracket is 35%. http://www.irs.gov/formspubs/article/0,,id=150856,00.html

Of course, lots of STATES have income taxes too. Some states don't but the vast majority do… Taking a swing at an average (in my head) for the highest bracket, I'm going to say it looks like about 6.5%... Ohio is a VERY average state for the U.S., their highest income tax bracket for 2007 is 6.555%. I'll use 6.5%... http://tax.ohio.gov/documents/forms/ohio_individual/individual/2006/PIT_IT1040_Instructions.pdf

Let's not forget LOCAL taxes. In the area in which I live, there are lots of suburbs with their own rate, they average about 2%.

The average annual health insurance premium in 2000 was $2,655 for single coverage and $6,772 for family coverage in private-sector establishments. http://www.ahrq.gov/news/press/pr2002/insprepr.htm

That last figure is for family coverage and so is higher than the other figure but those figures are also seven years old. Given that health insurance premiums have been rising dramatically over the last few years, I'm going to use the last figure. http://www.cbo.gov/ftpdoc.cfm?index=5152&type=0

Note also that these figures will go up dramatically as you age. http://www.ahipresearch.com/pdfs/Individual_Insurance_Survey_Report8-26-2005.pdf

An average couple in the U.S. making the median U.S. household annual income earns 48,201.00. http://pubdb3.census.gov/macro/032007/hhinc/new04_001.htm
Neglecting tax credits, shelters, etc. for sake of simplicity, they pay 6475.15 in Federal Income Tax. If they live in the state of Ohio, they'll pay another 1617.00 in State tax. They can probably count on a local tax bill of around $964.00. For an approximate bill of $9000.00. If they want insurance, they're looking at another $6000 in premiums! $15,000 per year total.

In Canada, our couple makes a bit less (Thank you Federal Reserve Board). Let's say about $48,000 Canadian. Again neglecting tax credits, etc. they'll pay $8143.43 in Federal Income Tax. Taking Alberta's tax rate (because it's easy) of 10% for everyone, the couple pays another $4800.00 for a tax bill of 12943.43… Of course, in Alberta residents are covered by the Canadian Health Care Act. http://hc-sc.gc.ca/ahc-asc/media/nr-cp/2002/2002_care-soinsbk4_e.html
While there are some services which permit "Extra-Charging", these fees are small, on the order of co-payments common in U.S. care, and will be similarly neglected.

It looks like our young couple comes out ahead by a few grand in Canada…

Two final points:
1) As health care cost rise in the U.S., this disparity is only going to get bigger.
2) For those individuals who suspect that Canadian health care is "Like going to the DMV", have you TRIED to get an appointment with a specialist in the U.S. recently? Long waits are quite common in the U.S.; you can easily wait MONTHS to see a good specialist... The DMV would be an improvement.