Are you willing to pay more taxes to ensure health coverage for all?

pebbles, BSN, RN · Jun 19, 2007

FACT:

I am an RN in Winnipeg, Canada. My tax rate was 17% last year.

My income was just over 68,000 (lots of overtime!) and tax was 12,000.

I don't know where the "50%" came from earlier in this thread, but if that is true is the extremely wealthy people and not regular old nurses.

But I don't pay the hundreds of dollars in addition to that in health insurance premiums.

Many of us have "private" insurance through work to pay things that the public system doesn't cover: prescription drugs, vision care, dental, etc.

fergus51 · Jun 19, 2007

FACT:
I am an RN in Winnipeg, Canada. My tax rate was 17% last year.
My income was just over 68,000 (lots of overtime!) and tax was 12,000.
I don't know where the "50%" came from earlier in this thread, but if that is true is the extremely wealthy people and not regular old nurses.
But I don't pay the hundreds of dollars in addition to that in health insurance premiums.
Many of us have "private" insurance through work to pay things that the public system doesn't cover: prescription drugs, vision care, dental, etc.

I think the 50% comes from the Fraser Institute, a conservative think tank based out of BC. I'd heard that calculation from them before, but the small print was that it included sales tax, gas tax, property taxes, luxury car tax, etc. (basically every single form of tax out there, regardless of the fact that we don't all pay all those taxes). I've worked in BC, Washington, Ontario and California. I take home about 70-75% of my pay in each. I think the real tax benefit the US has that we don't is that the interest on their mortgages is tax deductible. That would be nice since I own in Canada and not here:).

DarrenWright · Jun 20, 2007

"RN's in the US, one of the rare countries with a mixed system, make more than RN's in any other country in the world that uses a universal system."
There is no evidence in your statement that there is a direct cause and effect. Your argument fails to follow the laws of logic. Consider the variables of supply and demand, labor representation, etc. Consider the effective decrease in earnings afforded by private health insurance premiums/copays -so far this year I have forked out about $8,000 which effectively decreases my income by over $1,000 a month.

So why do you think American RN's make more? I'm interested in reading what you think is a more solid cause/effect. And I'm interested in learning the cause/effect of why the ratio of Canadian RN's (per population) entering the US is phenomenally large compared to the number of American RN's (per population), entering Canada.

And why is it illogical that the wages of RN's in the privatized system make more because they are in a privatized system?

HM2VikingRN, RN · Jun 20, 2007

[color=#333333]tax paid health care is a better deal:

the annual premium that a health insurer charges an employer for a health plan covering a family of four averaged $11,500 in 2006. workers contributed nearly $3,000, or 10 percent more than they did in 2005 (3).the annual premiums for family coverage significantly eclipsed the gross earnings for a full-time, minimum-wage worker ($10,712).

http://www.nchc.org/facts/cost.shtml

this equals 958 dollars per month on average for family premium coverage. admittedly this isn't out of pocket cost for the average family as the employer is paying this cost. assuming 31% administrative costs which have been amply documented in other threads 297 dollars per month of premium dollars are not being used for patient care.

imagine instead of your employer purchasing health care on your behalf it was paid through a payroll tax. everyone in the system no opt outs. use a 10% tax to make the math easy.

current system

current average wage 30$/hour or 4800/month.

real wage value is about 40 dollars per hour benefits included or 6400 dollars per month.

single payer

under single payer the new wage value would rise from 4800/month to 5595$/month. (adding 795$ to base wage. this is the value of the family coverage with a canadian expense ratio of 17%.) negotiated wages would go into your pocket not the health insurance companies.

family health insurance cost at 10% payroll tax would be 560 dollars/month. you and your family would end up with 398 dollars more each month to spend. there would obviously need to be some tweaking around the edges for single people without dependents but the central point remains that more money would be available for your family.

DutchgirlRN, ASN, RN · Jun 20, 2007

I would be willing to pay more taxes if I knew the health care would be going to American citizens. Citizens who cannot work or cannot otherwise obtain or afford healthcare. No free rides, no handouts.

IShallWearPurple · Jun 22, 2007

Quoting DarrenWright:

"And Canada, like the US, is experiencing a nursing shortage. The irony is that Canada is one of the primary sources of immigrating nurses for the US.

http://www.human-resources-health.com/content/2/1/3"

Let me begin by apologizing for imposing on your nursing commentary. I happened to be reading this with my wife, the student RN whose account I'm using, and felt that something needed to be said about the citation you use to support your claim. The link you provide is to an article entitled "The Role of Wages in the Migration of Health Care Professionals from Developing Countries," which presumably should support your claim that Canada is a "primary source" of nurses immigrating to the U.S.

The article does support your claim that Canada is experiencing a nursing shortage, although this is in no way the focus of the article. This information is included, in part, to account for structural factors shared by the U.S. and Canada (among others).The article, however, does NOT support the claim that Canada is a "primary source" of nurses immigrating to the U.S. In fact, the article assumes that the differences between five 'destination' countries (U.S., U.K., Canada, Australia, and France) are insubstantial enough that they can be treated as a single variable: "based on the assumption that perceptions of migration costs, working conditions and living conditions are similar among the five destination countries" (Section: Factors Influencing the Supply of Migrants).

The article never asserts that there is a pattern of migration to the U.S. from Canada. It also suggests that wages are only one among many factors, e.g. language, that influence migration decisions: "There is no distinct pattern of preference for the USA over other countries as a destination. Moreover, Canada never outranks Australia, France and the United Kingdom, even though for physicians the wages in Canada are considerably higher" (Section: Factors Influencing the Supply of Migrants). The article concludes, with qualifications, that the migration from 'low-wage' source countries (predominantly African) is not easily preventable by moderate increases in wages.

NONE of the data in the article even remotely support the claim that you make about immigration- NOTHING! I'm uncertain whether this is intellectual dishonesty, laziness, or inability to comprehend what you were reading. Perhaps you were just trying to show that Canada has a nursing shortage. Surely this could have been achieved by citing either Health Canada or the Canadian Nurses Association. Providing a link that merely appears to support your claim, a claim that may in fact be correct, does nothing to improve the discussion. While this may make you look 'learned' and 'rational,' it is merely a facade. (How, for instance, are the authors' conclusions affected by including South Africa in the same category as Zambia and Cote D'Ivoire?)

I'm hardly one to insist on scientific verification. There is a great deal to be learned from health care experience in order to compensate for what gets lost in statistical analysis. Combining anecdotal evidence drawn from experience with relevant data allows us to formulate decisions about the wildly complex world of health care policy.

(As a final note, since I have yet to respond to the issue of taxation and public health care, I'd just like to point out that the article you linked to was available to you because someone else paid for it.)

loricatus · Jun 22, 2007

I would be willing to pay more in taxes to obtain universal access to healthcare, not universal access to health insurance. I would love to see the insurance industry out of health care (essentially dictating what meds are prescribed, providers that can be used and which procedures are performed).

DarrenWright · Jun 22, 2007

Quoting DarrenWright:
"And Canada, like the US, is experiencing a nursing shortage. The irony is that Canada is one of the primary sources of immigrating nurses for the US.
http://www.human-resources-health.com/content/2/1/3"
Let me begin by apologizing for imposing on your nursing commentary. I happened to be reading this with my wife, the student RN whose account I'm using, and felt that something needed to be said about the citation you use to support your claim. The link you provide is to an article entitled "The Role of Wages in the Migration of Health Care Professionals from Developing Countries," which presumably should support your claim that Canada is a "primary source" of nurses immigrating to the U.S.
The article does support your claim that Canada is experiencing a nursing shortage, although this is in no way the focus of the article. This information is included, in part, to account for structural factors shared by the U.S. and Canada (among others).The article, however, does NOT support the claim that Canada is a "primary source" of nurses immigrating to the U.S. In fact, the article assumes that the differences between five 'destination' countries (U.S., U.K., Canada, Australia, and France) are insubstantial enough that they can be treated as a single variable: "based on the assumption that perceptions of migration costs, working conditions and living conditions are similar among the five destination countries" (Section: Factors Influencing the Supply of Migrants).
The article never asserts that there is a pattern of migration to the U.S. from Canada. It also suggests that wages are only one among many factors, e.g. language, that influence migration decisions: "There is no distinct pattern of preference for the USA over other countries as a destination. Moreover, Canada never outranks Australia, France and the United Kingdom, even though for physicians the wages in Canada are considerably higher" (Section: Factors Influencing the Supply of Migrants). The article concludes, with qualifications, that the migration from 'low-wage' source countries (predominantly African) is not easily preventable by moderate increases in wages.
NONE of the data in the article even remotely support the claim that you make about immigration- NOTHING! I'm uncertain whether this is intellectual dishonesty, laziness, or inability to comprehend what you were reading. Perhaps you were just trying to show that Canada has a nursing shortage. Surely this could have been achieved by citing either Health Canada or the Canadian Nurses Association. Providing a link that merely appears to support your claim, a claim that may in fact be correct, does nothing to improve the discussion. While this may make you look 'learned' and 'rational,' it is merely a facade. (How, for instance, are the authors' conclusions affected by including South Africa in the same category as Zambia and Cote D'Ivoire?)
I'm hardly one to insist on scientific verification. There is a great deal to be learned from health care experience in order to compensate for what gets lost in statistical analysis. Combining anecdotal evidence drawn from experience with relevant data allows us to formulate decisions about the wildly complex world of health care policy.
(As a final note, since I have yet to respond to the issue of taxation and public health care, I'd just like to point out that the article you linked to was available to you because someone else paid for it.)

I'm no authority figure here, but I don't think there's a need to apologize for participating. Another view is appreciated.

You are, however, incorrect in your observation. The second paragraph under "Trends in Migration Flows" says this;

In the USA, the number of foreign-trained nurses applying for licensure - a proxy measure of inflow into the USA nursing labour market - has increased steadily over the past few years moving from about 6,000 in 1998 to over 8,000 in 2001. The main sources are Africa (mainly Nigeria and South Africa), Canada and the Philippines.

This isn't a link that "merely supports" my claim, but rather a link that "actually supports" a factual statement that I made.

But if that was insufficient for you, I could turn to this presentation, from 2006 http://www.aamc.org/workforce/pwrc06/hagopian.pdf

which identifies Canada on slide #8 as one of the Primary source countries for the US (using a 2004 journal), or one of many other sources which reports the same thing.

So you can put away your concerns (insulting BTW), about intellectual dishonesty or laziness, because I don't make this stuff up, and in fact I know what I'm talking about. Now after your comment about "dishonesty" and "laziness," I'm going to have to ask you how attentive and motivated you were when reading this article (BTW, I will grant you the recognition of sincerity).

Now this is something I would gladly accept an apology for.

And I never made any comments about the rest of the stuff you mentioned about one country being a preferred country.

IShallWearPurple · Jun 22, 2007

Quoting DarrenWright:

"This isn't a link that "merely supports" my claim, but rather a link that "actually supports" a factual statement that I made."

Let me begin by saying, I am borrowing my wife's account one more time.

The passage that you quote is not asserting that Canada is a main source of 'immigrating nurses'.

"In the USA, the number of foreign-trained nurses applying for licensure - a proxy measure of inflow into the USA nursing labour market - has increased steadily over the past few years moving from about 6,000 in 1998 to over 8,000 in 2001. The main sources are Africa (mainly Nigeria and South Africa), Canada and the Philippines" (Section: Trends in Migration Flows).

The statements are that (1) foreign-trained nurses applying for licensure have increased and (2) the main sources of nurses applying for licensure are from Africa, Canada and the Philippines.

You wrote, "Canada is one of the primary sources of immigrating nurses for the US." What you claim as a 'statement of fact' involved replacing the subject of the sentence (foreign-trained nurses applying for licensure) with an independent clause and then combining this with a second sentence that refers back to foreign-trained nurses.

The clause states that licensure applications are a proxy measure for labour inflow (i.e., immigrating nurses). This proxy indicator is the best APPROXIMATION available for gauging nursing immigration trends, not only according to the presentation you cite but also according to the World Health Organization, which is the source the authors of the article refer to. As I said before, I am not challenging the validity of the claim that Canada is a source of immigrating nurses, I'm saying that providing a link to an article from which you construct a sentence is not the same as citing data. So let me reiterate..."NONE of the data in the article even remotely support the claim that you make about immigration- NOTHING!"

Lest you think I am splitting hairs (or should I say reading attentively), let me repeat that I am aware that the claim you make is supported by statistically significant approximations. This does not, however, mean that you can 'cut and paste' a sentence that is based on approximated data as a 'fact'. Perhaps, if you had provided a reference to something that includes this proxy measure, but also explains the limitations and difficulties associated with using proxy measures then you would not be tempted to speak of them as 'fact'. This is easily remedied by a quick reference to the WHO report (pages 26-28) the authors cite.

As I wrote before, "The article never asserts that there is a pattern of migration to the U.S. from Canada." The authors do assert that a proxy measure exists, but do not go so far as to equate this to immigration statistics. You, however, do draw out this implication. There is nothing wrong with doing so, but it is your conclusion and so needs more than a link to this article. You need to provide an explanation about how this conclusion is arrived at based on the assumptions and limitations that go into proxy measures. This can and should be done. But it was not done in the passage you cited.

Country PICU · Jun 22, 2007

No No No

DarrenWright · Jun 22, 2007

Quoting DarrenWright:

"This isn't a link that "merely supports" my claim, but rather a link that "actually supports" a factual statement that I made."
Let me begin by saying, I am borrowing my wife's account one more time.
The passage that you quote is not asserting that Canada is a main source of 'immigrating nurses'.
Yes it is. If you think it isn't, then I'd ask you to explain what they meant when they said:
"In the USA, the number of foreign-trained nurses applying for licensure - a proxy measure of inflow into the USA nursing labour market - has increased steadily over the past few years moving from about 6,000 in 1998 to over 8,000 in 2001. The main sources are Africa (mainly Nigeria and South Africa), Canada and the Philippines"
The statements are that (1) foreign-trained nurses applying for licensure have increased and (2) the main sources of nurses applying for licensure are from Africa, Canada and the Philippines.

Yes, and it also says this is a "proxy measure of inflow," or an authorative representation of where these nurses are coming from. I'm not making this up, and I have misinterpreted nothing. It is res ipsa loquitur.
You wrote, "Canada is one of the primary sources of immigrating nurses for the US." What you claim as a 'statement of fact' involved replacing the subject of the sentence (foreign-trained nurses applying for licensure) with an independent clause and then combining this with a second sentence that refers back to foreign-trained nurses.
I replaced nothing. I said "Canada is one of the primary sources of immigrating nurses for the US." I referenced it with the non-US source that points out Canada as one of the "main sources" of nurses to the United States. There is absolutely no misrepresentation here. And I'd like you to try and explain how this article says anything contradictory to the FACT that Canada is a primary source of nurses to the US, let alone fails to support it.
The clause states that licensure applications are a proxy measure for labour inflow (i.e., immigrating nurses). This proxy indicator is the best APPROXIMATION available for gauging nursing immigration trends, not only according to the presentation you cite but also according to the World Health Organization, which is the source the authors of the article refer to. As I said before, I am not challenging the validity of the claim that Canada is a source of immigrating nurses, I'm saying that providing a link to an article from which you construct a sentence is not the same as citing data. So let me reiterate..."NONE of the data in the article even remotely support the claim that you make about immigration- NOTHING!"
Proxy does not mean "approximation," but rather an authoritive representation.
Lest you think I am splitting hairs (or should I say reading attentively), let me repeat that I am aware that the claim you make is supported by statistically significant approximations. This does not, however, mean that you can 'cut and paste' a sentence that is based on approximated data as a 'fact'. Perhaps, if you had provided a reference to something that includes this proxy measure, but also explains the limitations and difficulties associated with using proxy measures then you would not be tempted to speak of them as 'fact'. This is easily remedied by a quick reference to the WHO report (pages 26-28) the authors cite.
I didn't cut and past; I linked the entire article. You responded by saying, "The article, however, does NOT support the claim that Canada is a "primary source" of nurses immigrating to the U.S." and "The article never asserts that there is a pattern of migration to the U.S. from Canada."

As I wrote before, "The article never asserts that there is a pattern of migration to the U.S. from Canada." The authors do assert that a proxy measure exists, but do not go so far as to equate this to immigration statistics. You, however, do draw out this implication. There is nothing wrong with doing so, but it is your conclusion and so needs more than a link to this article. You need to provide an explanation about how this conclusion is arrived at based on the assumptions and limitations that go into proxy measures. This can and should be done. But it was not done in the passage you cited.

It's not my conclusion; this is clearly stated fact; Canada is a primary source of nurses for the US. The explanation is already there, and you cannot redefine "proxy" to support your position...whatever it may be (because it's not real clear why you are spending all this time attempting to refute absolute fact).

The truth is that I've provided solid references and discussion...again, I don't make this stuff up. If you think I'm wrong, you should attempt to apply your own standards of reference to do so.

headsup · Jun 23, 2007

Sure.
RN's in the US, one of the rare countries with a mixed system, make more than RN's in any other country in the world that uses a universal system.

You know, I don't know who you are or what problem you have with socialized medicine, but you make some really silly comments.

My parents in law pay over $700 a month for their health insurance. Their prescirptions are partically covered, but they still pay huge amounts of money for their medications. I am an American living in Canada. I pay $80 a month for my family, and that is because we dual income middle class family and we pay the maximum. That is it. $80 per month and we are covered for any medical costs whatsoever, prescriptions are VASTLY cheaper up here to fill. Kids get free basic dental. My taxes average 17%.

If they were to take the $700 per month and put half of that towards universal healthcare, they would be ahead...