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One ambulance trip can easily cost $8,000. Now you are down to $20,000 for the year - hope you didn't have any kids.

But the point isn't whether $28k is livable in Nebraska, but how it compares to what people used to get back in the day.




Honest question: does that still cost $8,000 under Obamacare?

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What's Obamacare? My life hasn't changed.

And when Obamacare kicks in, my healthcare life will still be fundamentally managed by insurance companies, with somewhat changed regulation around the margins but still extremely profitable.

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The margin on health insurance companies is like 8%.

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You have to be careful there, because some of the largest consolidated insurance providers are nonprofits that are incentivized to maximize overhead (to the benefit of internal executives and managers). The ones that aren't have to compete with the ones that are.

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Very true.

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FWIW, I used to work on an ambulance and when the person didn't have insurance the cost was $500, not $8000. Not sure what we billed insurance though. Oh, and if they couldn't pay, we didn't follow-up. They were sent one bill and that was it.

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I've always heard that was because medical debt was legally very difficult to collect, true?

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So screw it.

I'm sorry but we can't constantly let the price of medicine / medical care drag down the world's economy as a whole.

"We've got this medecine that shall raise your life expectancy by one year if you have a cancer and it cost $20 000, let's offer everyone this".

"We've got this medecine that shall raise your life expectancy by two year if you have a cancer and it cost $100 000, let's offer everyone this".

"We've got this medecine that shall raise your life expectancy by three year if you have a cancer and it cost $100 000 000, let's offer everyone this".

"We've got this medecine that shall raise your life expectancy by four year if you have a cancer and it cost $100 000 000 000 000 000, let's offer everyone this".

Where do you put a limit of what's acceptable?

In the end it all comes down to death tables and one day politicians and everyday people will understand that.

If 99 persons can live decently with $28 K and the hundredth one can't pay the $8 K ambulance, so be it.

Because, in the end, it all comes down to death tables and we can't allow totally overpriced and unjustified crazy high medical (and related) cost, like a $8 K ambulance trip, ruin down the entire world's economy.

Also it would be nice if these arbitrarily high medical price ween't constantly used as a form of intellectual terrorism justifying more and more debt creation.

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You absolutely can.

It's about returns to worker productivity. As the article mentions, factory workers are hundreds of times more productive than they were in the 1960s. They are probably thousands of times more productive than they were in the 1760s.

How much has worker productivity increased in, say, symphonic music? In the last 300 years, I would guess it has perhaps doubled, if that (amplification) And yet symphonic concerts still happen, despite costs increasing without bound!

Medical costs rise because new services are available, but worker productivity rises slowly. Medicine may be a larger and larger fraction of the economy, but as long as worker productivity rises in OTHER fields, we will still be able to afford it.

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If only it were as simple as pill = dollar = life expectancy.

All I have to say is I'm happy to live in Canada and don't worry about these things.

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Glad I don't have your taxes, though.

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I love our Medicare system (Canadian) because it creates a peaceful feeling of reassurance. You show your Medicare card and you are good to go, no paperwork, no bills, nothing. It's hard to explain that feeling, the hospital is not a scary place, it is a safe place. It's there to help you. You just go to the doctor when you are sick, no big deal.

On average, we pay roughly 30-40% Income Tax. The less you make, the less you are taxed. If you make less than $38,000 in my province, you would pay something like 24% (15% federal tax + 9% provincial tax - http://www.cra-arc.gc.ca/tx/ndvdls/fq/txrts-eng.html). And if you make more you get taxed more, but it's reasonable.

Honestly, when you grow up here, you just get used to it. It comes off the paycheck just like retirement savings and employment insurance, and you don't think about it.

I'm a proud Canadian, equal healthcare for everyone is a value we share and I think it's worth paying for.

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When I add together my taxes plus the health insurance premium that comes out of my paycheck, my net take home is probably less than what it would be in Canada. Sure I have the choice to not pay for health insurance, but that's an illusory choice. I've got a wife and a kid--I'm not going to opt out of health insurance.

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Except that tax rates in canada are about the same as they are here in the states.

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