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Canada does not have very much ghettos compared to the States and there is percentage wise less people in poverty.
But its welfare programs are nowhere as generous compared to most Western European countries' models. It is a bit better than the States because there is not much stigma toward being on welfare like in the States.
Really? I thought the US had more generous welfare, and I'd say going on poggy is definitely stigmatized in Canada, although I'm not familiar enough with the US to compare in that regard.
Well the one big difference on being poor here and even if you are homeless, you still get healthcare.
Considering the ACA (Obamacare) expands Medicaid coverage to 133% above the FPL in States that opted out of Medicaid expansion and up to 350% over the FPL for States that opted into the expansion that is not the case anymore. So I am assuming homeless folks wouldn't pass the income threshold, so they would have fully subsidized healthcare.
Even families and individuals that pass that income limit will qualify for subsidies. For example in a State that does not opt into Medicaid expansion a family of 4 with a household income of $60,000/annually would qualify for a subsidy of up to 45% of their yearly Health Insurance Premium. Which for a gold plan would be approximately $400 a month in premiums for a family of 4.
Considering the ACA (Obamacare) expands Medicaid coverage to 133% above the FPL in States that opted out of Medicaid expansion and up to 350% over the FPL for States that opted into the expansion that is not the case anymore. So I am assuming homeless folks wouldn't pass the income threshold, so they would have fully subsidized healthcare.
Even families and individuals that pass that income limit will qualify for subsidies. For example in a State that does not opt into Medicaid expansion a family of 4 with a household income of $60,000/annually would qualify for a subsidy of up to 45% of their yearly Health Insurance Premium. Which for a gold plan would be approximately $400 a month in premiums for a family of 4.
Yes one would hope. What is the threshold before one is fully subsidized ? That subsidy is still for plans, not total healthcare isn't it? Also currently, those that are currently covered have plans that don't cover everything. What is or not covered in a GOLD plan? I have friends in the states who are covered, but find out that certain things on their plan are not covered, or are limited and end up paying a fair bit out of pocket, even WITH insurance.
Your second paragraph though is shows people will still be spending a lot of money on insurance.
Yes one would hope. What is the threshold before one is fully subsidized ? That subsidy is still for plans, not total healthcare isn't it? Also currently, those that are currently covered have plans that don't cover everything. What is or not covered in a GOLD plan? I have friends in the states who are covered, but find out that certain things on their plan are not covered, or are limited and end up paying a fair bit out of pocket, even WITH insurance.
Your second paragraph though is shows people will still be spending a lot of money on insurance.
The price I quoted was for a Gold plan, which is the second highest level after Platinum. It would be impossible to list everything it covers, but basic coverage limits are set under the new law, so even with a bronze plan you have to be fully covered for:
Ambulatory patient services - These include outpatient services such as doctor visits.
Emergency services - These include care received in an Emergency Room
Hospitalization - These include medically-necessary surgeries and other inpatient procedures
Maternity and newborn care
Mental health services
Substance use disorder services – These services include behavioral health treatment
Prescription drug coverage
Rehabilitative and habilitative services and devices - Rehabilitation covers services such as relearning to walk after a stroke. Habilitative services involve learning a new skill such as a speaking without a speech impediment.
Laboratory tests and services
Preventive and wellness services as well as the management of chronic diseases
Pediatric services (including both oral care and vision care)
As the plans increase in tier or metal level you will see more extended health benefits included.
As far as your friends health insurance plans, is this pre or post Obamacare? Because the coverage limits under Obamacare just started 30 days ago.
Also keep in mind for the family of 4 I quoted is for a Gold plan if they do not have insurance offered through their employer or self employed. The Gold plan covers everything listed above plus extended health benefits. When I was living in Ontario for example, OHIP covered the basics, but I still had to take out extended health insurance through my employer. For someone who is self employed in Canada, how much would it cost them to take out an extended health plan for a family of 4 through SunLife for example? Maybe not $400 a month, but possibly close.
The price I quoted was for a Gold plan, which is the second highest level after Platinum. It would be impossible to list everything it covers, but basic coverage limits are set under the new law, so even with a bronze plan you have to be fully covered for:
Ambulatory patient services - These include outpatient services such as doctor visits.
Emergency services - These include care received in an Emergency Room
Hospitalization - These include medically-necessary surgeries and other inpatient procedures
Maternity and newborn care
Mental health services
Substance use disorder services – These services include behavioral health treatment
Prescription drug coverage
Rehabilitative and habilitative services and devices - Rehabilitation covers services such as relearning to walk after a stroke. Habilitative services involve learning a new skill such as a speaking without a speech impediment.
Laboratory tests and services
Preventive and wellness services as well as the management of chronic diseases
Pediatric services (including both oral care and vision care)
As the plans increase in tier or metal level you will see more extended health benefits included.
As far as your friends health insurance plans, is this pre or post Obamacare? Because the coverage limits under Obamacare just started 30 days ago.
Also keep in mind for the family of 4 I quoted is for a Gold plan if they do not have insurance offered through their employer or self employed. The Gold plan covers everything listed above plus extended health benefits. When I was living in Ontario for example, OHIP covered the basics, but I still had to take out extended health insurance through my employer. For someone who is self employed in Canada, how much would it cost them to take out an extended health plan for a family of 4 through SunLife for example? Maybe not $400 a month, but possibly close.
The bit about friends in the US was pre-Obamacare. So with some of the things you listed, such as Ambulatory patient services, the insured, depending on the level of their plan, can go as many times as they like or is there a limit on most plans?
I don't fully understand Obamacare, it seems complicated and I just think that the poor are not going to receive the same coverage, hence care, that richer people will get.
Also in the different levels of plans can someone still be nickled and dimed…so many Q-tips, rubber gloves etc that are perhaps not covered, or do all plans cover the entire hospital stay?
I still think Universal EQUAL coverage would be better.
As for the Sunlife scenario, they don't seem to list prices on the website. I do remember that while I was working my extended health partially covered by my employer was only a few dollars per month.
Once I retired they offered extended health and dental through Blue Cross. It was Basic Extended for a family of 3 or more $109.93 per month. Enhanced Extended ( includes eye care) family of 3 or more $185.52 per month. Add dental on any of those another $105.54. I still have the offer. I didn't choose it since the extended coverage was very limiting really not worth it for me since I'm also covered by my partner. These prices are of course still " group " plan prices. I don't know what it would cost if I wasn't part of that " group ".
Since Healthcare in Canada is provincial what's covered varies, so extended may be worth it in some parts of Canada rather than others.
The bit about friends in the US was pre-Obamacare. So with some of the things you listed, such as Ambulatory patient services, the insured, depending on the level of their plan, can go as many times as they like or is there a limit on most plans?
Lifetime maximums are banned under Obamacare. As far as out of pocket expenses, such as deductibles and co-pays it varies per plan.
SEC. 2711 [42 U.S.C. 300gg–11]. NO LIFETIME OR ANNUAL LIMITS. [Replaced by section 10101(a)] ‘‘(a) PROHIBITION.—
‘‘(1) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish—
‘‘(A) lifetime limits on the dollar value of benefits for any participant or beneficiary; or
‘‘(B) except as provided in paragraph (2), annual limits on the dollar value of benefits for any participant or beneficiary. ‘‘(2) ANNUAL LIMITS PRIOR TO 2014.—With respect to plan years beginning prior to January 1, 2014, a group health plan and a health insurance issuer offering group or individual health insurance coverage may only establish a restricted annual limit on the dollar value of benefits for any participant or beneficiary with respect to the scope of benefits that are essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act, as determined by the Secretary. In defining the term ‘restricted annual limit’ for purposes of the preceding sentence, the Secretary shall ensure that access to needed services is made available with a minimal impact on premiums.
‘‘(b) PER BENEFICIARY LIMITS.—Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage from placing annual or lifetime per beneficiary limits on specific covered benefits that are not essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act, to the extent that such limits are otherwise permitted under Federal or State law.
Quote:
I don't fully understand Obamacare, it seems complicated and I just think that the poor are not going to receive the same coverage, hence care, that richer people will get.
I have no idea how you come to this conclusion. The poor will be covered by Medicaid, which is regular health insurance. For example in Boston, I have what would be equivalent to a Platinum Plan through my employer, which covers everything you could ever dream of, most of it I would never even think of using. The people on MassHealth (which is Massachusetts Medicaid plan) go to the exact same world class hospitals in Boston that I go to, they all accept it the exact same way that they would a plan through Blue Cross Blue Shield. There is no special secret hospital that folks with a higher income go to under the radar.
Quote:
I still think Universal EQUAL coverage would be better.
How you arrive at Universal coverage should not matter. Whether it come from Single Payer or a Public/Private partnership. If you dont agree with it, that is your opinion, but many countries around the globe have Universal Coverage and did not arrive there by single payer. If you dont like that model, then dont only take it up with Americans, but also the Swiss, The Dutch, etc...
Quote:
As for the Sunlife scenario, they don't seem to list prices on the website. I do remember that while I was working my extended health partially covered by my employer was only a few dollars per month.
Once I retired they offered extended health and dental through Blue Cross. It was Basic Extended for a family of 3 or more $109.93 per month. Enhanced Extended ( includes eye care) family of 3 or more $185.52 per month. Add dental on any of those another $105.54. I still have the offer. I didn't choose it since the extended coverage was very limiting really not worth it for me since I'm also covered by my partner. These prices are of course still " group " plan prices. I don't know what it would cost if I wasn't part of that " group ".
Since Healthcare in Canada is provincial what's covered varies, so extended may be worth it in some parts of Canada rather than others.
With the constant cuts to what OHIP covers, extended health insurance was something I opted for when living in Ontario. It was definitely needed.
Lifetime maximums are banned under Obamacare. As far as out of pocket expenses, such as deductibles and co-pays it varies per plan.
SEC. 2711 [42 U.S.C. 300gg–11]. NO LIFETIME OR ANNUAL LIMITS. [Replaced by section 10101(a)] ‘‘(a) PROHIBITION.—
‘‘(1) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish—
‘‘(A) lifetime limits on the dollar value of benefits for any participant or beneficiary; or
‘‘(B) except as provided in paragraph (2), annual limits on the dollar value of benefits for any participant or beneficiary. ‘‘(2) ANNUAL LIMITS PRIOR TO 2014.—With respect to plan years beginning prior to January 1, 2014, a group health plan and a health insurance issuer offering group or individual health insurance coverage may only establish a restricted annual limit on the dollar value of benefits for any participant or beneficiary with respect to the scope of benefits that are essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act, as determined by the Secretary. In defining the term ‘restricted annual limit’ for purposes of the preceding sentence, the Secretary shall ensure that access to needed services is made available with a minimal impact on premiums.
‘‘(b) PER BENEFICIARY LIMITS.—Subsection (a) shall not be construed to prevent a group health plan or health insurance coverage from placing annual or lifetime per beneficiary limits on specific covered benefits that are not essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act, to the extent that such limits are otherwise permitted under Federal or State law.
I have no idea how you come to this conclusion. The poor will be covered by Medicaid, which is regular health insurance. For example in Boston, I have what would be equivalent to a Platinum Plan through my employer, which covers everything you could ever dream of, most of it I would never even think of using. The people on MassHealth (which is Massachusetts Medicaid plan) go to the exact same world class hospitals in Boston that I go to, they all accept it the exact same way that they would a plan through Blue Cross Blue Shield. There is no special secret hospital that folks with a higher income go to under the radar.
How you arrive at Universal coverage should not matter. Whether it come from Single Payer or a Public/Private partnership. If you dont agree with it, that is your opinion, but many countries around the globe have Universal Coverage and did not arrive there by single payer. If you dont like that model, then dont only take it up with Americans, but also the Swiss, The Dutch, etc...
With the constant cuts to what OHIP covers, extended health insurance was something I opted for when living in Ontario. It was definitely needed.
I guess I find it complicated because there are so many plans and options. In Canada as you know, one plan per province etc. Also under Obamacare are the insured still the ones that will have to file and fill out endless forums, like they used to? That can be stressful dealing with insurance companies, it's just so much easier in Canada.
Do the Swiss and the Dutch have to deal directly with private part of their medical, or is it like Canada where the hospital and clinic may be private but you still deal with on insurer?
Again I don't know much about Medicaid in the US, but from what I've read on another thread, the current people on medicaid, mainly seniors I suppose, are not fully covered and still have out of pocket expenses. Is that true and has that changed under Obamacare?
Really? I thought the US had more generous welfare, and I'd say going on poggy is definitely stigmatized in Canada, although I'm not familiar enough with the US to compare in that regard.
The US only has generous welfare if you work
enough years to receive it. Big difference. It's not
just handed to you just for being a citizen like in
other countries. You have to work enough and
earn enough throughout the years just to receive it.
Last edited by Ronnie101; 01-31-2014 at 06:02 PM..
The US only has generous welfare if you work
enough years to receive it. Big difference. It's not
just handed to you just for being a citizen like in
other countries. You have to work enough and
earn enough throughout the years just to receive it.
That sounds a lot like Unemployment benefits where you have to work so many weeks in a year to qualify for the benefits.
I've never been on welfare here in Canada but those i know who are on it are mostly single moms who havent worked for a long time.
As a New Englander I have watched and visited Canada, including a cross country trip from Montreal to the Alaska border many years ago. I am currently planning a visit to Nova Scotia and Newfoundland. I have been reading about the economic problems of these Provinces after the collapse of the cod fishery. Has the economy of these places improved or are they still having problems?
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