[grecy]

> I'm not sure you have a strong understanding of the purpose of our system to be honest.

I've been here for 7 years, I think I have a pretty good understanding. I'm just not expressing to you well enough what I mean.

I know Canada has health care for all, and I know you can optionally buy more with your own money. Great.

All I'm saying is I wish employers were not involved in buying it for me. Healthcare should be divorced from employment for a whole range of reasons. Go and live in a country where healthcare and employment have nothing to do with each other and you'll see what I mean. I'm not just talking about me either, I'm talking about my friends, neighbors, workmates. Their options are all limited because they don't want to change employer because of the health benefits.

[manicdee]

Here's how it works in Australia: if you are looking to move to a different employer, you weigh up the perks of one job versus the cash of the other (perk-less) job.

Here's how it works in Canada: if you are looking to move to a different employer, you weigh up the perks of one job versus the cash of the other (perk-less) job.

Here's how it works in the USA: if you are looking to move to a different employer, compare the health care first, then start worrying about salary and perks.

The corporations in Canada don't offer you anything that you can't get yourself, the healthcare isn't more expensive than the rest of the world for no good reason (looking at you, USA), and the only difference comes down to whether you end up with 10 years of history with one health insurer or not.

[grecy]

Every Canadian I know that's contemplated a change of employer has very seriously weighed up the Health Benefits at Company A vs. Company B.

In Australia, that doesn't happen.

[inafield]

Your point is still not relevant because it's offered as a benefit, not control. Complaining about it is like complaining that you're being paid a specific salary and not another one. Don't like it? Go somewhere else. Want to go somewhere else and don't like it? Don't go there then.

Part of an employer offering health benefit is to compete against other employers. They don't have to buy it, and you don't have to accept it. However, few employers offer a buy-out policy, which is something I would really like to see.

Currently I'm on GWL through my employer. While it's not the greatest, it's not bad for the amount of money. However, if I had the choice, I'd take the money from my employer and add my own cash to it to buy something like Blue Cross.

[run4yourlives]

You should look into this, because although it isn't advertised, you can in fact opt out of your employer's plan in a large majority of cases. There could be exceptions if your employer is smaller and/or several people have already opted out.

Couple of things to note first however:

1. It's not impossible, but it isn't likely that you'll be able to find the same coverage on an individual plan for the same price. You could choose to opt for less/different coverage of course that is more to your liking.

2. Talk to your employer... they may be quite interested in learning why you don't care for the plan. One of the reasons I so like HCSA's is that you aren't limited to such a narrow scope of services... it is basically your company saying "Hey, for medical and dental here's $2K a year. Spend it on whatever CRA figures is a medical expense." A good benefit consultant should be able to work with your employer to make their plan something that is attractive to employees.

3. Pay attention to the things your employer pays for beyond health and dental. They're probably paying for Life Insurance, Dependent Life, ADD, LTD etc etc. Some of these benefits can be a lot cheaper in the plan, and are nothing to top up. Life Insurance for example you can buy as much as you want.

4. Make sure you qualify health wise. Apply for some optional life through your employer before you go out on your own. It would really suck to be rejected privately, then not qualify for re-entry in your employers plan either.

5. I'll say this to anyone - Buy Critical Illness insurance. As much as you can afford. This benefit is such a gimmie it's not even funny. It is basically free money to you (for anything) if you contract a major illness. Buy a house with it if you want. Take a vacation. No restrictions, no caveats. With cancer rates approaching 50%, it sure would be nice to temper your chemo treatment with a new Porche or a trip to Europe wouldn't it?

[inafield]

1.) Insurance providers are, unfortunately, set up that way in Canada. Bulk processing of applicants is cheaper administratively than lots of individual applicants. I think any insurance company that wants to rock the boat will take a long hard look at this group vs. individual practice.

2.) GWL's 50-75% coverage vs. Blue Cross' top-tier 90-100% coverage is a no-brainer if you want to spend the extra (a lot) of money.

3.) They are, which is why I haven't switched. I get minimal life, dependent, ADD, and LTD. In fact, it is so minimal that I went and got extra that isn't tied to my employment. The company won't stop paying for it though, because they want the $60k they'll get if I die or am permanently disabled.

4.) Fully passed.

5.) I've heard this before. I'll have to look into it. Despite being more fiscally conservative than most other Canadians, budget is still tight.

[run4yourlives]

1. I'm in the industry. It has more to do with pooling of risk than bulk processing, but same idea more or less. Insurers can and do rock the boat all the time, but around the core players their nature is to be conservative. Check out HSCA plans for an example of innovation here.

2. That's your plan, not the carriers themselves. Both offer everything from nothing to 100% coverage. Sounds like you have a pretty low end plan. Seriously, talk to your employer about an HCSA... you can use it to pay deductibles and it is designed exactly for plans like yours.

3. The company won't stop paying for it though, because they want the $60k they'll get if I die or am permanently disabled.

Pretty sure this isn't happening. In fact, I'm pretty sure that's not even legal. They may have an additional benefit as part of their general insurance policies (key man, etc.) but all the payout for a life/add claim goes 100% to the people you've designated as a beneficiary.

5. Getting 15k-20k of CI for under $10 a month is the average rate. That's probably less than you spend on coffee. Given your LTD is probably about as good as the 75% EHC you have, I'd look into it. Nothing like not having to worry about expenses when(if) you get sick. Covers everything from heart attacks to cancer. You can usually insure your spouse too.

[run4yourlives]

>All I'm saying is I wish employers were not involved in buying it for me.

I still don't understand this. What difference does it make? In most cases, you're getting a deal.

It's a benefit. The same way free coffee is a benefit. What you are suggesting is akin to saying that because you aren't a coffee drinker, there's something fundamentally wrong with employers providing coffee a little/no cost. Nothing is stopping you from paying for better coverage on your own the same way nothing is stopping you from going to Starbucks.

It might not matter that much to you, which is certainly fair. Tell your employer as much. I can tell you that most would relish not having to fork out as much cash as they do for their plans if they didn't have to.

[grecy]

> In most cases, you're getting a deal.

I suppose you're going to tell me to get $100 worth of cell calls for $30 a month?

You've been tricked by marketing, and you're eating it up. The system doesn't have to be the way it is, and you're saying it's better this way because "you get a deal" because of the bulk-buying setup. If the practice of employers buying healthcare was outlawed, the system would change, and it wouldn't be more expensive for individuals to buy what they want/need.

> It's a benefit. The same way free coffee is a benefit.

Except that the healthcare is not free - it's coming out of your salary, and the choices are being made for you.

> It might not matter that much to you, which is certainly fair. Tell your employer as much

You miss the point. It's not about me, it's about society as a whole. From experience, I can tell you Canadians are a lot more reluctant to change employers than Australians, in part because their healthcare is tied to their employer. As a consequence, Canadian employers have a lot more power than Australian ones.

My brother had been in Canada for 6 years straight when he went back to Australia. After 1 month there I asked what was the biggest difference between Aus/Canada that he could notice. Without hesitation, he said "Employees in Australia are treated much better than Employees in Canada... nobody ever talks about healthcare in Australia, as it's a basic right of being born, and has nothing to do with your job"..

Until you've lived somewhere where unemployed (and never employed) people have the same set-up as CEOs, you won't know what we're talking about. Do yourself a favor - go and experience it.

[run4yourlives]

>You've been tricked by marketing, and you're eating it up.

Um, no... I've seen the actuarial tables, understand them and program systems to support them for the industry. Unless you are in exceptional health and remain so, group insurance is by far the better deal in most cases. That's why employers offer it!

Please just concede this point until you actually understand how actuarial science works. There are indeed some bad deals out there (looking at you flex plans), but group vs. individual insurance isn't one of them.

> it's coming out of your salary, and the choices are being made for you.

No, not really. This may be true of your specific plan but many plans are 100% employer paid. Employers offer benefit plans in lieu of salary because there are different tax breaks and such associated with not paying salary directly - ei and cpp contributions, for instance. If an employer pays you $300 a month in benefits it does NOT mean that they could pay you $300 more in salary and it would be a wash.

>"Employees in Australia are treated much better than Employees in Canada.

That may be, and I'm sure it varies greatly by industry and other variables... but that isn't at all what we are discussing here, is it?

[grecy]

The parent comment we're replying to, and the highest rated comment in this thread starts with:

> Linking basic health care to employment as a default is ridiculously stupid.

People are agreeing with that, and I'm saying it also applies to extended healthcare.

My argument: health and employment should be divorced.

Your argument: you get a better deal when they are connected.

I think you're being naive because you're being tricked by marketing and the current system and rules. If they entire system were overhauled to divorce them, there is no reason it needs to cost more to buy as an individual. I ask you - how much profit are health care providers making in Canada under the current system? With those billions in profit, surely there is room to change the pricing scheme so it doesn't cost more for individuals.

[run4yourlives]

I made the parent comment. I also pointed out as to why employers offering extended services works in the very next sentence. You are providing no real evidence to the contrary other than the fact that Australia doesn't do it. Apples to oranges.

There is no viable reason why employers should be banned outright from offering extended benefits as a condition of employment to compete for talent.

If they entire system were overhauled to divorce them, there is no reason it needs to cost more to buy as an individual.

This statement shows a complete lack of understanding of actuarial science, which is the basis of all insurance. See Here: https://en.wikipedia.org/wiki/Actuarial_science

A simplistic example: Employer A, hiring white collar office workers will get better rates when they say that they won't hire someone that is a (for example) a pilot, so the insurance company excludes all pilots from the base tables they use to rate the group. You as an individual don't get this luxury. You use a larger pool of people, but they aren't predefined as much into your own lifestyle subset, ergo, you don't get the benefit of lower rates. Even better, your employer's annual renewal actually takes into account the actual experience of your company directly. So, if everyone in your office sees the doctor one less time this year over last, your rates go down. You don't get this benefit in individual insurance - the pool is just too big to make a meaningful difference to a single data point.

At any rate, HN comments is not the right environment to teach someone actuarial math. Read the link for more details.

how much profit are health care providers making in Canada under the current system?

The nice thing about using math is that everything is out in the open. Profit on insurance premium is actually pretty low - in the 5-10% range. It's strength though is that it is entirely predictable, so it is rare that the profit is suddenly a loss. Insurance companies make most of their money through selling services and via investments.

My conclusion here is that although well intentioned, I think you are entirely ignorant of the topic at hand.

[grecy]

> I made the parent comment.

D'oh, I didn't see that.

> Linking basic health care to employment as a default is ridiculously stupid. There is no real relation between a person's health and their job. Basic health care needs to be connected to the individual, while "extended health care" (or additional options, etc) can certainly be offered as a benefit.

I put it to you that no white collar (and a chunk of Blue collar) employers in Canada don't give "extended health care" as part of employment.. which is to say the basic health care provided in Canada is not sufficient for those people. They need those extras. For those people to have sufficient coverage, their healthcare is now tied to their employment, which you yourself said is "ridiculously stupid". There is no moral justification for this, only the monetary one (which I'll address below)

> There is no viable reason why employers should be banned outright from offering extended benefits as a condition of employment to compete for talent.

There absolutely is when those extended benefits are required to live at an acceptable standard for lots of people, which essentially makes them basic benefits, just using different semantics.

Of course, the Canadian government only wants to scale-back the basic benefits and increase the public's reliance on "extended health care", thus transitioning the system to more closely match the current US system, where if you don't have a job with "extended health care", your health care sucks.

> Interestingly enough, a socialized (single payer/universal, etc.) system of basic health care with privatized add on's and extras is basically the way every civilized society on the planet operates

Yep, and Canada is one of the few where your employer gets to stick it's nose into those add on's and extras, which is, as you say "ridiculously stupid"

> This statement shows a complete lack of understanding of actuarial science, which is the basis of all insurance. See Here: ...

It's very interesting to me that I'm talking about trying to increase the standard of living, freedom of choice, and people's HEALTH, and you're constantly talking about bean counting, expenses and accounting.

It's sad that you actually work in the health industry in Canada, and you're more interested in schooling me on basic accounting principles than having a discussion on how the system could be modified to actually increase people's standard of living.

That's exactly what's wrong with the American system - accounting is more important than health care - and you're so far into the Canadian system you can't even see you're justifying the way in which Canadian system is doing the same thing on the basis of accounting.