Vic Dura <vpdura[at]XXXhiwaay.net> wrote:
- quote -

I had shoulder surgery (very non-emergency) under HMO plans.
It took about 3 weeks from initial "I think I should see
the surgeon" to post-surgery discharge.

- quote -

ITYM "no insurance-like coverage"; they do get some degree
of care, if they so desire.

Seth

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John D. Goulden wrote:

- quote -

Depends on what you mean by get it free. There are a lot of
people who can't afford health insurance, but they aren't
poor enough to qualify for medicaid. They can get care when
emergencies come up, but they will always get billed for
that unless they qualify as low-enough income.

There is no preventive care available for those who can't
afford it but earn too much to qualify for public benefits.
And even emergency care for them is not free.

Stu

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"John D. Goulden" <jgoulden_news[at]goulden.org> wrote in

- quote -

There is an article in this week's New England Journal of
Medicine by William H. Frist, M.D. (or his staff) entitled
"Health Care in the 21st Century". Here is the url to the pdf:
<http://content.nejm.org/cgi/reprint/352/3/267.pdf
The sidebar of the pdf says:
From the office of Senate Majority Leader William H. Frist,
Washington, D.C. Address reprint requests to Dr. Frist at
the Office of Senate Majority Leader William H. Frist, S-230,
U.S. Capitol, Washington, DC 20510, or at
dean_rosen[at]frist.senate.gov.

Unfortunately, you'll need to sign in as subscriber to NEJM
or pay them "just $29" for 24 hrs of access. I haven't read
the article but the free first 100 or so words are:

Health Care in 2015

I would like you to meet a patient from the year 2015. He
lives in a world in which years ago America's leaders made
tough but wise decisions. They built on the best aspects of
American health care and unleashed the creative power of the
competitively driven marketplace. These changes resulted in
dramatic improvements to the U.S. health care system — lower
costs, higher quality, greater efficiency, and better access
to care.

The patient, Rodney Rogers, is a 44-year-old man from the
small town of Woodbury, Tennessee. He has several chronic
illnesses, including diabetes, hypercholesterolemia, and
hypertension. He is overweight. . . .

<rantPlease remember that the much hated HIPAA regulations
started out as an attempt to make health information
portable, so that you could be properly treated if something
happened far from home. The regulations have become a
terrible set of things you have to agree to if you want
treatment, set in language that most people will have
trouble fully understanding. That was done with the purpose
of protecting confidential information (a good thing (TM),
but much exaggerated).

Once upon a time I thought that common sense was easy to
understand and act upon, but more recently I have been
informed by the housekeeper at work (VA hospital) that
common sense isn't very common at all.

</rant
--
Best regards
Han
email address is invalid

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Mr. Goulden wrote:
[yes, moderator, we are getting further and further OT...
kill the thread if you must...]

Moderator reply:
Socialized medicine is a tax issue.

- quote -

It is unfortunate that many people do not have health
insurance. This is especially problematic among the elderly
(see the annual US Census Bureau "Current Population Survey"
reports for the details) but they can rely on
Medicare/Medicaid for at least a portion of their health
care. However, anyone who needs medical treatment in the USA
can get it, free, at any public hospital, at numerous free
clinics, and from many physicians. Part of the high price
of medical care (and high payroll taxes - so we're sort of
on topic now) is to help defray the costs of such
treatment.

More examples: my general practitioner (the same one who got
me the same-day MRI) volunteers one night a week at a local
emergency room. If the patient doesn't have insurance, he
doesn't charge them (I'm sure he writes it off as a business
loss or something, but the patient pays nothing). One
pediatrician in our community is well know for providing
immunizations and "well baby" checkups free to those without
insurance (he tells me the main problem with this is not the
time or expense, but that his malpractice insurance provider
doesn't like it.) My mother, a retired RN, volunteers at a
church-sponsored free clinic, where anyone who comes through
the door is treated without charge. Virtually all of the
medical supplies at that clinic, from antibiotics to
wheelchairs, are donated by local physicians and hospitals;
many local physicians and nurses volunteer there as well.

No, it's hardly the best system. Problems with access to
health care in this country are among our most pressing
issues. However, the system we have, with all of its
problems, does provide at least basic and necessary care to
anyone who needs it. I would argue that a French- or
Canadian-style system is NOT the way to remedy the problems
with access to health care in the USA.

--
John Goulden

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"John D. Goulden" <jgoulden_news[at]goulden.org> wrote:

- quote -

Yes, there is a great deal of difference in health plans.
That indeed further complicates comparisons and I believe
substantiates my point that you can't simply compare tax (or
any other) rates without meticulously defining what those
rates produce in terms of societal benefits. No doubt very
difficult, but would make an interesting PhD dissertation.

- quote -

I don't think folks with HMO plans see that kind of speed.
Indeed, a very large and growing percentage of people in
this country have no health care at all.

--
To reply to me directly, remove the XXX characters from my
email address.

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- quote -

[getting off topic]

Comparing health care in different countries is also
comparing apples and oranges. Example from personal
experience: I wake up one morning in excruciating pain; get
in to see my general practitioner at 10:00 AM; he determines
what is probably wrong (ruptured disk) and gets me scheduled
for an MRI to nail down the details at 2:00 PM that
afternoon at a local hospital. The MRI results were analyzed
that evening, I got in with the consulting surgeon the next
afternoon to discuss the problem, and I had minor surgery
two days later.

Total cost of this little adventure was well into five
figures; insurance paid for most of it. My friends in Canada
chuckle at the cost but were stunned by the speed; according
to them, the wait for an MRI in Canada can be six to eight
weeks, and that "free" back surgery can require half a
year's advance notice. Given that, I figure the $xxx/month I
pay for family health insurance and a largely private health
system is worth every penny.

--
John D. Goulden

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Oh sorry I moved here from Canada looking for better tax
rates and higher pay ;-)...both are true but not to the
extent I was expecting it ;-)...

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- quote -

Welcome to the USA! Although we moan and groan quite a bit
about it, our taxes are fairly light compared to those of
many other nations. And no VAT!

Your federal tax (1) and state tax (4) are technically
collected once per year, due by April 15. If you didn't move
here until after the first of the year, you don't have to
worry about this until next year. At that time you will fill
out some relatively simple paperwork (if you have questions,
the regulars in this newsgroup are quite helpful, and there
are many free or inexpensive computer programs to walk you
through the process - you can do the entire process online
as well) and either pay what you owe over and above what has
already been deducted or receive a refund for overpayment.
Most people in the USA work things out in such a way that
they get a small refund each year - talk your employer to
discuss your options here. Social Security (2) and Medicare
(3) are payroll taxes which fund some retirement and medical
benefits to people who are retired and / or disabled. The
deduction for insurance obviously pays for your health
insurance (the overall quality and availability of medical
care in this country, in my humble opinion, is second to
none). Other deductions you don't mention might be for an
appropriate retirement plan (you're never too young to start
planning for retirement) or a stock program, if your
employer offers one. Nearly half of my gross pay goes to
taxes, health insurance, 403b retirement plan, S500
medical-expense plan, and other various expenses /
deductions. You get used to it after a while.

- quote -

--
John D. Goulden
(not a cpa or lawyer, just a taxpayer...)

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If you are indepedent worker or run your your business you
are responsible for paying these by yourself instead of
paycheck deduction. One of the biggest surprises for people
just starting out independently is some of them forget set
such funds aside and may see a huge tax bill at filing time.

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Dick Adams <rdadams[at]smart.net> wrote:

- quote -

That certainly seems to be the case, but I wonder if that is an
"apples to oranges" comparison?

For example, I believe that taxes in many European countries
pay for health-care. Whereas here in the U.S., we have to
pay that ourselves. I pay $797/month for an 80% coverage
policy for my wife and I. (We don't smoke, are not
over-weight and are pretty healthy. I wouldn't be surprised
if many others pay a lot more than that). IMO to compare
U.S. and European taxes, that $797/month would have to be
added to our tax bill. Then, as you mention, some countries
with high tax rates do not as a matter of unofficial policy
( ...don't ask, don't tell... ) put a lot of effort into
enforcement.

It seems like reasonably accurate comparisons would be very
difficult to make without taking into consideration a lot of
complex social factors.

Is anyone aware of any studies that have tried to account
for such factors?

--
To reply to me directly, remove the XXX characters from my
email address.

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dan_mihai[at]hotmail.com says...

- quote -

Welcome to the USA.

As to the deductions:

1. Yes
2. Yes (on the first $90,000 of earnings this year
from the same company)
3. Yes
4. Yes, in 43 of the 50 states.

You may have noticed that the things you buy in stores cost
less. We do have sales taxes in most states, but no VAT.

Gary

--
E-mail to the above address is rarely read. If you want to
contact me directly, please send an e-mail to: gary at
gdgoodman dot com.

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dan_mihai[at]hotmail.com says...

- quote -

You did not include the country from which you came. In my
travels, I have found taxes in European countries to be
outrageously high and then VAT on top of that.

Believe it or not U.S. taxes are low when compared to
other developed countries - except possibly for France
where you can engage in tax evasion and then ask for
tax forgiveness.

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Hi, I just moved to the US and got my first paycheque...are
the following the regular/common deductions:

(1) federal tax
(2) social security
(3) medicare
(4) state tax

These are the major deductions I see, plus there are a few for the
medical/dental/insurance plans with the company, but (1) - (4) are taking
quite a bit off the overall pay ;-(.

THANKS!!!

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