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So, is non-doctor assisted suicide legal in Canada?

Steve


Absolutely ... as long as it succeeds and doesn't leave a mess to clean up. }};-D

Pre-1972 it was illegal (Justine's Dad again) but even then if it failed they would wipe out your debts and make appointments for you with the docs from the funny farm.

Some years back a guy in Northern New Brunswick drove head on into an on coming 18 wheeler coming the other direction. He died and I think one of the 2 guys (father and son) in the truck also died or was severely injured. I suspect had he lived there would have been charges?

Anymouse
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It all sounds very complicated to me?

How do the people managing all this stuff even keep track of who has what?

Tim <currently keeping track of two granddaughters and their dog while daddy takes mommy out for dinner for her birthday>

Tim
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Bruce,

Even today, this has little to do with your contribution to a pool when calculating your payout and recurring cost.

I'm guessing you have a year or two on me as the portion of wages sent to Medicare were never capped for me - and I'm going to go out on a limb and say that I've probably paid more than most during my working years (which, I guess, is a good thing compare to the alternative:-).

Now that I'm retired, my payment is based on my current income. Again, it would be silly to complain that I'm paying far more than the minimum. That said (I guess because of that), I get ticked off when people suggest the "rich" retirees pump more into the system by those who paid far less in per week during their entire working life and currently pay the $99 minimum.

I've always felt that insurance is not meant to protect you from all costs, but just those which are too onerous to bear. So I take the standard A&B and supplement them with a high deductible part F+ (which allegedly also covers 85% of foreign medical expenses - never had to test it though). This forces me to accept a potentially $2,200 deductible (of costs not covered by A&B) in consideration of annually saving around $2,000 in additional premiums. So I'm only betting $200 which, since I'm basically healthy, has worked out so far. Similarly, I take pretty much the cheapest part D as I think my total drug expense last year (other than some antibiotics picked up abroad at a fraction of what they would have cost with the insurance) was about $4.

So, why not Medicare Plus part C? The plans tend to cap total coverage, while the vanilla plan doesn't. So I've opted to give up all the shiny objects that come with the plus plans in order to get catastrophic coverage (which is what I think is more important to me).

Jeff
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The above is pretty complicated and I think people who want Medicare for all do not know the costs or the complexities.

I know its complicated. We have Medicare parts A & B, Part D is paid by the employer that I retired from (around $240/mo for MDH and myself). The retiree employer let us cover our children until they exceeded 26 y.o. for a reasonable amount, which I don't remember.

We both have a supplemental plan from Transamerica that covers costs above & beyond the Medicare payments. In general, its decent coverage with no in-network or out-of-network issues.

I could see a buy-in for folks over 50, with no drawing on currently paid in amounts. That's when a lot of people have accumulated misc. ailments due to age/injuries and COBRA payments become severely escalated.
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The above is pretty complicated and I think people who want Medicare for all do not know the costs or the complexities.

For those who have been held captive until January, 2014 to the private insurance that allowed no shopping if one had pre-existing conditions, my wife and I paid $40,000/year for health insurance premiums not counting co-pays (and no, that is not a misprint or a misplaced comma or number of zeroes). So how many years of Medicare would one year of the old regimen pay for?

There are not a few who are pushing to go back to pre-2014 health insurance....which outcome would be worse macro-economically?

Yes, Medicare and the potential combination of supplemental plans are complicated, but I would urge most people to read very thoroughly about the penalties incurred by not taking Part B at the same time one is eligible for Part A. An issue that IMO gets very little coverage but has lifetime ramifications that can add up to quite an expensive choice.
https://www.medicare.gov/your-medicare-costs/part-b-costs/pa...

I'm old enough to get Medicare A & B, a supplement, and Part D. Quite the deal compared to pre-2014.
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<<For those who have been held captive until January, 2014 to the private insurance that allowed no shopping if one had pre-existing conditions, >>


Would you have liked your health insurance company to be able to drop your wife when she got sick?


You were perfectly free to drop them as always, it just wasn't in your interest to do so, since they were likely paying out a lot more than you were paying in. And you were perfectly free to shop around too.

I'm amused that you thought that was SO unfair!

I suppose you liked Obamacare, when you were able to stick your high costs on young people and get a vastly lower rate, also subsidized by young people.


Seattle Pioneer
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Thank you for recommending this post to our Best of feature.

The above is pretty complicated and I think people who want Medicare for all do not know the costs or the complexities.

I know its complicated. We have Medicare parts A & B, Part D i ............



Seriously I hadn't noticed? }};-@

We have few decisions to make other than whether to go to our normal doc's clinic (Our new guy does next day appointments), walk in (great for the small things right now), ER (great if you look like you are on deaths door, otherwise long waits). Money is never mentioned at any of them but everyone gets paid.

Then there is 911 for an ambulance that gets you head of the line at ER but not always 'Free' (mine is due to supplemental insurance though I have never used it (should have once)).

https://novascotia.ca/dhw/ehs/ambulance-fees.asp

Pharmacy gets a bit more complicated.

Seniors without private insurance pay a "Calculated Annual Individual Premium" I think my FIL paid $430 and everything was covered.

I have private insurance that normally covers 80% however I learned a $10 lesson last week that I shouldn't refill prescriptions before 2/3 of the original dose would be taken. It was a case of the doc told me to take two a day but didn't write it on the prescription so the pharmacy assumed it was one a day. My first 12 cost me $2.38, second was $12.xx! I called the guy at Sun Life who explained how it works told me I could get the $10 back if I filed a paper claim. Too much trouble as I've become addicted to automatic claims or doing it online for such things as glasses (hang on to the receipts).

I also have subsidized dental insurance that even my dental office ladies*** are in awe of ... seriously 90% of everything is paid.

*** - The whole staff are women, they have their own baby's playroom supervised by the two staff at the reception and payment desk.

Tim
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"I suppose you liked Obamacare, when you were able to stick your high costs on young people and get a vastly lower rate, also subsidized by young people. "
__________________________________


When considering insurance policies, it is always imperative that the pool be large enough and include enough people that are unlikely to have a catastrophe that the price is acceptable. All my working life I paid into the Medicare system with the tacit promise that when I retired, it would supply medical insurance.

Why should ACA be any different?
(I'm unclear why Obama never objected to his name being used as it wasn't the program he requested, but rather Congress's creation).

There was a good looking guy who was placed at a charity event next to an attractive young lady at the dinner table and they hit it off and were having a great evening. As the party was winding down, he queried "if I offered you a million dollars cash, would you sleep with me tonight?". She looked him up and down and said, "why not". He reached into his wallet, took out a sawbuck and said "let's go". She blushed and asked "what sort of girl do you take me for" to which he answered "we've established that, what we're bargaining over is the price".

If you think that medical insurance, as a general program, is not something that should be available to anyone - fine, I understand that you are willing to take the risk that you can afford whatever malady hits you through your life. On the other hand, if you believe that medical insurance is important to have available, then it's obvious (at least to actuarials) that the larger the percentage of the pool is of people who are ill, the more expensive their coverage should be.

Do young people get sick? SUre, but at a lower rate than the elderly, so a coverage of everyone will mathematically cost more than the young paying into a program which does not benefit them until retirement, but the incremental cost will be their current coverage.

It's true that a government run, single payer system which can negotiate prices will have ill effects on the following (to name a few):

Drug companies
Insurance companies
Hospitals (in many cases)
Doctors (in some cases)

Why? Because it will enforce competitive prices, consistency of treatment and cutting of redundancy and waste. And that means that the cost of coverage (in a non-political, mathematical, perfect world) should be substantially lower than it is now - even for the healthy young.

So, since the young (working age, at least) already pay for (almost entirely) the health insurance of the retired, why would they object if they get coverage as well?

Jeff
(Who often wonders why he should be financing federal flood insurance on the houses of people who are dumb enough to rebuild their houses on barrier islands and river flood zones after they have been destroyed more than once already - or maybe we're the dumb ones for continuing the practice?)
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All my working life I paid into the Medicare system with the tacit promise that when I retired, it would supply medical insurance.

We all have paid in but not in amounts necessary to fully fund medicare. Part B premiums, as is Part D, are subsidized 73%, on those with annual incomes less than $85000-less on higher annual incomes, by federal general revenues*. Those portions of medicare, like social security, are pay as you go programs.
https://www.fool.com/retirement/2017/01/29/an-intricate-look...
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It's not just whether you have catastrophic coverage. If you don't have insurance, a lot of time you can't get treatment at all unless you pay up front. And a visit or two to a doctor can easily take a family's grocery money for a month.

If you can afford to lose your grocery money for a month, you have no problem; but if you can't, this is a big problem.
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I was going to respond about "death panels" and the end of life cost of medical procedures/care that were more for the psychological benefit of relatives than to maintain quality of life, but was faced with a cornucopia of articles which, maybe out of bias, explained the matter in a format which sounded like the tranches created by financial engineers in 2007.

One of the less convoluted articles (https://www.theatlantic.com/health/archive/2017/06/how-we-sp...) summarized (over-simplified?) the high-cost structure this way (dated June, 2017):

Last year, America’s total medical costs hit a new record of $3.4 trillion, according to the federal government. That’s about 18 percent of the country’s total GDP, meaning that one out of every six dollars we spent in 2016 went to health care. The national doctor bill dwarfs anything else we spend money on, including food, clothing, housing, or even our mighty military.

If that $3.4 trillion were spread equally throughout the population, the bill would come to some $10,350 for every man, woman and child in the country. But fortunately—for most of us, anyway—the cost of health care is not equally distributed. Rather, a small number of Americans run up most of the expense. The biggest medical costs are concentrated on a fairly small segment of the population—people with one or more chronic illnesses, plus victims of accidents or violent crime. The cost is so concentrated, in fact, that an estimated five percent of the population accounts for 50 percent of total medical costs.

For the purposes of this project, we’re calling these people The Platinum Patients—they’ve also been described as “super-utilizers” or “frequent fliers.”

This concentration of total cost on a small segment of the total population is reflected in another common aspect of medical spending: the concentration of treatment, and cost, in the end of a life span. For most people, the vast majority of all the health care they’ll ever get comes near the hour of death. Hundreds of billions of dollars each year are spent treating Americans who are in the last weeks, or days, of life.


A while back, I was responsible for arranging the funerals for five immediate family members of my wife and myself over a five year period. These included those who died "ultra-quick" (car accident), chronic illness culminating in six weeks in the ICU, and three "in between". Been there, done that, got the tee-shirt.

My advice is to think through how you want your affairs handled and write a medical directive - before you or others have their ability to be logical clouded by events in real-time.

Similarly, guidelines based on statistics are appropriate when it comes to government/insurance coverage during the end of life. If one feels that they want to roll the dice on the 5% box, then they shouldn't expect others to pay off their bet. Those who feel like fading their own bet should not be stopped from funding the Hail Mary bet from outside insurance (will presumably expensive, everything you can imagine is ultimately insurable for enough money) or their own pocket.

Jeff
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My advice is to think through how you want your affairs handled and write a medical directive - before you or others have their ability to be logical clouded by events in real-time.


Then there is this? Our government is in the process of revising the initial version since some people were excluded that shouldn't have been leading to some forced early decisions.

https://www.cbc.ca/news/politics/maid-assisted-death-increas...

Number of Canadians choosing medically assisted death jumps 30%

...

Cancer was the most common underlying condition, cited in 65 per cent of cases
Kathleen Harris · CBC News · Posted: Jun 21, 2018 1:01 PM ET

There were 1,523 medically assisted deaths in Canada in the last six-month reporting period — a nearly 30 per cent increase over the previous six months.

Cancer was the most common underlying medical condition in reported assisted death cases, cited in about 65 per cent of all medically assisted deaths, according to the report from Health Canada.

Using data from Statistics Canada, the report shows medically assisted deaths accounted for 1.07 per cent of all deaths in the country over those six months. That is consistent with reports from other countries that have assisted death regimes, where the figure ranges from 0.3 to four per cent.


Oh and there there is this bit. }};-D

In such a climate, euthanasia or assisted suicide certainly could become a means of cost containment... Savings to governments could become a consideration. Drugs for assisted suicide cost about $75 to $100, making them far less expensive than providing medical care.Aug 7, 2018

Anymouse
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"For those who have been held captive until January, 2014 to the private insurance that allowed no shopping if one had pre-existing conditions, my wife and I paid $40,000/year for health insurance premiums not counting co-pays (and no, that is not a misprint or a misplaced comma or number of zeroes). So how many years of Medicare would one year of the old regimen pay for?"

Wow, that is a lot of money, my sympathy to you and your wife.
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Drugs for assisted suicide cost about $75 to $100, making them far less expensive than providing medical care.Aug 7, 2018

Thing is, people have been offing themselves for centuries, without a doctor's assistance. A lot of people don't even know it's happening to them. Kervorkian abandoned drugs and used carbon monoxide on the last few people he did.

So, is non-doctor assisted suicide legal in Canada?

Steve
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So, is non-doctor assisted suicide legal in Canada?

Steve


Absolutely ... as long as it succeeds and doesn't leave a mess to clean up. }};-D

Pre-1972 it was illegal (Justine's Dad again) but even then if it failed they would wipe out your debts and make appointments for you with the docs from the funny farm.

Some years back a guy in Northern New Brunswick drove head on into an on coming 18 wheeler coming the other direction. He died and I think one of the 2 guys (father and son) in the truck also died or was severely injured. I suspect had he lived there would have been charges?

Anymouse
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For the purposes of this project, we’re calling these people The Platinum Patients—they’ve also been described as “super-utilizers” or “frequent fliers.”

A recent episode of New Amsterdam mentioned the "frequent flyer" problem. The example they portrayed was a homeless man who had visited the ER over 100 times in the previous 12 months, at a cost of $1.4 million.

At the time, I was curious if that was based on a real case or not. :(

In any case, the question raised on the show was what they could do to prevent another $1.4 million in costs for the next 12 months. Paying for an apartment? Providing free preventative care? Although costly, those measures would be far less than $1.4 million.

The other question asked, which I think is very relevant, is how many others could be helped with that $1.4 million?
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<<So, since the young (working age, at least) already pay for (almost entirely) the health insurance of the retired, why would they object if they get coverage as well?>>



It's quite true as you suggest that government has decreed that Medicare will be paid for by those who are working, not paid for out of taxes paid by those who are benefitting, as should be the case.


But why do you think put upon young people should also pay even more to subsidize health insurance for those 50-65?

Are there no limits to the amount young people should be gouged to pay benefits to the elderly?



Seattle Pioneer
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The example they portrayed was a homeless man who had visited the ER over 100 times in the previous 12 months, at a cost of $1.4 million.


An ER visit is billed at US$ 14,000? }};-@

An uninsured outpatient (ER) visit in Canada is billed at C$618 while a non-resident of Canada pays C$927.
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Actually, what I was suggesting was that, incremental to the program costs which exist today, the unretired, working portion of the population (including 18-64 year olds) incrementally add their share of medical insurance to Medicare (not that the young begin paying for the "almost retired" and get nothing in return).

This can be done in conjunction with my proposal to cut drug prices to what is charged under similar terms and conditions elsewhere in the world and cutting insurance companies out of the mix (except for private supplemental insurance should people desire to pay for that out of pocket) as well as standardization of hospital reimbursements modeled on what works in places like Canada and Europe (including emergency room charges which are parallel to today's urgent care charges). The savings should more than make up the cost of the incremental services involved.

Is this proposal socialist? Of course, but no more socialist than Medicare - a program so popular amongst the retired that no politician would consider recommending it be cancelled.

A hidden benefit would be that, since companies and unions would no longer pay for medical insurance, equivalent amounts would be added back to salaries - which would increase income tax revenue (but, of course, medical insurance of this sort could be tax deductible), but more importantly, politicians could no longer hid increased benefit packages (at least these) from voters who would find out about the liabilities years later.

As the Nordic countries have discovered, government is there to represent the best interests of the population. It doesn't mean capitalism is dead - it is very much alive, but it can peacefully coexist with socialism which serves the interests of the people living in the country. Again, its a case of jettisoning the rigid definition of an ideology developed a century and a half ago for a completely different society and demographic and constructing a model which best suits the majority of the population today.

Jeff
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An ER visit is billed at US$ 14,000? }};-@

Without insurance? Maybe.

In 2015, I went to the ER and stayed overnight. The hospital charged Medicare $22K. I ended up paying about $600 out of pocket and Medicare paid about $2700. Follow-up home care (nurse, PT, OT) charged Medicare $28K, which they paid in full and I paid nothing. If I were a homeless person, there would have been no follow-up home care, but any issue that came up would have required another ER visit. Imagine what that might add up to...?

At the end of 2016, I went to the ER and ended up with a 6-day stay at the hospital and a 17-day stay at rehab. Total charges were $139K, Medicare paid $51K, I paid about $1800.

When my kidneys failed in 2007, during a 6-month gap between COBRA and Medicare, the hospital offered a 75% discount to anyone that paid the remaining amount in full within 7 (or was it 14?) days of the charges being billed. I ended up paying about $170K out-of-pocket for that event (covered about 3 months, including thrice weekly dialysis). About 2 weeks in the hospital and 2+ months in a skilled nursing facility. I later learned from a paramedic that its name of "Hearthstone" was known as "Headstone" by them.

I guess I'm one of those "Platinum Patients"! :(

Just imagine the accumulated costs if I live another 30 years...
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When my kidneys failed in 2007, during a 6-month gap between COBRA and Medicare, the hospital offered a 75% discount to anyone that paid the remaining amount in full within 7 (or was it 14?) days of the charges being billed. I ended up paying about $170K out-of-pocket for that event (covered about 3 months,

My only ER experience (in Canada) was when I showed up with what turned out to be a gangrenous gall bladder (serious pain). I was in pretty bad shape (waited too long) and they put me on a guerney and hauled me around for all the tests then scheduled me for general surgery that night. The surgeon woke me up later and informed me they got the right thing because it was all "yucky and smelly".

The people at the hospital apologized because they didn't have a private room (that my supplemental insurance entitled me to) but insisted on installing the TV and phone that was also included. I wasn't there long enough to use them much but did get a call from my daughter in California.

Saw my family doc a couple weeks later for follow up and after tearing a strip off me for delaying and informing me I could have died (she had never heard of a gangrenous gall bladder) informed me that I heal amazingly quickly.

Didn't cost me anything directly other than some pain killers and a small parking bill that was mostly waived.

Tim <works for me>

Democratic socialism is further distinguished from social democracy on the basis that democratic socialists are committed to systemic transformation of the economy from capitalism to socialism, whereas social democracy is supportive of reforms to capitalism.
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So, since the young (working age, at least) already pay for (almost entirely) the health insurance of the retired, why would they object if they get coverage as well?

Because as illustrated above, the cost would need to be significantly higher than what they currently pay - and I state this as someone that supports a M4A solution.

https://www.cms.gov/research-statistics-data-and-systems/sta...

•NHE grew 3.9% to $3.5 trillion in 2017, or $10,739 per person, and accounted for 17.9% of Gross Domestic Product (GDP).

•Per person personal health care spending for the 65 and older population was $18,988 in 2012, over 5 times higher than spending per child ($3,552) and approximately 3 times the spending per working-age person ($6,632).

--------

The only way insurance works is if, on average, we collect over the average of $10,739 per person spent in 2017. Of course, there would be savings but even if we cut that by 20% (a very ambitious number considering the fact that we were spending $19,000 on average for everyone already Medicare age in 2012), it would still cost an average of $700 a month per capita. A family of four would have a cost of $2800 a month. If you discount kids, you of course have to increase the cost for adults.

And, all this ignores the fact that taxes for Medicare currently are not enough to cover expenses. The vast majority of people pay far LESS into the system than they get out. We make up the difference from other taxes.

412945-Social-Security-and-Medicare-Taxes-and-Benefits-over-a-Lifetime.pdf

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

While I support a M4A solution, I don't know how we get there without a) a reduction in benefits b)an increase in cost/taxes c) a reduction in compensation for medical professionals or d) all of the above.

The METAR implication is that a M4A solution will most likely result in a significant reduction in the profitability of anything healthcare related. I don't how it can be accomplish otherwise. The entire chain from suppliers to practitioners will have to squeezed.
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