BC's Declining Healthcare: Man Sells Everything to Pay for Brain Surgery in the US

[etsen3]

There's bad breaks, untimely job loss, denied insurance claims etc, but I bet the majority of Americans who go broke because of medical bills is due to plain and simple financial mismanagement.

You live in a country with world beating buying power, set aside some money for medical contingencies.

 

Medical bills can be huge though.  Hard to save up that cash, could take years and if you're living paycheck to paycheck, good luck.

[Electro Rock]

Medical bills can be huge though.  Hard to save up that cash, could take years and if you're living paycheck to paycheck, good luck. 

You can save up money in the U.S. at any income level more easily than you can any other wealthy nation.

I've had enough saved to pay for OP's surgery cash, imagine what I could do if I didn't have to pay with .77 dollars, paid $500 a month less in taxes, paid 30-40% less for most goods and services, only had to pay like $500 a year for car insurance, etc etc?

Not to mention, if you're poor in the U.S. and you don't have a good reason as to why, you're a loser point blank. 

[Jaimito]

If the pineal cyst is large enough to cause the headache, the surgeons will treat it.  they don't refuse because the government is not paying, but surgeons will refuse when it is not indicated.  for that particular medical paper they sited, it is also select individuals that might be benefit from the surgery.  the newspaper article said he didn't even see a neurosurgeon yet.  that's an access to specialist issue. 

If he wants to remove it on elective basis, then save the money and pay for it.  it will be the same in US.  insurance company there will reject his claim if it is not medically indicated. 

[Oregon Canucky]

There's bad breaks, untimely job loss, denied insurance claims etc, but I bet the majority of Americans who go broke because of medical bills is due to plain and simple financial mismanagement.

You live in a country with world beating buying power, set aside some money for medical contingencies.

 

Wow, That is so not true that it is sad. Heres my simple breakdown...

I make 36,000 a year or (3000 a month) 

I LITERALLY pay 1/3 of my income to taxes,retirement, social security and insurance fees (150 bucks a month for insurance)

So, I take home 2 grand a month.

my rent in portland oregon is LITERALLY 1100 for a 2 bedroom apt in a rough neighborhood.

that leaves me 900 bucks for food, utilities, car insurance etc

----------------------------------------------------- 

My Insurance pays about 60% of my bills until im at 5,000 out of pocket. then it picks up 100 percent until the year ends.

If i dont have to pay interest i still have to make a medical payment of 416.66 bucks a month to get that 5,000 paid off before next year.

 

Trust me, it isnt MOSTLY money mismanagement. When i made minimum wage, i litterally brought home about 1400 a month (not paying into insurance or retirement)... so much for seeing a doctor. heh.

[Electro Rock]

Wow, That is so not true that it is sad. Heres my simple breakdown...

I make 36,000 a year or (3000 a month) 

I LITERALLY pay 1/3 of my income to taxes,retirement, social security and insurance fees (150 bucks a month for insurance)

So, I take home 2 grand a month.

my rent in portland oregon is LITERALLY 1100 for a 2 bedroom apt in a rough neighborhood.

that leaves me 900 bucks for food, utilities, car insurance etc

----------------------------------------------------- 

My Insurance pays about 60% of my bills until im at 5,000 out of pocket. then it picks up 100 percent until the year ends.

If i dont have to pay interest i still have to make a medical payment of 416.66 bucks a month to get that 5,000 paid off before next year.

 

Trust me, it isnt MOSTLY money mismanagement. When i made minimum wage, i litterally brought home about 1400 a month (not paying into insurance or retirement)... so much for seeing a doctor. heh.

Make more money or find cheaper digs, or both, its much easier to make it happen where you are than in Vancouver, or really most of Canada period. 

Last year an Oregon based manager that I just met offered me a $70K a year job, I couldn't take it because visa but you don't see those kinds of opportunities here in Vancouver, with its economy 45% smaller than the smaller city of Portland's, unless you're entitled special people. 

My income is considerably higher than yours but my takehome is only a few hundred higher, in a place where nearly everything costs more, where I'd be paying $1100 to rent a freaking bachelor in a crap neighborhood. 

[taxi]

Make more money or find cheaper digs, or both, its much easier to make it happen where you are than in Vancouver, or really most of Canada period. 

Last year an Oregon based manager that I just met offered me a $70K a year job, I couldn't take it because visa but you don't see those kinds of opportunities here in Vancouver, with its economy 45% smaller than the smaller city of Portland's, unless you're entitled special people. 

My income is considerably higher than yours but my takehome is only a few hundred higher, in a place where nearly everything costs more, where I'd be paying $1100 to rent a freaking bachelor in a crap neighborhood. 

The solution in Vancouver always seems to be to raise another tax, but then give nothing back in return. Take our gas for example (which has the highest cost in North America):

http://www.vancitybuzz.com/2015/03/vancouver-highest-price-gas-north-america/

17 cents for a "translink tax"

6.67 for a "carbon tax"

Then the regular fuel and service taxes on top. Yet, I have not seen any change or upgrades to our Translink system.

[taxi]

Government isn't groceries, what every single person gets out of it varies. People next door to each other could be using vastly different amounts of federal funds. We are all getting two days worth of groceries out of our federal government, though. You can go anywhere in the country and have a comparable quality of life, and your federal tax burden won't change.

In this case, nothing is going "back" to the provinces. The money was never the province's, was never included in any provincial budgets, or is in any way related to the province where it was collected. 

Tell me, what is the shortfall for the province? What other taxes get collected to make for it?What do we in BC pay for in Ontario? Seems you me you're conflating a handful of separate issues in order to be mad about this. 

BC has lots of shortfalls. This thread was about a shortfall in the medical system. We are in massive need of an upgrade to our mass transit system. Meanwhile, Toronto is getting their upgrades to their subway system. Various industries in BC are in serious trouble, but the federal government is subsidizing manufacturing in Ontario. Don't get me started on the financial and banking sectors in Toronto and why our tax money shouldn't be going there.

I honestly don't know how to make this any simpler for you. If everyone pays $20k in taxes, but then residents in some places get more of that money than others, it's unequal distribution and some residents are giving money to other residents. It would be one thing if there were actually people facing economic hardship in Toronto vs. an excess in Vancouver, but that's not happening.

[Oregon Canucky]

Make more money or find cheaper digs, or both, its much easier to make it happen where you are than in Vancouver, or really most of Canada period. 

Last year an Oregon based manager that I just met offered me a $70K a year job, I couldn't take it because visa but you don't see those kinds of opportunities here in Vancouver, with its economy 45% smaller than the smaller city of Portland's, unless you're entitled special people. 

My income is considerably higher than yours but my takehome is only a few hundred higher, in a place where nearly everything costs more, where I'd be paying $1100 to rent a freaking bachelor in a crap neighborhood. 

While i get what youre saying (and i make more money every year) and there ARE opportunities for more pay (but not cheaper digs) the problem is when youre in between. When i made minimum wage and attended college (so i could get higher pay) i could see NO DOCTOR. not for the flu, broken bones, dentistry, medication.... nothing... then i couldnt see a doctor even after i landed a job that paid 2 bucks over minimum wage.

I get that governments suck at running things, they just do... but if the US is supposed to be so great, how come our fulltime workers (making over minimum wage) can not afford and apartment or a doctor?

Per https://www.portlandoregon.gov/phb/article/522288

a high % of individuals make less than 40g a year (3333 a month before taxes)

and according to https://www.rentjungle.com/average-rent-in-portland-or-rent-trends/

average rental on a 1 bed place is 1323

 

 

[taxi]

While i get what youre saying (and i make more money every year) and there ARE opportunities for more pay (but not cheaper digs) the problem is when youre in between. When i made minimum wage and attended college (so i could get higher pay) i could see NO DOCTOR. not for the flu, broken bones, dentistry, medication.... nothing... then i couldnt see a doctor even after i landed a job that paid 2 bucks over minimum wage.

I get that governments suck at running things, they just do... but if the US is supposed to be so great, how come our fulltime workers (making over minimum wage) can not afford and apartment or a doctor?

Per https://www.portlandoregon.gov/phb/article/522288

a high % of individuals make less than 40g a year (3333 a month before taxes)

and according to https://www.rentjungle.com/average-rent-in-portland-or-rent-trends/

average rental on a 1 bed place is 1323

 

 

Healthcare should definitely not be private. The issue is that although the government sucks at running things, you can't have health care based on supply and demand. When your really sick, you'll pay anything to get better, and a private healthcare system will abuse the @#$@# out of that.

[Oregon Canucky]

Healthcare should definitely not be private. The issue is that although the government sucks at running things, you can't have health care based on supply and demand. When your really sick, you'll pay anything to get better, and a private healthcare system will abuse the @#$@# out of that.

Yeah i dont think either of us have the answer. I just know that no matter how you slice it were both being done pretty dirty... One thing that stuck with me is after i procured insurance, i ran to the dentist to try to catch up on my dental care...

The sign outside said "New patients 20 dollars for exams an Xrays!"

I was like Hell yeah! so i go in and do it... They say, okay so you insurance is covering some of this but you still owe us 50 bucks to see us today." I said "excuse me there must be a mistake. your sign outside says..." She cut me off at that point and said, "oh thats for people without insurance"

I was LIVID for more reason than one... Im paying more for having insurance than i would if i had kept that pretty card in my wallet AND they can charge my insurance whatever they feel like charging, and someone else a completely different amount. My 50 bucks pays for the next few people that dont have insurance i guess.

[kazin!]

Good debate by all so far and a surprisingly educated one given CDC's typical posters.

In regards to the patient, it is very unfortunate that he hasn't been able to see a neurologist. Like Jaimito said, that's an access issue. If the neurologist green light-ed the procedure, it'd be covered. The patient needs to advocate for himself to get expedited access to a neurologist, whether it be by being persistent or by finding an advocacy group of some sort. You CAN get expedited referrals to specialists if your condition is dire; ask my brother...

Obviously it's easy to say as an outsider that isn't going through the symptoms he's experiencing, but it almost sounds like he didn't do all he could to advocate for himself and is immediately going to the last resort of selling off everything and going to the States for an expensive procedure that has no guarantees. When emotion is included in decisions, it generally clouds judgement. The pain can't be helping either.

In regards to our public system, it is what it is. It needs a major overhaul. As people have said, there's bureaucracy, there's poor access, there's not enough capacity, there can be poor quality of care. As someone who works in health care administration, the absolute truth is that there is no need for a more distinct two-tiered (public/private) health care system in Canada (yes, this already exists. See: Vancouver Canucks players who get surgery immediately). The solution, then, is to change physician remuneration. The vast majority of physicians in Canada are compensated using fee-for-service. This mean they bill the provincial insurance plan for each service they render and are paid by the province. Why is this an issue? It encourages overbilling and to chug patients through their clinics like they're high throughput factories; the more patients they see the more they make. Much research has been done on physician remuneration and I side with the literature  for capitation or some other blended model. Fee-for-service just doesn't work in this day and age. Unfortunately, the physicians are an extremely powerful political group and I highly, highly doubt this will change unless there is extremely strong federal leadership. At this point, though, it appears that the federal government (whether it is the Liberals or would've been the NDP or Conservatives) want to just look for cost-savings within the current system. This isn't a bad thing, but it's only going to help slightly.

[taxi]

Good debate by all so far and a surprisingly educated one given CDC's typical posters.

In regards to the patient, it is very unfortunate that he hasn't been able to see a neurologist. Like Jaimito said, that's an access issue. If the neurologist green light-ed the procedure, it'd be covered. The patient needs to advocate for himself to get expedited access to a neurologist, whether it be by being persistent or by finding an advocacy group of some sort. You CAN get expedited referrals to specialists if your condition is dire; ask my brother...

Obviously it's easy to say as an outsider that isn't going through the symptoms he's experiencing, but it almost sounds like he didn't do all he could to advocate for himself and is immediately going to the last resort of selling off everything and going to the States for an expensive procedure that has no guarantees. When emotion is included in decisions, it generally clouds judgement. The pain can't be helping either.

In regards to our public system, it is what it is. It needs a major overhaul. As people have said, there's bureaucracy, there's poor access, there's not enough capacity, there can be poor quality of care. As someone who works in health care administration, the absolute truth is that there is no need for a more distinct two-tiered (public/private) health care system in Canada (yes, this already exists. See: Vancouver Canucks players who get surgery immediately). The solution, then, is to change physician remuneration. The vast majority of physicians in Canada are compensated using fee-for-service. This mean they bill the provincial insurance plan for each service they render and are paid by the province. Why is this an issue? It encourages overbilling and to chug patients through their clinics like they're high throughput factories; the more patients they see the more they make. Much research has been done on physician remuneration and I side with the literature  for capitation or some other blended model. Fee-for-service just doesn't work in this day and age. Unfortunately, the physicians are an extremely powerful political group and I highly, highly doubt this will change unless there is extremely strong federal leadership. At this point, though, it appears that the federal government (whether it is the Liberals or would've been the NDP or Conservatives) want to just look for cost-savings within the current system. This isn't a bad thing, but it's only going to help slightly.

what are you suggesting as the alternative to fee for service? Flat salaries? Hourly wages?

The alternatives seem just as open to abuse.

 

[kazin!]

what are you suggesting as the alternative to fee for service? Flat salaries? Hourly wages?

The alternatives seem just as open to abuse.

 

Yes, I agree that all payment schemes are subject to abuse; that's just human nature. The best, though, would probably be a blended model that sought to reduce such abuse. As it is, FFS does not suit our system well and I don't think many people would disagree.

[Lockout Casualty]

BC has lots of shortfalls. This thread was about a shortfall in the medical system. We are in massive need of an upgrade to our mass transit system. Meanwhile, Toronto is getting their upgrades to their subway system. Various industries in BC are in serious trouble, but the federal government is subsidizing manufacturing in Ontario. Don't get me started on the financial and banking sectors in Toronto and why our tax money shouldn't be going there.

I honestly don't know how to make this any simpler for you. If everyone pays $20k in taxes, but then residents in some places get more of that money than others, it's unequal distribution and some residents are giving money to other residents. It would be one thing if there were actually people facing economic hardship in Toronto vs. an excess in Vancouver, but that's not happening.

The taxes are collected from individuals. It makes no sense to then arbitrarily question their application to regions. Also, for the record, a shortfall is when you have a budget, but you fall short. The spending reflects the budget, and therefore any extra funds would not necessarily be used where you're implying they would be. In other words, there are no shortfalls. You're misrepresenting the situation. Again. 

I don't know how to make it any simpler for you, but if everyone pays 20k in taxes and there are people across the nation that benefit to a greater tune than 20k, it means residents everywhere have access to more than their share of the tax burden is worth. You can argue the federal government does not spend enough in the west, but it's ridiculous and dishonest to suggest the west is subsidizing anything, anywhere. Taxes aren't collected from the west. They're collected from individuals. Equally.

[taxi]

The taxes are collected from individuals. It makes no sense to then arbitrarily question their application to regions. Also, for the record, a shortfall is when you have a budget, but you fall short. The spending reflects the budget, and therefore any extra funds would not necessarily be used where you're implying they would be. In other words, there are no shortfalls. You're misrepresenting the situation. Again. 

I don't know how to make it any simpler for you, but if everyone pays 20k in taxes and there are people across the nation that benefit to a greater tune than 20k, it means residents everywhere have access to more than their share of the tax burden is worth. You can argue the federal government does not spend enough in the west, but it's ridiculous and dishonest to suggest the west is subsidizing anything, anywhere. Taxes aren't collected from the west. They're collected from individuals. Equally.

Except...they are literally taking money from people in the West via taxation and then redistributing it to people in the East. For example if 5% of my paycheck is taken off and then given to someone in the East, that is not a payment to the East?

[Lockout Casualty]

Except...they are literally taking money from people in the West via taxation and then redistributing it to people in the East. For example if 5% of my paycheck is taken off and then given to someone in the East, that is not a payment to the East?

Except.. that's not what happens in reality. They take money from everyone and use it where it will have greatest impact, while maintaining national standards (at least that's how it should work, the the fault isn't with the system, but a given government not acting in the spirit of said system). And they don't redistribute it to people in the east. I've said it before, an individual in the west could be using a greater amount of federal resources than they contribute just as an individual in the east.

Your example is in line with the rest of your argument - not based in reality. 

[taxi]

Except.. that's not what happens in reality. They take money from everyone and use it where it will have greatest impact, while maintaining national standards (at least that's how it should work, the the fault isn't with the system, but a given government not acting in the spirit of said system). And they don't redistribute it to people in the east. I've said it before, an individual in the west could be using a greater amount of federal resources than they contribute just as an individual in the east.

Your example is in line with the rest of your argument - not based in reality. 

Greatest impact?

We need the money everywhere. Instead of spending it on healthcare in BC. they are propping up investment banking and manufacturing in Ontario. That's reality.

[Lockout Casualty]

Greatest impact?

We need the money everywhere. Instead of spending it on healthcare in BC. they are propping up investment banking and manufacturing in Ontario. That's reality.

Yes, greatest impact for the nation. That's what the federal government does. The money that goes to Ontario manufacturing or what have you would never be used for healthcare in BC. Healthcare transfers are not tied to the individual tax burden of BC residents. 

Like I said a week ago, you're conflating issues.