Fiscal Cliff Folks Debate Social Security & Medicare “Fixes”

Category: Financial and taxes in retirement

December 19, 2012 — Legislation coming out of Congress in the next few weeks is likely to affect all Americans. Most of our federal tax rates will either stay the same, or we will fall off the fiscal cliff and rates will go up. As both parties state and restate their positions, there have been some new proposals that could potentially affect both social security and Medicare, both popular programs for baby boomers. Also in the news – cars that make driving easier for aging baby boomers.

Medicare
The latest proposal being discussed to help keep Medicare solvent is to raise the eligibility age for Medicare from the current 65 to 67 years of age. It does have the virtue of saving a program money for a program that is headed for serious trouble in the near term (the latest estimate is that Medicare trust funds will be exhausted in just 11 years, 2024). But most folks think this proposal will get nowhere, as organizations like AARP are vehemently against it. The President is said to have taken this idea off the table. If the change in eligibility were made, it would affect millions of people in a negative way (although such important changes usually do not affect people already near the eligibility age).


Social Security Chaining
Indications are that President Obama and some Democrats have warmed up to the idea of a “chained” consumer price index. This approach would result in lower Cost of Living Adjustment (COLA) payments to Social Security recipients. The theory assumes that consumers faced with rising prices for some expenses will shift to less costly substitutes, which means that the COLA does not go up as fast. Some opponents of this approach (and there are many) refer to this as a “Diet COLA”, saying that seniors have many more inflationary pressures than the CPI measures. The impact of Social Security on the federal budget is theoretically neutral, as it is meant to be a self-funded program. Nevertheless, current estimates are that the program will only be able to pay out about 75% of promised benefits in 2033, unless changes are made. MarketWatch has more on the Chained CPI Developments.

Cars for Aging Baby Boomers
We had to mention this popular story about baby boomers and their cars. Seems car manufacturers are making cars a lot easier and safer to drive, just in time for us baby boomers and our declining skills. Cars can now park themselves, give alerts about cars in blind spots, following too close, etc. The marketing approach: For heaven’s sakes don’t say they are for seniors, they are just “easier” to drive. See “Drive These Cars (Before They Drive You)”.
For further reading
What You Think You Know About Social Security Might Hurt You

Comments: Please add thoughts and comments below about changes to Social Security and Medicare that might help save the programs and keep them solvent – Washington could use a few good ideas!

Posted by Admin on December 18th, 2012

49 Comments »

  1. Another trend in cars that boomers will likely adopt will be the electric vehicles such as the Volt and Leaf. Retirees already are familiar with electric vehicles. In some retirement communities, golf carts are the main source of transportation. Many of these are electric so it’s not a great jump to an electric vehicle. Just read a story yesterday about the first Volt owner. He has had the car for 2 years and only used 26 gallons of gas and no maintenance issues. That sounds like something I might like after I’m done with my daily commuting to work.

    by LS — December 19, 2012

  2. I would love to see the age eligibility for Medicare reduced, not raised, with a premium that the earlier users would pay in full. Health care is the huge unknown for those hoping to retire before conventional age. These days they say that sitting behind a desk all day is worse for your health than smoking, and yet it is implied that those on desk jobs should be healthy enough to work into their 70’s. Younger retirees paying full price will hopefully be and stay healthier, using the program less while paying in more. This will also free up jobs for those looking to work.

    by Julie — December 19, 2012

  3. In reagrds to the vehicle article, when I move to a retirement community (hopefully the ‘Rock Till Ya Drap’ village) I would like to reduce my monthly expenses by getting rid of my vehicles, insurance, gas, and maintenance. I would like to see a community that offers a free shuttle service (part of monthly fee) to take me into town when I need to go or run me to the airport. I really see my need for a dedicated vehicle dropping significantly when I retire, even if I work part time.

    by Jerry — December 19, 2012

  4. And in regards to raising the eligibility age for Medicare… are they crazy. If anything, we should be having a REAL discussion about lowering it and what it would take to increase the payroll deduction to make it happen. This idea about raising the retirement age is just as crazy… hardly have enough jobs for folks and if corporation continue to cut or do away with medical benefits, medical cost will (and are) quickly depleting folks retirement savings. Politicians want us to believe that terrorism is threat to the US but in reality, healthcare will bring this country to it’s knees. Just look around… we, young and old, are all getting fatter and if we don’t start to be proactive regarding out health starting at a very young age, we are in for some real hard times. Can anyone say Wall-E (great social commentary movie even if it was animated)

    by Jerry — December 19, 2012

  5. The medicare payroll tax is 1.45% of hourly pay. Would it really cause the economy to collapse if it was raised to 1.55%? An individual making $25 per hour currently pays $0.3625 per hour into medicare. Raising the rate to 1.55% increases it to $0.3875 or 2.5 cents per hour or $1.00 per forty hour work week.

    by Pat Schiermeyer — December 19, 2012

  6. Asking folks to contribute more to keep SS and Medicare solvent makes perfect sense to me. I know many folks are against raising taxes as I am too, but if the increases are solely for these 2 programs (as they would be… look at your paycheck stub) and the damm goverment keeps it’s hands out of SS, why would you not want to improve these 2 programs. In regards to old folks retiring, things are going to get much worse. Cutting programs like these will leave way too many seniors living in poverty.

    by Jerry — December 20, 2012

  7. LLet’s be real folks. Julie, I understand your statement, but the purpose of this article was to determine a way to make Medicare & Social Security solvent well into the future. How does reducing the eligibility age accomplish that goal? Many of recommendations I have read are self based on your individual needs. What will be required is a wholesale solution, which will likely satisfy some and anger others, but that’s a reality we have to face up to.
    One possible solution for Medicare could be based on employment status. If a person chooses to retire at age 60 then let’s make them eligible, but not without an out of pocket cost. Medicare currently pays 80% of medical costs and the Part “B” is designed to cover the other 20%, hopefully. What I’m about to say would need verification and clarification from the actuaries / number crunchers. If you decide to retire at age 60 then Medicare would only cover let’s say 70% of your costs, which would gradually increase to the full coverage of 80% as you approach full eligibility age of 65.

    On another note, those people who are gainfully employed past the age of 65 (and there are many more doing so these days) you would be ineligible for Medicare while employed and it would be up to our Govt to ensure companies, municipalities and other agencies provide the proper medical plans to these employees. Of course the employee would still be required to foot their fair share of the insurance premium. Once the individual retires from the workforce or is terminated, then that person would have 6 months from that date to sign up for Medicare coverage.

    This scenario addresses early retirement as well as pushing out eligibility for those that may not need it instead of these “ACROSS THE BOARD” solutions that are generally unfair and do not work well.

    I am not going into too much detail for obvious reasons, but I also have a Social Security solution.

    by Paul LoMonaco — December 21, 2012

  8. I have a suggestion that would help make Social Security more solvent. I have suggested this to a politician on two occassions, but it did not move forward.
    There are many Americans that are taxed on up to 85% of their social security benefits as they make “too much” in other income. All the tax paid goes into the general fund of the government.
    SUGGESTION: Designate the taxes paid on social security benefits as funds for social security. These funds, combined with the payroll taxes paid by workers and employers would keep the fund more solvent over the next few years.

    by Gene M — December 22, 2012

  9. “One possible solution for Medicare could be based on employment status. If a person chooses to retire at age 60 then let’s make them eligible, but not without an out of pocket cost. ”

    Paul, this is exactly what I suggested. By lowering the age eligibility, you would have healthier people paying full price for Medicare while using it less. They would potentially also stay healthier, since they would get out from behind their desks and hopefully become more active. I am also fully behind means testing. If you can afford it, you should pay in more.

    We are in a good place personally, retiring at 55 with the ability to retain group health insurance from work at full cost. Unfortunately, that benefit could disappear at any time, leaving us scrambling for insurance, and causing us to budget for $20,000 more per year than we actually need to live on in case the retiree health care goes away, as it has in so many companies. We had to wait for 55 in order to retire, and would have done so earlier if we had this early Medicare enrollment option. While most people don’t save enough over their working life to afford early retirement, more would think about the possibility if they had a health care solution….even at full cost. That would open up more jobs, keep us healthier and more active as we age, and pay into a program that needs an infusion of cash.

    by Julie — December 22, 2012

  10. Actually, the fix for Medicare is universal health care–like every other civilized country but ours has. They all spend much less on medical care and have better outcomes than we do. The discussion is focused on insurance, not health care. Reframe the discussion.

    The fix for Social Security is to have the tax apply to all earned income. Some people stop paying into Social Security after their first paycheck. If necessary, raise the percentage a tad. What would really help would be to return it to being a retirement program. All the rest of the stuff that has been grafted onto it could either be paid from the general fund or discontinued. Retirees, after all, have paid for their Social Security. As they have for their Medicare.

    by Linda — December 22, 2012

  11. Bravo Topretirements members. Your ideas are the most original and thoughtful I have seen anywhere. Lets put you guys on the congressional committee and get something done! Thanks for the great contributions everyone.

    by John Brady — December 22, 2012

  12. “Actually, the fix for Medicare is universal health care–like every other civilized country but ours has. ”

    Linda, I don’t disagree, but was trying to minimize my scope. I would go one further and say that we also need to get more personal responsibility into health care choices. Had I been designing Obamacare, which would also eliminate the need for Medicare, I would have gone with an HSA type approach. Have a high deductible health care program where the first $5,000 comes from out of pocket and everything beyond that is taken care of. Means testing would apply to see if the gov’t would need to put that $5k in for you, and what you could pay towards your insurance premium. The $5K would accrue in an HSA type account, buildable over the years for those making their own contribution, replenished by the gov’t for those in need, but accessible only for health care in a way similar to food stamp access.

    For those not familiar with HSA’s, it’s sort of a medical IRA where you put in pre-tax funds to use on medical costs. Unlike the FSA, if you don’t spend it all in one year, you keep it, and continue to put in a set number of dollars the following year. Currently, I believe this is only an option for people who work for companies that provide the option.

    Free anything gets abused, either by the health care provider or the user. Give people control, educate them how to best use that control, and health care costs will be lest wasteful. It is by eliminating the waste that we bring costs under control.

    by Julie — December 23, 2012

  13. Julie, if I’d had an HSA available to me all the time I was working, my retirement would indeed be rich. I very rarely spend money on medical services. I chose to be self insured on drugs since I don’t take any.

    We definitely need more personal responsibility and not only with healthcare choices.

    by Linda — December 23, 2012

  14. You cannot contribute to an HSA if you are enrolled in Medicare! That is a problem and one that has tested in the courts.

    Seems the government does not want those of us on Medicare to continue padding our accounts and therefore, it is not allowed.

    I purposely did not ENROLL in Medicare at 65, but once you start taking Social Security (which I did at 66) YOU MUST. . I repeat…YOU MUST be enrolled in Medicare and no longer are you allowed to put funds into your HSA. The account is still active, but no future contributions can be made.

    MAKES NO SENSE.

    by John — December 24, 2012

  15. To be eligible to contribute to a HSA, you must be enrolled in a high-deductible health plan. Medicare is not one of those.

    You do not have to enroll in Medicare ever. You should enroll in Medicare Part A at age 65 as there are no premiums associated with Part A because you have paid the Medicare tax while employed. You can delay enrolling in Part B if you are still working and covered by an employer health plan even if over age 65. You can start Social Security even if still working and not be enrolled Medicare Part B. Once you stop working and are no longer covered by an employer plan, either your plan or a spouse’s employer plan, you have a limited window to enroll in Part B without the late enrollment penalty. If you have lifetime health insurance from an employer, you may choose never to enroll in Part B.

    by LS — December 25, 2012

  16. Just a thought … The government make up these rules we are supposed to abide by so they can change the rules and often do change the rules … so telling me that if (and I don’t even know if HSA will help) HSA will help solve the problem then the government can change the rules to solve the problem … The fact that politics are entrenched in the way things used to be done is a lot of the reason we can not move forward … By the way “fiscal cliff” here we come … Thank You Politicians (Very few know or care about our pain or country) I don’t know which political party I dislike more … sorry lost the train of thought, must be getting old.

    by maxit4fun — December 25, 2012

  17. LS, If you draw social security, YOU MUST be enrolled in Medicare!

    I have had a High Deductible Insurance plan (still employed, as I own my business) for many years and as soon as I started drawing SS, they ENROLLED me automatically. The HSA is a great plan and would work if Uncle Sam would work with you, but they won’t.

    by John — December 25, 2012

  18. Just a thought. If you think the fix is universal health care try living in Brazil. I live there part time and if you have the money you can buy private insurance which is very good. But, the majority have to depend on government run health care and the health care is horrible. The lines to see a Dr. are long and it has been noted that people have actually died waiting to see a Dr. The government run health clinic are less than ideal. I would just be a bit cautious about being so excited about the government taking over one sixth of our economy unless you have had the experience of the government ever running anything efficently or cost effective.

    by Ron Jacobson — December 26, 2012

  19. The Huffington Post published an article, “Raise the Eligibility Age for Medicare, But Let Under 67’s Opt-In” which discusses this issue in some more depth.

    by John Brady — December 26, 2012

  20. Thanks to John Brady for the link to The Huffington Post article. There are truly some great ideas regarding the Medicare/Social Security dilemma we face on this thread. I’m curious if anyone has forwarded any of this information to our apparently brain dead politicians.

    by Shari — December 26, 2012

  21. Single payer health care is not “government-run” health care – rather, its goernment FUNDED health care. I am Canadian and had great health care when we lived there. The federal government funds each province for health care and the Provincial governments pay the doctors. ALL health decisions are made by the doctors – NOT by government – and Docs (as a group) negotiate their salaries through their Medical Associations. Its not a government system. This is a misnomer and one that is used to leave the impression that individual citizens are somehow at the whim of a government. Nothing could be farther from the truth. We have first class health care in Canada – I have never waited to see my doctor more than a few hours or the next morning. I know there are people in Canada who have had issues finding a doctor and getting access… Those are normally folks who live in small towns or in the rural areas – where there are few doctors and hospitals. The same thing applies in the U.S. Doctors want to live and work in a setting that affords them access to research, a community of medical practitioners and then there are the other amenities that the rest of us enjoy – theatre, music, sports, school and communities that are family-friendly. Canadians pay high taxes which pays for universal health care. The cost is one they are prepared to pay to have: the choice of doctors, no such thing as being denied by anyone for any reason, no matter the illness nor how long one is ill. We didn’t always have this system (started in the 60s) and some of us old enough to remember when we didn’t,and can recall the burden it placed on families. I had a sick mother and my father was financially ruined trying to keep her alive and well. He never really recovered financially. The system in Canada has evolved over decades to where everyone has it no matter your income. It is the great equalizer. IF, however, you wish to pay for some of it, you can purchase some services. OR, certainly, come to the U.S. where the costs are many times more for ALL services – doctors, hospitals, MRIs, drugs. That’s because the costs are negotiated and accountability is built into the system. There’s also the myth that because its “free” its misused. Not so. Most Canadians – me included – wait until we HAVE to see the doc. We look after colds and flu outselves, and try to wait until its really necessary to go see a doctors. We are aware of our personal responsibility to not abuse the privilege. Not everyone thinks this way, its true. But the majority do. Its not a perfect system but those who have it, wouldn’t give it up for the world.

    by sheila — December 27, 2012

  22. Julie & Linda:
    You are really lucky to be healthy.
    Some of us need the standard medicare & an extra supplemental plan. Forget some medical “IRA” plan, that would never work for people like me. Last year if I had not had a good supplemental health plan, I would have had to pay over a 1/2 million because of 3 major cancer surgeries, 1 pre-cancer surgery, and an entire year of treatments. Since I live on less than $20,000 a year, that just might have been a problem.
    I am not eligible for medicaid, but make too much ( HAH!) money. I pay over $200 a month for my supplemental insurance & am happy to have such a good plan.

    by Marge — December 27, 2012

  23. Marge,

    I am sorry to hear about the health problems you have faced, but indeed an HSA with a high deductible insurance would cover you well…at least the one I have created in my head for my perfect world. 😉 Unexpected health issues happen out of our control and we should not face financial devastation because we or our spouse have had an uncontrollable health crisis. Insurance should be for that which you can not afford to pay, and for each of us that is different. So if the HSA requires you to pay the first $5,000, AND allows you to bank that $5,000 in your medical savings account annually, eventually convertible to retirement funds, you will be more careful in managing the small stuff. The HSA funding would be means tested so that if you could not afford to fund it yourself, it would be Federally funded, though most likely not accrued year to year beyond the initial sum. Anything over that $5,000 deductible would be paid for by your insurance co. Clearly, that would also involve some hard decisions as to what is medically advisable given our age and condition. I watched with protestation as my parents were put through medical procedures that would have been best left undone.

    Dollar amounts can vary, income levels to qualify for means testing too, but the bottom line is that if we are given incentive not to go to the emergency room for the sniffles, as some people without insurance are currently forced to do, then maybe we can get costs under control and get the health care system solvent. I realize I am mixing Medicare and the need for universal care together, but if we are universally covered, then we don’t need separate plans.

    Retiree health care used to be much more common until Medicare became mandatory. The gov’t basically gave companies an excuse to eliminate retiree health care and replace it with Medicare, and now that the fiscal burden is too high they are looking to leave us high and dry. Beware the unintended consequences of legislation. In my opinion, the Federal Government has no moral right to wind down Medicare given that it was their interference in the first place that caused many to lose their ability to retire even earlier than Medicare allows now. Medicare was not without it’s benefits, as before your health care in retirement was only as good as the solvency of your company and their desire to maintain the program, but many would have been well covered without it, a rarity today.

    Yes, we are healthy, but pre-existing conditions would render us uninsurable if we did not have group health care via a corporate retiree plan, even though thanks to modern medicine we are very healthy! We have seen too many supposedly healthy co-workers without pre-existing conditions, in their 40’s and 50’s, die behind their desks, particularly in this era of 60+ hour work weeks and continuing to work at home once the work day is “over.” I will not risk DH any longer than absolutely necessary, and have been saving hard for the past 20 years with that exact intent.

    Ahhh…time to get off my soapbox!

    by Julie — December 27, 2012

  24. John is wrong. No one is ever REQUIRED to take Medicare, not even if you take SS. If SS signs you up at age 65, they have broken the law, by taking your money each month without your signature – assuming you did not go in and sign up. One can put off taking Medicare until one wishes, but may have to pay a penalty for not signing up at age 65. But no one is ever REQUIRED to take Medicare and SS cannot automatically sign you up. If one has no health insurance, one would probably be a fool to not take Medicare; something in the way of health insurance is better than nothing. But no American citizen is REQUIRED to participate in Medicare insurance, A or B. In fact, as more and more of my doctors begin to refuse to take any Medicare patients at all, and as they begin to refuse to accept Medicare assignment, I am seriously considering dropping my Medicare insurance totally, and just keeping the health insurance plan I was (fortunately) able to carry into retirement. Medicare insurance is becoming more expensive and fewer doctors will accept patients who have it.

    by carol — December 28, 2012

  25. John, Julie and Carol

    Social Security will assume you want Medicare Parts A and B if you are receiving SS and then become eligilbe for Medicare. They will send you a Medicare card enrolling you in A and B. I as stated previously, there is no cost for Part A (hospital) and there is no reason not to take it. If you do not want Part B, send the Medicare card back and they will issue you a new card for just Part A. Once again, Medicare is not mandatory for most people. However, some health plans such as Tricare for Life for military veterans do require you to sign up for Part B to continue Tricare coverage.

    Editor’s note: We just checked this at Medicare.gov and LS is correct. If you are signed up for Social Security, Medicare will automatically (and legally) enroll you in Medicare Parts A and B at age 65. Because Part B involves premiums, you have the option to turn that part down. Part A is free (to you) and most insurers will require you to have it. However, in the odd event you never apply for Social Security, we are not aware of any law that would require you to sign up for Medicare (but again, most private insurers will require it).

    by LS — December 28, 2012

  26. Sorry, LS. When I stated “Retiree health care used to be much more common until Medicare became mandatory.”, I should have said when Medicare came into being it gave companies the excuse to get out of retiree health care. Either way, the result was the same, with retiree health care being an almost extinct work benefit.

    by Julie — December 28, 2012

  27. Why funds sent to other countries? These funds should be cut back to help the deficit?

    No one ever speaks about this, it’s our money.

    by The Sarge — December 28, 2012

  28. Carol is correct that many doctors will not accept new Medicare patients. Here in the District of Columbia, if you have not an already established relationship with a Primary Care doctor, then forget signing up with one if you only have Medicare. I am a nurse and many of may neighbors contact me for help to find a GYN, or even a Dermatologist that will take Medicare–this is necoming more and more dfficult as well as with Primary Care.

    I think Part A Medicare would be taken by most people, but perhaps one should consider a medical doctor who uses alternative treatments instead of a classically trained MD who prescribes drugs at the drop of a hat. Many of the alternive doctors do not participate with any insuance, but they do keep one healthy and out of the hospital as much as possible. Also they charge less.

    by Jdennifer — December 29, 2012

  29. Hi,
    Like John Brady says, BRAVO to all the ideas. I think, stepping back a bit, is that we need to revamp both Social Security AND Medicare to reflect the current situation. A blanket “fix” won’t solve the problems.
    I have worked for 26 years and have met requirements for Social Security on my own. I was also a housewife for 17 years and qualify for 1/2 of my ex-spouse’s SS benefit which I can take and defer my own, allowing it to grow 8% per year. I am certainly not complaining, but that illustrates that the current rules need to be redone to not allow this kind of “double dipping”. At the same time review other ways of funding.

    Medicare, of course, would be solved with Universal Healthe Care, but we would have to fight the Insurance lobby to get it! We actually pay MORE now with private insurance than we would with public insurance.

    by Lulu — December 29, 2012

  30. Hi Lulu:

    Other countries like Canada have had private insurance and then outlawed it for the public good. We in the USA coyuld do the same. I think that Medicare for all is the way to go as the codes for billing it are developd and we would not have to reinvent the wheel. The all doctors who want a license in the USA must be required to participate in addition 10% of their practices could be devoted to private patients if the choose–England allows this. With the young people paying into the systems it could be tweaked so that everyone would benefit. I cam convinced that those who live in countries that have Universal Healthcare feel some security as they have both health care and their pensions taken care of even though they pay more in taxes–they do not have to worry abour the most vulnerable times in their lives bad health and old age.

    by Jennifer — December 30, 2012

  31. to Lulu: Why shouldn’t we fight the insurance lobby? Why should we allow that lobby or any other lobby to control how we live? It is a national disgrace that congress does what these folks tell it to.

    by Linda — December 30, 2012

  32. Someone mentioned above that Medicare pays 80% of a charge, that is untrue. They pay 80% of the approved cost. I have no idea how they arrive at “approved.” I recently had rotator cuff surgery. Medicare paid $108.16 out of a billed $384.00 for pre-op visit, $935.34 out of $12,415.00 billed for surgery, $24.06 of $243.00 billed for xray of shoulder – that is 10%!!! I could list many more. I have never seen Medicare pay 80%. This program is a disaster and it is no wonder Doctors are increasingly refusing to take us as patients!!! Several years ago I asked a saleswoman at a Senior living place in Denver if I would have trouble finding a Dr there, she said it would not be easy. It is bound to worsen as doctors become scarce – especially primary care doctors.

    by Penny — December 30, 2012

  33. Hmmmmm, wonder why the Canadians and others come to America for operations? After all they get it free(?) where they live. Oh I remember – they might have to wait 9 months and in the mean time could die!

    by Robert — December 31, 2012

  34. Robert, do you actually have any experience with Canadians and their health plan? First of all, the plan is not free. They pay for it. Secondly, if their having to wait for 9 months for surgery would mean that they would die, they won’t have to wait for 9 months. My Canadian boss who now lives in the US went to Mayo about a kidney problem. They decided he needed to have a kidney removed and they could schedule him at 8:00 a.m. the next morning. He declined, told the doctors he would prefer to think about it. He said it was like they had a slot they needed to fill. Ultimately, he decided against having one of his kidneys removed. He’s still alive and well today. He said that would never happen in Canada. He missed his Canadian health coverage.

    by Linda — December 31, 2012

  35. Maybe American doctors would be more willing to take Medicare (National Health Service) patients if their medical school education were free, as it is in England. And in England, most doctors, after they do government medical work for several years to pay for their medical education, begin a private practice and work parttime for the NHS as contracted doctors.

    by carol — December 31, 2012

  36. Let’s here from Shiela, a former Canadian on how she see’s their medical system. From a previous comment: I am Canadian and had great health care when we lived there. The federal government funds each province for health care and the Provincial governments pay the doctors. ALL health decisions are made by the doctors – NOT by government – and Docs (as a group) negotiate their salaries through their Medical Associations. Its not a government system. This is a misnomer and one that is used to leave the impression that individual citizens are somehow at the whim of a government. Nothing could be farther from the truth. We have first class health care in Canada – I have never waited to see my doctor more than a few hours or the next morning. I know there are people in Canada who have had issues finding a doctor and getting access… Those are normally folks who live in small towns or in the rural areas – where there are few doctors and hospitals. The same thing applies in the U.S. Doctors want to live and work in a setting that affords them access to research, a community of medical practitioners and then there are the other amenities that the rest of us enjoy – theatre, music, sports, school and communities that are family-friendly. Canadians pay high taxes which pays for universal health care. The cost is one they are prepared to pay to have: the choice of doctors, no such thing as being denied by anyone for any reason, no matter the illness nor how long one is ill. We didn’t always have this system (started in the 60s) and some of us old enough to remember when we didn’t,and can recall the burden it placed on families. I had a sick mother and my father was financially ruined trying to keep her alive and well. He never really recovered financially. The system in Canada has evolved over decades to where everyone has it no matter your income. It is the great equalizer. IF, however, you wish to pay for some of it, you can purchase some services. OR, certainly, come to the U.S. where the costs are many times more for ALL services – doctors, hospitals, MRIs, drugs. That’s because the costs are negotiated and accountability is built into the system. There’s also the myth that because its “free” its misused. Not so. Most Canadians – me included – wait until we HAVE to see the doc. We look after colds and flu outselves, and try to wait until its really necessary to go see a doctors. We are aware of our personal responsibility to not abuse the privilege. Not everyone thinks this way, its true. But the majority do. Its not a perfect system but those who have it, wouldn’t give it up for the world.

    by lefty omally — December 31, 2012

  37. Carol, it is true that College and even Medical School are free in other countries. My husband was an MD/Ph.d and got some of his traiing in England. The Enlish docs get a salary, pension and othe benefits and they DO NOT have to employ an office staff or billing service. They live very well, just not over the top as American Doctors do. In the future here in the USA a doctor will be more humanittian as they too will be salaried, and those who choose the profession will not do it for huge incomes. There are programs to defer the tuition of Medical School if doctors agree to work in underserved areas here in the USA. Thre problem is not many do–only foreign trained doctors tend to do so.

    by Jennifer — December 31, 2012

  38. CANADIAN Health Care: As I stated, we Canadians love our health care. I also stated, no system is perfect, but universal health care in countries, like Canada, that offer it is a huge improvement over what is offered in the U.S. I am healthy, thank goodness. But my husband and I worry about what would happen if or when we aren’t, while we are living here. yes, we have Medicare but so what? If we can’t find a doctor to look after us because Medicare doesn’t pay them enough (according to the Doc) or the coverage isn’t adequate then really we have substandard coverage. In Canada – contrary to what Robert thinks – we do have to wait for things like hip and knee surgery (although less waiting times than previously). However, heart, cancer and other urgent matters are dealt with immediately. IF, for whatever reason, the hospital can’t accommodate a patient that requires this kind of urgent care then the patient may be sent to the U.S. for the surgery – AT THE EXPENSE of the province in which the patient lives. This is all covered by the high taxes we pay for the privilege of having coverage for all – regardless of one’s income. Young, old, seniors, rich or poor – all have access to the same docs and same hospitals. Is it perfect? Not if you have to wait for hip surgery and can’t get it right away…. But oh my, its head and shoulders ahead of what is on offer here. The costs are driven here by demand – Americans are willing to let the insurance companies and doctors, medical suppliers, hospitals set their own rates and they just rise, and rise. There surely must be a tipping point soon as the system is very badly broken and we the patients are the losers. I am praying for an American single payer/universal healthcare system. Its the only way for all of us who need medical help to survive. My husband and I believe we are blessed in our mid-late 60s to have good health…but are equally aware that this could change on a dime. So, in the meantime, we are doing everything we can to eat the right foods, live as healthy a lifestyle as we can so we can avoid the healthcare system at all costs… Happy New Year and my wish for you all is a healthy 2013..

    by sheila — January 1, 2013

  39. Sheila:

    Great post–Amen to that! I have cousins in Canada and they do not worry about a greedy healthcare system putting them out of business or taking their homes. I too am praying that Americans will get on their phones and let their representatives know how they feel about getting Universal Healthcare.

    PS Sorry for the typos in my last post–my keyboard sticks at times.
    Regards,
    Jennifer

    by Jennifer — January 1, 2013

  40. Linda, you are correct. I should have worded it differently. As with all Socialst programs you of course pay for the services with higher taxes etc and a certain lack of freedom and choices.

    All choices have consequences. I personally object to being taken care of by a government whether it’s Canadian, American or any other.

    My point is (again) Some Americans want Government to take care of them from the cradle to the grave while they sit on their fat asses, stuff themselves and become obeese (70% of America is now overweight and 20-25% of the 70% are obeese. Their children ae obeese and their pets too. Approximately 40 million now on government assistance – food stamps etc.

    It’s one hellva mess and Freebies and continued printing money is not going to solve the problem – in the meantime everyone wants FREEBIES.

    What ever happen to Self Reliance – oh no, just let my good ole Uncle Sam take care of me. Work – why should I work when I get all this free stuff.

    American has lost it’s soul

    Robert

    by Robert — January 1, 2013

  41. Robert, as several people have pointed out to you, the medical insurance in Canada is not free. And the “government” is not taking care of you. The people of Canada have decided to tax themselves so that they may have a rational system of health care. Who do you think is currently taking care of you in the US? I guarantee you it’s your health insurance company. They could give a damn about your health. They’re all about taking in more money than they have to pay out.

    We do not have a rational system here in the US and we are paying twice as much as the Canadians for worse outcomes. It’s not about health care in the US, it’s about health insurance. Two vastly different issues. I know people who pay $900/month for health insurance. That’s insane!

    by Linda — January 1, 2013

  42. Folks. It’s getting a little heated on this topic – obviously it’s one we all feel very strongly about. So far so good, but if we stray too much into political venting then we’ll have to do some editing. 🙁 The Topretirements site guidelines could be paraphrased by saying that there is too much ranting and raving on the cable shows and in the halls of congress, we would prefer this to be a gentler, kinder refuge.:cool:

    by Admin — January 1, 2013

  43. I suggest you google Canadian health care system. Many Pros and Cons.
    Of course one of your choices is Move to Canada since you are so enamored with their system and the European systems.

    ciao – Happy New Year

    by Robert — January 1, 2013

  44. ADMIN. My intention was never to have the discussion become political. However, I do think its important to make sure the facts about it NOT being a “government” program are provided. I also want folks to understand that the cost for having access to Universal healthcare is quite high taxes. I have no problem paying high taxes in order to have that kind of access. Others have an opposite view and don’t want to pay those taxes – no matter what. As a Canadian living in the U.S. for a number of years, I am constantly hearing myths about what the Canadian healthcare system IS and ISN’T – much of which is inaccurate or downright propoganda and untrue. Apologies if my contribution provoked a political firestorm. I agree that there is enough bickering in Congress and that this blog should be a place to provide info. BUT you have to know that if the subject is about Social Security, Medicare, Fiscal Cliff, Deficit, debt ceiling or any other hot button issues – there is going to be a plethora of views expressed – some of which may not be presented in a very pleasant fashion, unfortunately. Thanks for giving us all a forum to express our thoughts, share our knowledge and learn from each other.

    by sheila — January 2, 2013

  45. I do have to agree with Robert (in a kinder, gentler way) that the country has moved from an environment of personal responsibility and Yankee ingenuity to “I should get everything and you should pay” society. I believe in paying taxes, just wish the government has some common “cents” in spending my money.

    I do wish the conversation was on health rather than health care. No politician would get elected but I think good health behavior should be rewarded and health care should be more expensive for those who smoke, become fat (excluding those who have a REAL medical reason for such) or have other bad health behaviors.

    Some health system basics for those who care: There are four basic types of health care systems in industrialized countries. Canada is a national health “insurance” system. The US is a complicated, pluralistic system. There is a national health system (example United Kingdom) and a socialized health insurance (example Germany) as well.

    The funding for national health insurance and national health system are general taxes. The socialized system is usually general taxes and employee-employer MANDATED payroll contribution. Funding for the pluralistic system is (are you ready) pluralistic. Not really all that different except that the USA tends to make things so complicated. And of course, the USA has the lowest general mean marginal tax rate of the four countries illustrated. We (me included) do not wish to pay.

    Each system has some advantages and disadvantages, but we tend to look at them from our personal perspective. I could go on about this, but your eyes are glazing over.

    by elaine — January 2, 2013

  46. Thanks Shiela for your comment on the Canadian Health system. I have heard the stories both pro and con and it was refreshing to hear it from someone that has used it. I had previously commented to Robert about your post but it was edited removing the first sentence and thus making it sound as if it was to you. Unfortuately the Admin. selectively edited my comment which was factual and allowed others that are idiological in substance to stay unedited
    . Thanks again for your time and insight. Lefty

    by lefty omally — January 2, 2013

  47. As someone who has to pay nearly $1000 per month for coverage for my wife and myself, I cant wait for another year to get on medicare. My wife has 3 years to wait. Now I am under a system that is out for pure profit, not my best interests.
    My daughter had to declare bankruptcy when she owed over $25,000 that her insurance company would not cover. This country can do way better than this insanity.

    by Bill — January 3, 2013

  48. Bill. The system is worse than you think. My wife and I, both retired, pay about $110.00 a month each to Medicare. I buy supplement health insurance from my last employer who gives me a small discount, and that coverage for both of us is just under $400.00 a month (not bad. It includes a prescription drug plan.) What I tell people near retirement is that they have to start paying attention to what Congress is up to. And that somebody may be a conservative now, but unless we fight to stop all wars, shutdown most of our foreign military bases, and cut the Pentagon’s budget, the government will put the budget burden on retirees’ social security, medicare, and medicaid. This is not a liberal/Conservative. I’m a realist who has paid double into Social Security and Medicare since Reagan, and so have you. And now the U.S. government is trying to default on paying back the $1.4 trillion dollars in Social Security funds it owes U.S. citizens.

    by Ed T — January 4, 2013

  49. ELAINE: Thanks for the definitions. I’ve never heard it explained that way before. Helpful to know the differences. Although you may think health “behaviors” will lower health costs, I’m not sure that’s the major driver of health costs. Its a fact that as we age, we aren’t as healthy as we have been in our youth. Yes, we can eat well, exercise and not smoke nor engage in risky lifestyles. However, many of us are unhealthy as a result of things outside of our control – heredity, environment, diseases that we may contract from other,, precarious food safety system, compromised water sysems, are just a few examples. The drivers of health care are the cost of health insurance (and the administration costs associated with it); doctor’s salaries; the administration costs docs incur when trying to get insurance companies to pay and the admin. costs of trying to get government to cover costs; the cost of hospitalization – room costs and charges for everything from tissue to bandaids to dressings (this is double/triple “dipping” as they get it at cost, charge the patient retail at exhorbitant rates and then show it as an expense when filing with IRS); cost of medical devices – the cost for an MRI ranges from $800 – over $4,000, based on where you go and what you can negotiate; the cost of prescription drugs – the costs are 5-6 times what they are in industrialized countries with universal health care. These are the items that must be brought under control. No one is “managing the store” on these items. Its capitalism at work – which is fine – unless you are having to foot the bit. You aren’t paying taxes for Universal health care but you are paying for all of these things as a health consumer – and then some. Your tax dollars to pay for this and manage these costs would be very much less than you pay for health care now. Trust me. I’ve seen both systems up close and personal. Since we moved here to Texas, I’ve had physicians put me on medication I didn’t need; send me for tests that weren’t required (at exhorbitant costs) until I figured out what was going on. (I was new to the U.S. and didn’t have a clue that this was standard procedure). I’ve now determined I’m my own best health care advocate and do everything I can to stay well and question these kinds of medical decisions on my behalf. I live in dreaded fear of every getting really sick. I’m blessed to have an excellent pension income and we are very well. BUT if we didn’t have either then I’m afraid life could be stressful and our quality of life might be less. We are most grateful for our personal situation and agree with BILL, ED and LEFTY that we must do everything we can to preserve what we’ve all paid for – Social Security and Medicare. Even with all their “warts” they are the best we have right now and we must ensure that those EARNED BENEFITS stay right where they are. Do I think there need to be some adjustments to have them there for the next generation. Yes, I do. But not if lower income seniors have to bear the burden. I have no problem paying taxes when I have a higher income than most. I can afford it.

    by sheila — January 5, 2013

RSS feed for comments on this post. TrackBack URL

Leave a comment

Salary Data custom salary reports specific to your state and industry.