What would you do?

[twinimini]

Okay, the Super Committee has fallen flat on its face. So now, let's put our fine TTR folks in charge. After all we can't do any worse than the jokes that occupy Congress and the White House.

So, here is the $64 trillion (or quadzillion) question....what would you do to eliminate the deficit? End Social Security? How 'bout Medicare? Maybe dissolve the military? Tax everyone who makes over $100,000 at 70%? What's your cure?

[MarknTami]

I would eliminate all income tax and replace it with the "Fair Tax" or "Consumption Tax by another name. Everyone makes purchases, even the illegals that are here working under the table. It has been proven to increase revenue without costing the individual that is currently paying taxes more. Of course those that are decking the system will have to pay their share. I would freeze all government spending and implement a 10% across the board reduction of all Government budgets. I would allow all corporations that have their money overseas to bring that money back to our soil tax free so they can invest it here. I would require mandatory drug tests for anyone receiving public assistance. I would also require all women receiving public assistance to have a birth control implant until they can prove that they can provide for themselves. Unemployment would be limited to 6 months. Their are jobs available if people would thinking that these jobs are below them. I would also put prisoners to work. They got themselves there, it should be part of the penalty instead of the free ride. That would be what I would do day one if I could wave a magic wand...

[gabesz]

I would take away all benefits from Congress. No free health care, no insider trading on stocks based on inside knowledge they have. I would limit their terms to one term and not more then 2 seperate terms in their lifetime. No member of congress will be able to serve consecutive terms. President is limited to 2 consecutive terms. No person in congress would be allowed to serve in any public office more then twice in their lifetime. Members of Congress will be required to work outside of any lobbying organization after they serve their term. If they work in any lobbying organization and try to use their influence in Congress in any way they would be penalized minimum $500,000 and 10 years of prison. Not early parole. And these would be felony charges so they will never be allowed to vote again for anyone.

I would set the consumption tax at 10%. Government cuts should be 25% not 10%. Corporations who have money overseas would be required to bring them back or pay a 50% income tax on all GROSS worldwide sales with NO deductions for any corporate expenses. Also I would make it mandatory if the corp is in the USA they employees such as call centers be in the USA and all products they make at least 70% must be made in the USA or pay 50% of income tax on GROSS worldwide sales. Public assistance should be available for 3 months maximum. If you do not find a job you will get no money from the government. Unemployment should be limited to 90 days maximum. Prisoners would have to work and have no TV, computers, radios or any other goodies they have not in the prisons. Its a place to serve the sentence for a crime not a country club. Prisoners have to work 60 hours per week minimum.

All this is drastic but it would change the way things are run.

[B & B]

Having limited knowledge of US policy's, but being next to the US and being heavily influenced in many things US, I'll try an approach. I also may have the benefit of not having any emotions invested.

Let's start with a progressive income tax system. Up to the first 12K of income is tax exemept, the portion from 12K to 35K is taxed at 25%, 35K to 80K is taxed at 35%, and the portion above 80K is taxed at 40%. Remeber, these increased taxes are only the portion above each threshold, so the person making 13K still brings home more than the person at 12K, and the person at 36K still brings home more than the person at 35K, etc.

Next, we reduce the number of tax deductions, and you can only reduce your level of taxable income down to a nominal value, let's say 20K just for discussion purposes. So we make charities, 401K's, some eduction costs (tuition, books) a tax deduction, not a write off, but an income reduction, so if you make 35K and donate 1K, to a charity, then your taxable income becomes 34K. We get rid of things such as your primary residence being a tax write off, secondary residences are never a write off. We reduce the lifetime capital gains exemption down to about 100K.

A consumption tax, every purchase costs an additional "X", let's say 8%.

No more government grants in the form of "you build your plant in my county and you don't have to pay state taxes for 10 years.

Now we look into the business of government, what is there original mandate. They are here for the infrastructure, sewars, lights, highways, etc. we keep them in the business of their mandate, they are not entitled to making charitable contributions, we make them more accountable for the money they spend, no more 5K toliets in certain areas, governmemt travel does not entitle you to the best hotels, economy class is good enough for me, it is good enough for you unless you want to pay for upgrades out of pocket.

We rethink major spending, does the military need to be as big as it is, we want to protect our borders, but is it necessary to protect everyone's borders, we got bin laden, we got hussein, do we still need to be in those countries.

We offer tighter, more stringent oversight committees, we re-regulate certain industries (banking for example).

I understand you currently have over 1000 health insurance agencies in the US, if I go in for a procedure, does my insurance provider cover that procedure...If that figure is accurate, there is a lot of duplication, a lot of wasted hosptial administration, and a lot of duplicate high end salaries to the CEO's of the insurance companies. How about reducing (if not eliminating), this insurance boondoggle to about 5 companies.

Insurance settlements. A Dr's malpractice insurance is through the roof because the settlements are so exorborant. Make the lawyers work off a salary structure, no more fee for settlement, you get 10 million, my firm gets 40% of that.

Prison reform, as I understand it, looking at the G20 economies, the prison population in the US equals the prison population of the other 19 economies combined. Is there that many bad people in the US, or do we need to re-examine the incarceration rules, I don't have the answer there, but I honestly do not believe that there is a disproportionate amount of bad people in the US.

Gun control...Thought I would throw that in for $hits and giggles

Just a few ideas from a different perspective...

[Jamie]

You all do know that any consumption tax would cause those that are currently not paying any income tax to be now taxed. And those receiving tax refunds larger than the tax they paid in to now be doubly taxed. So that will never fly because it would be seen as a tax that is more unfair on the poor.

Jamie

[diamondheaded]

Originally Posted by Jamie

You all do know that any consumption tax would cause those that are currently not paying any income tax to be now taxed. And those receiving tax refunds larger than the tax they paid in to now be doubly taxed. So that will never fly because it would be seen as a tax that is more unfair on the poor.


Jamie

so correct



rob

[Brewster]

How about you move the White House, Congress and the Senate to Guam. Make it a full fledge state or the new D.C.

As soon as they are all settled in the rest of the country can join Canada and stick Guam with the debt.

[twinimini]

Originally Posted by Brewster

How about you move the White House, Congress and the Senate to Guam. Make it a full fledge state or the new D.C.

As soon as they are all settled in the rest of the country can join Canada and stick Guam with the debt.

Brewster I really like your suggestion the best, but if only it could be done. We could probably get Greece and Italy to guarantee the debt also. Oh well, we can dream. BTW, Brewster, this is similar to another proposal out there. When it was disclosed that 5% of the US population incur 50% of all health care costs, someone suggested that we deport that 5% to Canada. Luckily for you, we didn't do that!

From my perspective I would never want a consumption or national sales tax. I know the hue and cry of "You're taxing the poor!" would be out there, but my reasoning isn't that at all. As those of us who live in states that have sales tax have seen, that tax is a really easy way for the politicians to raise taxes in a very subtle way. Our local sales tax started at 2% and now we're just under 9%. Generally we find that sales taxes just become a license to steal by the government.

The first thing I would hit would be the entitlements. Social Security would become more needs based. If you are on Social Security and still making a good dollar then you shouldn't be drawing. I'd start a phase out of Social Security at $100,000 and there would be no Social Security paid out if you are over $200,000. I would gradually raise the "early" retirement age from 62 to 65 and full retirement from 66 to 70. Medicare would also feel the axe and the so called supplemental insurances would see their government subsidy drop dramatically. I would also raise the cap on Social Security taxable earnings from the $110,000 (in 2012) to closer to $120,000. I would subject rental income profits to Social Securtiy taxes also.

For income taxes I'd hit both ends. I'd raise the rates on regular income for the top brackets by 2% and make capital gains subject to a 20% tax instead of 15% if you make over $200,000. I'd also cut the earned income tax credit as well as the child credit. The cuts wouldn't be huge, but a drop of $50 in the child credit is long overdue and the same for the earned income credit.

Welfare would be changed dramatically. Food stamps would allow you to buy fruits and vegetables and selected meats. Food stamps or any public assistance could not be used in any fast food restaurant. Yep, a lot of ghetto Mickey D's would be gone. Also if you are on any form of public assistance such as welfare or unemployment you would have to be subjected to drug testing on a regular basis. Test positive and your assistance will be gone. If you are on public assistance and you use an ambulance for a taxi, your assistance will be hit for the cost of that ambulance.

On the military I would reduce the overseas forces in a lot of the non-essential bases. Biggest targets would be Germany, England, and Japan. It may be cool to get assigned to those places but we can't afford it anymore. On hardware purchases, there would have to be a justification for the need for the particular weapon. The justification has to be better than we really need this new toy.

So that's just the start. Let's see, so far I've ticked off the seniors, the poor, the rich, and the military. Looks like a bi-partisan compromise to me!

[Brewster]

Originally Posted by twinimini

Welfare would be changed dramatically. Food stamps would allow you to buy fruits and vegetables and selected meats. Food stamps or any public assistance could not be used in any fast food restaurant. Yep, a lot of ghetto Mickey D's would be gone. Also if you are on any form of public assistance such as welfare or unemployment you would have to be subjected to drug testing on a regular basis. Test positive and your assistance will be gone. If you are on public assistance and you use an ambulance for a taxi, your assistance will be hit for the cost of that ambulance.

A lot of good ideas there. Along the Welfare line of thought. I once heard someone suggest that the government should go out for annual bids on their welfare food and clothing expeditures.

So for instance, Target, Walmart, etc. all bid on all the clothing business allotted to people on social assistance. The government ends up paying 85-90 cents on the dollar. Charges are placed on government issued debit cards restricted to a specific dollar amount. You could even restrict the type of purchases (ie. regular not "designer" jeans, etc.) although that could be a bureacratic nightmare.

Same system applies to food purchases. Cards not valid at Micky'D's...lol.

It would reduce the discrectionary spending considerably.

I really agree with withdrawing troops from all but essential bases. Keep in mind that any reduction in military spending with impact a substantial arms industry.

You have to balance spending reductions with the impact on local economies all the while responding to the urgent need to cut spending, ASAP. Tough job!

[Canadian Dos Equis fan]

Frankly I think the solution doesn't have to be as drastic as most people think it needs to be.

1.) Cut funding to all departments except for health care and social security by 1.5% per year for at least 4 years. These numbers do not go up because of inflation. And yes this includes the military.

2.) Additional cuts for the military, reduce the size of the standing army by 10% over 5 years. The US spends more on it's military than the rest of the world. a 10% cut while significant still leaves you with the largest military on the planet by far.

3.) end the Bush tax cuts, they were meant to be temporary in the first place. Phase that tax rate back in over the next two fiscal years (not starting until the next tax year).

4.) Sign a bill which locks in spending and tax levels for a period of 4 years (within say... 1% of departmental budgets) except in case of war/national emergency which must be ratified by 2/3 of each house and the president.

5.) Congrats if you are in congress or the senate. Effective immediately if you have served more than 12 years you are no longer eligible to seek that office. That should get some stale blood out of there.

6.) Failure to enact any of the above will result in firing the existing congress, senate and sitting president directly into the sun. Oh and lobbyists will be shot on site.

[Franco27]

Plenty of ways to do it, none popular ....

Introduce a progressive rate of income taxation (10% for low income, rising to 40% + for those earning over $200k), force government agencies to find cost cutting measures of 10%, or cut their budgets by 10%.

Make companies who have their HQ's in tax havens yet have most of their staff and do most of their business in the US, move their HQ's back to the US. Actively chase down private citizens who offshore their earnings to avoid tax.

Instead of pumping billions in to the banks as a quantative easing measure, which probably doesn't go anywhere but the bonus pot.... give that money out as vouchers to the public that have to be spent on certain consumables in industries that are struggling,

By consumption tax do you mean what we have as Value Added Tax (VAT) - whereby 20% is added on to the value of the goods at sale?

[Brewster]

Originally Posted by Franco27

Make companies who have their HQ's in tax havens yet have most of their staff and do most of their business in the US, move their HQ's back to the US. Actively chase down private citizens who offshore their earnings to avoid tax.

Does this mean you would make The Rolling Stones come home to England?

Originally Posted by Franco27

By consumption tax do you mean what we have as Value Added Tax (VAT) - whereby 20% is added on to the value of the goods at sale?

Yes that is what they mean but OUCH! 20%? Is that what you are paying over there? Come to think of it I guess it isn't too far off from some of our provinces at around 15% combined federal and provincial. We're lucky in Alberta. Only the 5% GST or VAT as you know it.

[Franco27]

Originally Posted by Brewster

Yes that is what they mean but OUCH! 20%? Is that what you are paying over there? Come to think of it I guess it isn't too far off from some of our provinces at around 15% combined federal and provincial. We're lucky in Alberta. Only the 5% GST or VAT as you know it.

Yeah it's on EU & UK goods & services, but not all, like food is exempt I think and some other items are at a reduced rate, but petrol isn't - so we pay double on that - an initial duty, and then 20% VAT at the till, happy days!

Oh and you can keep the stones, probably costs more to keep them going than what they are worth haha!

[Brewster]

Originally Posted by Franco27

Yeah it's on EU & UK goods & services, but not all, like food is exempt I think and some other items are at a reduced rate, but petrol isn't - so we pay double on that - an initial duty, and then 20% VAT at the till, happy days!

Oh and you can keep the stones, probably costs more to keep them going than what they are worth haha!

You know..I just read somewhere that a woman actually invented beer. A priestess in ancient Egypt. Do know if that's true but if it is...What a woman!!!

[twinimini]

I guess I should be really in favor to the GST tax in Canada. It sure helps our economy on this side of the border. Go to any mall in the Buffalo area and you'll see a ton of Ontario plates. Canadians love to come over to this side of the river to escape the good old Goods and Services Tax in Canada. As Rod Roddy used to say on The Price is Right, "Come on Down!"

[Canadian Dos Equis fan]

Originally Posted by twinimini

I guess I should be really in favor to the GST tax in Canada. It sure helps our economy on this side of the border. Go to any mall in the Buffalo area and you'll see a ton of Ontario plates. Canadians love to come over to this side of the river to escape the good old Goods and Services Tax in Canada. As Rod Roddy used to say on The Price is Right, "Come on Down!"

There is an effect, even in Alberta where the rate is only 5%. However it did replace a much higher tax on goods only (so no restraunt meals etc) that was if I remember right about 13%.

There are other levels of taxation and costs associated with bringing manufactured goods in from the states that keep our prices higher. this doesn't include what I could call gouging on the part of companies as well. I am in the process of buying a truck which will cost me 39k here as opposed to somewhere stateside where it would liekly be closer to 32-33k. The actual GST while it has an emotional effect (since you see it on your reciept) really doesn't have too much of a real monetary effect.

Besides, if you guys ever want to balance your budget it's inevitable there are going to have to be some tax increases in my opinion.

[twinimini]

Originally Posted by Canadian Dos Equis fan

There is an effect, even in Alberta where the rate is only 5%. However it did replace a much higher tax on goods only (so no restraunt meals etc) that was if I remember right about 13%.

There are other levels of taxation and costs associated with bringing manufactured goods in from the states that keep our prices higher. this doesn't include what I could call gouging on the part of companies as well. I am in the process of buying a truck which will cost me 39k here as opposed to somewhere stateside where it would liekly be closer to 32-33k. The actual GST while it has an emotional effect (since you see it on your reciept) really doesn't have too much of a real monetary effect.

Besides, if you guys ever want to balance your budget it's inevitable there are going to have to be some tax increases in my opinion.

There is no question that we will have to raise our taxes here to balance the budget. It will just have to happen because noone seems to really want to cut expenses. Sadly entitlements are the drug of government. Once you start the population on them they can't give them up. The druggies have their crack and their cocaine and government has their entitlements.

[Trooley Insane]

The US needs to get in the oil business....it appears to be working for Canada!

[Ben & Lisa]

Dos Equis, are you aware that Pensions, Heathcare and welfare are 60% of the federal budget. With out major cuts to these a balanced budget is impossible.
I might also point out that many people in the US not only dont pay any income tax, but they get a rebate via a earned income tax return. In your country everyone pays at least some tax. As it is now in the US the top 25% pay 86% of the taxes.The top 25% is anyone over $66,000 per year.
One other thing I might point out is it pertains to per capita health care spending that the US spends more than twice what Canada does.
Clearly health care and SS must be pared back.

[twinimini]

Originally Posted by Ben & Lisa

Dos Equis, are you aware that Pensions, Heathcare and welfare are 60% of the federal budget. With out major cuts to these a balanced budget is impossible.
I might also point out that many people in the US not only dont pay any income tax, but they get a rebate via a earned income tax return. In your country everyone pays at least some tax. As it is now in the US the top 25% pay 86% of the taxes.The top 25% is anyone over $66,000 per year.
One other thing I might point out is it pertains to per capita health care spending that the US spends more than twice what Canada does.
Clearly health care and SS must be pared back.

For Social Security to be reformed would take a massive effort. First, you would have to have the politicians admit that it really isn't a pension plan but really more of a Ponzi scheme. We are paying in now for those that are drawing now. Then we would have to change that way the plan is administered and start a phase out of benefits at maybe $100,000 and capping out at $250,000. If you are retired and making over $250,000 a year you really don't need Social Security and shouldn't be receiving it. Another change would be to make Social Security Disability harder to get. I know more than just a few people who are on disability who are very capable of working but won't because the government is taking care of them.

The next change I would make is to change Medicare. If you are still working you should be able to use your own health insurance and not be FORCED to take Medicare. That is the way the system is right now. Once someone reaches 65 they HAVE to take Medicare even though their own existing insurance may be cheaper and have better coverage. I would also get the health insurance companies out of the business of politics. The "free" add on insurance that people receive who are on Medicare also cost the taxpayers $881 a month per person on Medicare. Add that to what an individual may pay of as much as $260 a month for their Medicare and you have a single policy costing over $1100 a month.

Much was made of AARP supporting Obamacare. What wasn't mentioned is the massive profit that AARP makes on their health insurance business. A profit that will increase substantially once Obamacare is fully installed. If AARP wasn't allowed to be in the insurance business I can guarantee they wouldn't like Obamacare.

[Canadian Dos Equis fan]

Well the expenditure for health care is very high here in Canada, If I remember correctly it is at least 50% of our budget. I don't know the exact numbers but that's because there are federal and provincial funds going into the system.

In all fairness I may have had a couple beer before posting my earlier comments. But the question I have is this: If the US spends more per capita on health care than a country like Canada which has universal health care which delivers a more comprehensive service to its citizens, simply due to the fact everyone is covered, where is the money going?

If companies/organizations like AARP profit so much from health care out of tax payers pockets isn't that actually an argument in favour of universal health care?

Ah heck, politics confuses me. How about I rescind my previous ideas except for two. Term limits for everyone and my tongue in cheek launching bad politicians into the sun!

[Jamie]

I think even the person farthest to the right agrees that in the end there will have to be tax increases to bring down the debt.

The reason we are hard over against it right now is that we believe that there need to be the maximum cuts possible first. Otherwise any tax increase will reduce the need for cuts to bloated programs.

I have a real hard time saying we need to cut defense and SS and other existing programs to pay for the massive addition of Obamacare that was just added.

That was sold as be a cost reducer that they all now agree actually adds costs. A lot of the savings was based upon cutting payments to doctors that have already been cut by 35%. If you cut them anymore they will be treating patients at a loss. Sorry but that isn't going to happen, they will stop treating the people. Another government program will have to be born of government hired doctors to treat people with the taxpayer picking up the cost.

So cut the Obamacare costs first and then let’s take a look at what's left to work with.

Jamie

[twinimini]

Originally Posted by Canadian Dos Equis fan

Well the expenditure for health care is very high here in Canada, If I remember correctly it is at least 50% of our budget. I don't know the exact numbers but that's because there are federal and provincial funds going into the system.

In all fairness I may have had a couple beer before posting my earlier comments. But the question I have is this: If the US spends more per capita on health care than a country like Canada which has universal health care which delivers a more comprehensive service to its citizens, simply due to the fact everyone is covered, where is the money going?

If companies/organizations like AARP profit so much from health care out of tax payers pockets isn't that actually an argument in favour of universal health care?

Ah heck, politics confuses me. How about I rescind my previous ideas except for two. Term limits for everyone and my tongue in cheek launching bad politicians into the sun!

Dos, there are a lot of reasons why our health care costs are out of control. Part of it is the influence of big drug companies on the political system here in the US. For example, Obama's first choice to head up the cabinet post for Health, Education and Welfare was actually a lobbyist for the big drug companies. In Canada your drug prices are regulated by the government by bid. In the US our prices are left to the discretion of the drug companies. One of my clients was taking cancer medication. The cost in the US was over $8,000 a month. When he started buying the drugs in Canada his cost dropped to $3,000 a month.

Also in Canada doctors can only perform so many procedures and, as such, their income is limited. One of my clients is a prominent surgeon. His income went up five fold by coming to the US and practicing here. Frankly, doctors in the US make substantially more money than they do in Canada.

Another reason is the abuse of the system by so many patients. There was an article in the Buffalo paper about one welfare recipient who used an ambulance over 300 times in one year. All of the ambulance calls were because this guy wanted to see his friend who lived next to the hospital and he knew he would have to pay a taxi, but the ambulance was "free" to him because welfare would pay for it. Also many on welfare will go to the emergency rooms and get simple over the counter drugs because they are "free" to them, but if they went to a drugstore they would have to pay for them. As you can see there is a pattern here.

Jamie's point is also well taken. If the money is there it will get spent. In fact if the money isn't there it will still get spent. Obamacare and the black hole that exists in so many government programs just has to be stopped or we will cease to exist. Pretty bleak assessment, but I still don't see a leader out there who can unite the people and change things.

[Ben & Lisa]

Originally Posted by Canadian Dos Equis fan

Well the expenditure for health care is very high here in Canada, If I remember correctly it is at least 50% of our budget. I don't know the exact numbers but that's because there are federal and provincial funds going into the system.

In all fairness I may have had a couple beer before posting my earlier comments. But the question I have is this: If the US spends more per capita on health care than a country like Canada which has universal health care which delivers a more comprehensive service to its citizens, simply due to the fact everyone is covered, where is the money going?

If companies/organizations like AARP profit so much from health care out of tax payers pockets isn't that actually an argument in favour of universal health care?

Ah heck, politics confuses me. How about I rescind my previous ideas except for two. Term limits for everyone and my tongue in cheek launching bad politicians into the sun!

The US essentially has comprehensive health care and the reason it cost more is because its of higher quality. I mention this not as a slight to CA BTW. And I lived in CA for 6 years, so I have an idea of what both places are like.

[B & B]

Originally Posted by Ben & Lisa

The US essentially has comprehensive health care and the reason it cost more is because its of higher quality. I mention this not as a slight to CA BTW. And I lived in CA for 6 years, so I have an idea of what both places are like.

Whoooops, hackles raised, hair standing up...

Please explain, higher quality???

higher costs are obviously not associated with higher malpractice insurance brought about by out of control insurance settlements by lawyers who charge on a percentage of the settlement rather than an upfront fee.

But I digress, please feel free to explain the higher quality health coverage and how you quantify that. Beyond the old 2 days for an MRI versus 6 months.

I am unsure how to quantify it myself, I don't have the answer, but we have discussed the topic in the past. Is better health care quantified by average life span, infant mortality rates, obesity levels, or any other variables?

[Ben & Lisa]

More availability, newer technology, less waiting, more cutting edge hospitals, etc.

[Ben & Lisa]

Originally Posted by B & B

Whoooops, hackles raised, hair standing up...


Is better health care quantified by average life span, infant mortality rates, obesity levels, or any other variables?

NO, its not as these factors are highly influenced by lifestyle. Have you ever guessed at the average weight of the people around you in a Walmart store in the USA?

[B & B]

Originally Posted by Ben & Lisa

NO, its not as these factors are highly influenced by lifestyle. Have you ever guessed at the average weight of the people around you in a Walmart store in the USA?

I suspect that the ultimate mandate for health care is to keep well people from getting ill, and ill people from getting dead. Ultimately I would suppose that the success or failure based on this would be measured in average life expectancy. Higher infant mortality rate reduces average life expectancy, increased obesity reduces average life expantancy, more smokers reduces average life expectancy, etc.

Part of health care is communicating to the public the dangers and pitfalls of engaging in risky behaviours. Health care is more than hospitals, it is also public awareness. The high incidence of AIDs in Africa has as much to do with risky behaviours and low morality towards women as it does with substandard health care. (Obviously this is highly exagerrated as proximity to health care and drugs is a big factor here). But my point is that health care is more than Dr's and hospitals, it is public awareness, morality laws (no drinking underage, no smoking underage), etc...

Bearing all of the health care factors in mind makes me wonder about the accuracy of your statement. Obviously waiting times, new procedures, etc is one component, but not the be all and end all.

[Canadian Dos Equis fan]

Originally Posted by Ben & Lisa

More availability, newer technology, less waiting, more cutting edge hospitals, etc.

Well my opinion is that differences in those factors are generally attributed to Canada's much lower population, larger size and broader mandate.

Besides if there is a service that a nearby Canadian hospital can't offer that an American one does then the Canadian health care system (as well as the provincial sytem that actually administrates it) simply pays for your care in the American hospital.

The metric that is most important to me is if someone living at or under the poverty line is in need for an expensive treatment, which is not immediately life threatening (removing emergency room care), how are they treated? Odds are that person in the US doesn't have insurance, what is the likelihood that they will be given that treatment? What I have always liked about the approach the Canadian (and other systems the UK for example) take is that it doesn't matter how much or how little you have monetarily. If the treatment is available you get it.

If there is one service I feel should absolutlely be available to all people regardless of economic standing it's healthcare. Anyways I'm not trying to pick on the American system, just explaining what I do prefer about ours.

[Ben & Lisa]

Keith, in your scenario the person would be covered under Medicaid and wouldnt pay a single dime and would have the same access as a person like myself that has employer provided insurance.

As for the reason Canada doesnt have the best doctors, technology, and facilities is simply a matter of economics. We better be getting something better after all we are spending more than double per capita.
I might mention that it is not my intention to slight Canada in any way. My family is of Canadian origin and I lived there for 6 years. I LIKE CANUCKS! However there are pretty stark differances in health care quality between the two that I have experienced in person.