Re: How many jobs depend on the Detroit Three?

In a recent radio discussion of health care schemes, someone claimed that Canadian hospitals do *not* have the enormous billing staff that one finds in the USA: they may have one or two just to deal with the Americans who come across the border and pay "full price" because it's still cheaper than in the USA.

And don't imagine that the US and Canadian schemes are the only two ways to do things. Look at Australia, Taiwan, Japan, Switzerland, the UK and Germany, to name just a few.

This whole discussion reminds me of a conversation with a friend who had worked in Chile under both the "socialist" (I mean *really* socialist, not what the Democrats get accused of) and the anti-socialist regimes: under socialism the basic necessities of life were affordable but in short supply; under the anti-socialist regime everything was plentiful, but few people could afford it.

Perce

Reply to
Percival P. Cassidy
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What is interesting in this debate is how we have blue collar people sniping at other blue collar workers because they make more than them. Instead of saying "I want to be paid as much as them" they say "they make too much". How does this even make sense? Seems like big business has everyone convinced that blue collar people should be living sub-middle class lives, living paycheque to paycheque. These other blue collar workers should be trying to get their wages increased rather than someone else's wages decreased.

What should be looked at is why blue collar wages are so low. How is it that people in the developed world accept having to compete for jobs with people in China and India not to mention Mexico? Is their cost of living the same?

We should be addressing globalization and free trade and whether it makes sense to compete directly in all areas of trade. Maybe we should only trade in areas that are beneficial to all considered rather than just the corporations.

Reply to
Tim

I don't see where union blue collar wages are all that low. But that's neither here nor there. The American way of life in recent years is to live at a level 15-25% higher than what is earned. That's why there is so much market volatility now. When people are earning $25/hour, they try to live like they're making $35/hour. Never mind the taxes that are taken out; I want what I want and I want it NOW! Not everybody has this way of thinking, but enough do to make a difference. I have never had more than 1 credit card in my life, and I pay it off as soon as I get the bill because I don't want to pay the interest. The only reason I kept one is for credit rating purposes. For most purchases, I use my debit card, or wait until I can afford it. I'm retired now, living off my checking account until my SSI kicks in. I didn't make a lot of money in my 45 years of working, but I didn't let myself get deep into debt, which explains why I could retire a little early.

Of course, that's just me- your lifestyle may vary greatly.

Reply to
SC Tom

Actually, I said blue collar, not union blue collar. I see some people writing into various blogs saying that they only make $18/hour and people who make $28/hour are overpaid. One guy said he couldn't afford a new car and so he resented that auto workers could. He should be asking why he is making so little that he can't afford a new car rather than ask why others can.

The American way of life in recent years is to live

Reply to
Tim

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-------------- in the U.S., healthcare spending as a proportion of GDP increased from

7% in 1975 to 15.3% in 2005. In Canada, the figures rose from 7% to 9.8% over the same time period, remaining constant at about 8 to 10% of the nation?s GDP for the last 20 years.

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

10% is 1/3 less than 15%.

And just to be clear, some reports assign the name "medicare" to Canada's health care system. All readers should note that there is no such single pan-Canadian health care system. Each province operates it's own health insurance system, none of which go by the name "medicare". For example, health care in Ontario is funded by OHIP (Ontario Health Insurance Plan).

And there are complications when a resident of one province is treated in another province. If a resident of Toronto is diagnosed with some rare disease, he simply can't travel to a specialist in Vancouver (BC) and be treated and expect OHIP to pay for it without prior approval. And if there is no such approval, then he'll have to pay out-of-pocket for the treatment, or fight OHIP in court after the fact.

This document:

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explains why drugs are cheaper in Canada. I think it over-emphasizes the "market separation" theory, which claims that the Canadian and US drug markets are sufficiently partitioned from each other so that the drug companies can charge different prices in each market according to what each market can afford, and since (according to the article) Canadians are "poorer" than Americans, then the drug companies must charge proportionately less for drugs in Canada to maximize sales and net-profits.

The above document does not fully explain the effect on Canadian drug prices by the "Patented Medicine Prices Review Board (PMPRB)". The PMPRB uses international price benchmarking to regulate Canadian prices, in effect creating price ceilings. The Canadian price for new products cannot be more than the average price of the seven international peers the PMPRB uses as the reference group.

When it comes to health care in Canada, the PMPRB is the only federal agency or legal body that affects health care costs (specifically, drug costs) across all of Canada. But even with the PMPRB, the individual provinces themselves can (and do) negotiate their own drug prices directly with the drug makers, which usually results in prices that are less than what is dictated by the PMPRB.

Back in the USA, just as malpractice insurance and court awards drive up healthcare costs, so too does law suits against drug companies drive up drug costs. To quote the article:

"The US legal system in effect imposes a huge tax on pharmaceuticals that Canadians do not have to pay."

One other thing makes US health care costs high (not mentioned in the above document) is that it's common in various state laws that health insurance purchasers (individual companies, municiple gov'ts, other entities, etc) can't band together into large groups and negotiate their own health insurance and drug plans. By being prevented by law from forming large purchasing groups, they can't enjoy the bargaining power that the Canadian provinces have.

What has been lost in the Canadian healthcare systems are the costs associated with lawsuits and malpractice insurance, and the costs associated with thousands (and even millions) of white-collar administrative jobs in both the health insurance companies and the healthcare delivery side (hospitals, private clinics, etc) that are involved with record keeping, billing, reimbursement tracking, and in general fighting over payments. All those back-office, paper-pushing jobs play absolutely no role in health care delivery to the patient, but yet are necessary to make the US health care system work.

Reply to
MoPar Man

It seems thats the current trend in American thinking. Bring down the top as a way to help the bottom. Punish those who worked hard to get to the top. Trouble is, you can't raise the bottom by bringing down the top.

Reply to
miles

And there are differences in what the different plans pay for and the costs they get in both premiums and taxes. a

But for prescription drugs the prices that will be paid are set by the plans. While it is based on the average of a basket of different country's prices, all but the US also have government price controls. So the pharms have the choice of either taking what the Canadian's will pay or not selling the medications at all. So, they are PAID proportionally less because that is all the Plans will allow. In fact, if a company produces a new medication and decides not to wait for the allowable price to decided upon by the bureaucracy, if the allowable price is less than what the pharm thought it was going to be, then the pharm has to return the difference. The drug companies must charge less to get ANY sales and profits. One interesting stat that argues for the idea that they are not really different markets if let alone is that Canadians pay more for generics than in the US. One of the (relative) cost savings for the US is actually more expensive in the Great White North. Another interesting stat is the the Western Countries and Japan all are comparable to the US in the PERCENTAGE of total healthcare expenditures go to drugs. This would tend to argue that if everybody spent the same total as the US, drug prices would be pretty much the same.

Which I just spent a whole bunch of time above explaining how it fits in, so I won't bother again (g)>

But again, it is a take it or leave it. Sorta hard to "negotiate" under those circumstances.

Governments often exempt themselves from troublesome things like anti-trust laws (g).

But there are still rationing methods included in the CDN system. Otherwise you couldn't control prices any better than we can. You ration by the queue and by budgets that can mean some hospital shut down except for emergencies toward the end of the year.

Reply to
Kurt Ullman

Not to mention the profits the private companies make and refuse to divulge. People talk about how much less efficient public companies are (don't agree for the reasons stated by MoPar) but don't mention that private companies take out huge amounts in profits. We have to pay for that too but it is probably never mentioned as a cost by people advocating private over public because it is not considered a cost from the companies perspective.

Reply to
Tim

And now competing with Mexican or Asian workers is just another way to bring down the top. These corporate big wigs are probably laughing in their sleep at the way they put us in this position (I'm not blue collar incidentally).

Reply to
Tim

I remember this being negotiated during Mulroney's terms in office.

Reply to
Tim

And it carries over into all aspects of life. Look at the education system- X% of students don't attend class, do homework, or pass tests, so instead of holding them back a year, let's just make the curricula easier. So now, 10th grade math is taught in the 12th grade. If you want to have some fun, go to any store, make a purchase (say the total is $3.72), and give them a $5 bill. After they've punched that in, tell them you've got the change and hand them 3 quarters. Oh boy! You can see the smoke coming from their ears!

Reply to
SC Tom

Absolutely not true.

The only thing we have a waiting line for is elective orthopedic surgery. That's because our othopedic surgeons are very busy performing emergency hip surgery on EVERY senior citizen that slips and falls in their bathtub and breaks their hip.

Cite?

Quite the opposite.

Many new drugs and proceedures are available first in Canada (and Europe) before they become FDA approved.

Robotic surgery systems were first used in Ontario before they became widely deployed in the USA.

Translation: There is more use of generic drugs in Canada vs the usage of the exact same (and more expensive) branded-label drug.

"For almost a decade (up to the year 2001), Canada was ranked number one among 175 countries in the United Nation's Quality of Life survey."

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Most and Least Livable Countries: UN Human Development Index, 2006:

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Canada rank: 6 USA rank: 8

The criteria for calculating rankings include life expectancy, educational attainment, and adjusted real income. The 2006 index is based on 2004 figures.

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Differences in Generic Drug Prices between the US and Canada Authors: Gooi, Malcolm1; Bell, Chaim M. Source: Applied Health Economics and Health Policy, Volume 6, Number 1, 2008 , pp. 19-26(8)

Results: Using the lowest quote for each selected drug, 12 of the 19 (63%) generic medications were least expensive in the US, with an average saving of 47% per drug for these 12 drugs. Seven of the 19 (37%) drugs were least expensive in Canada, with an average saving of 29% per drug for these seven drugs. Overall, there was a sizable variation in prices for the same generic medications within and between the US and Canada.

Conclusions: The lowest priced generic medications were not consistently found in either the US or Canada. The price controls and ensuing savings applied in Canada to prescription patented medications do not fully extend to generic medications.

Americans would like to believe that, but it's not true. Canadian doctors use the same drugs, devices, and proceedures, and have access to the same diagnostic devices (ultrasound, MRI, CT) that US doctors have.

for example).

In Canada, health care is rationed by need. If a Canadian doesn't need an MRI scan, he won't get one. If an American doesn't need an MRI scan, but he wants one, and is willing to pay for it, then he can buy one.

Use of the term "subsidized" is strange in that context.

I could say that the US gov't is heavily subsidized (by taxpayers). Is that a useful statement to make? No.

In both the US and Canadian healthcare systems, doctors are paid for their services. Companies that supply medical devices, hospital supplies, and drugs are paid for their products. Everyone is paid a negotiated price for what they provide. The difference is who the payer is (or how many payers there are), and how the payer(s) is/are funded.

Yes, in the US you have to deal with the federal programs of medicare and medicade.

In Canada, we have no such federal programs that are involved in the payment of costs associated with medical services directly to either patients, or hosptials, or doctors. Instead, federal money that is "earmarked" for healthcare is transfered directly to provincial treasuries in bulk, and that money is combined with provincial income tax and provincial sales tax and all 3 sources of money are combined and form the pool of money that a province will draw from to fund (among other things) the health care system in that province.

Reply to
MoPar Man

How much is too much? Wages are generally (but not always) paid in accordance with skills and responsibility. Machinists and electricians usually make more than assemblers, who usually make more than janitors.

I don't know that business has the blue collar worker convinced of anything. They have work available, The worker can accept the wage or move on to some other place. If not enough workers apply, the business will offer a higher wage. As long as people accept what is offered, it must be acceptable to enough people.

You state that blue collar wages are so low. Give some specifics please. I know plenty of blue collar workers that make $25 to $45 an hour. What they have in common is that they possess more skill, have more education and training, than those that do not make that much. In my company, blue collar workers make from $10 to $28. Wide range of wages, wide range of skills.

Wages, of course, are just one portion of the cost of having an employee. Insurance, pension, healthcare, vacation time, and all the other benefits are added to the base cost.

Your last sentence is interesting. How about some examples? If the corporation benefits, do others benefit also? Here is one example. Corporation A makes televisions. They pay their workers a good wage and sell the TV for $3500. The company makes a small profit, they sell about

500 units a week. Corporation B designs televisions, but has them manufactured in some far off land. They employ a few skilled people, but only have a low paid warehouse staff to move the cheap TV from import container to the shipping dock. They sell the identical featured TV for $500, they sell 5000 of them a week, make a good profit, and you and I can afford one. Maybe even two of them. Who benefits? Look around your house and see how many items we have that are not affordable if made here by highly paid workers.

I don't know the answer but it is just as much a moral dilemma as a business decision. The same guy that complains of imports, complains of making low wages, will scour the town to find the lowest possible price on his TV, turn of the ball game and take about the star that is making $10 million a season and think he is not paid enough because his ERA is better than the guy on the other team that makes $15 million a year.

Pogo was right.

Reply to
Ed Pawlowski

That's not even funny. You'd think a cashier would be anticipating this after, oh, I don't know, the second or third day on the job. But there's either a lot of noobs running the registers, or they just can't be arsed to even put a minimal amount of thought into their job.

nate

Reply to
Nate Nagel

Within a company yes, but not throughout the economy as a whole. Are people working on a factory line that much more skilled than a janitor? Is a janitor more skilled in a GM factory than one in a factory that makes dryers and is non unionized? Do you think people should be able to raise their family on $18/hr? In what locations is that enough to pay for a house and car and raise a family?

Well obviously so many people are attacking these line workers for being overpaid. Who do you think puts that idea out? Certainly not unions. Do all of these people just come to that idea on there own?

Yes, but when these companies can threaten to move the work to China, what option do these people have. That is why I say that the workers are not benefiting from globalization. The corporations are by being able to sell things here and make them somewhere else. Of course, when people are no longer able to buy the products, then the problem with the approach begins to show as it is now throughout the retail industry.

I gave an example of some people making $18/hour. Some people say minimum wage is acceptable for some of these people. Do you think no one is making minimum wage? So there you go. Everyone making minimum wage is an example. The fact that you have to ask indicates you are arguing from an ideological perspective rather than actually thinking things through.

What they

Reply to
Tim

The boys at the Frazier institute would tend to disagree. The found Hip replacements median total wait time (gp referral to treatment) was

20.7 weeks. You also have a waiting time of 4.6 weeks for medical oncology and 5.8 weeks for radiation oncologists. Neurosurgery waiting lists run 31.7 weeks. Actual wait times exceeded clinically "reasonable" times in 81% of the comparisons.

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> There is also a lag time (at least compared to the US) where> > many new drugs and procedures aren't available. >

Nope. Means there is more use of older generics which means (in the case of heart failure for instance) higher levels of angina, higher disability, lower quality of life.

Which, of course, is a completely different kettle of fish from MEDICAL quality of life which looks at aspects of a person's life specific to whatever disease we are talking about.

****The price controls and ensuing savings

Emphasis mine.

Which goes to make my point since the savings was higher in the US (47% savings in the US vs 29%). I never said that individual ones weren't different, just that overall they cost more in Canada. They also cost more to the system since the ones that tend to be higher are also those that tend to be used more.

Frazier notes months long waits for for the above, with the longest for US. They have access to many, but not used the same.

That is what Canadians like to believe.

No. Subsidized in this context means that much of the cost of a good or service is paid for by someone other than the person using the service in a way that hides the true costs from the user. We subsidize by having the employer pay much of the costs. You subsidize by splitting the subsidy more evenly between the government and the employer. No perjorative meaning here, just simple economics.

Finally something we agree on. I would add not a real pertinent statement either.

Pretty much my point.

Which means also that you can't go to another province and get treatment paid for easily..

Reply to
Kurt Ullman

If it comes from the Frasier Institute, I would question their methodology. They are the ones who think it makes any sense at all to compare tax rates between countries. Only an idiot or someone who wants to mislead people, would do that.

Reply to
Tim

Define socialized medicine.

Reply to
Lloyd

Since they use mostly the actual figures from the Provincial government, who would you like to use or are you still trying to suggest that there are no waiting lines?

Reply to
Kurt Ullman

Probably. The US spends more per capita on health care than any other nation on earth.

So you're saying the drug companies are cheating Americans by overcharging us compared to what they charge in other countries? But I thought free markets and capitalism were the solution to everything!

Reply to
Lloyd

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