A single payer system is a step in the right direction, however, there are deeper issues with the American healthcare system.
The unit cost of healthcare is so much higher than in other developed countries.
In British Columbia, physicians bill at total of around $31 CAD ($23 USD) for a standard office visit. They pay all their overhead out of this fee. Typically doctors keep 65% of their billings and the offices take 35% for overhead. From what I can tell, a similar visit in Washington State will run between $60 and $200 USD when billed to insurance.
Why is this the case? What are the factors in the American system that prevent reasonable pricing?
The first issue is that it's extremely difficult to run a long term controlled study on nutrition. Adherence to diet interventions is difficult to measure and it drops off over time. As a result most nutrition studies are epidemiological cohort studies which are not particularly good at determining causality.
The second issue is a question of funding. Diet and exercise interventions are not something that are typically monetized be the pharmaceutical industry. As such there is little private sector funding going into nutrition studies. Couple that with the fact that they're extremely expensive and you have a serious deficit in studies.
There is already some process available to measure this as Canada has tax deductions available specific to your "primary residence". CRA definitely has a way of auditing this. Sharing that information with a provincial level organization may not be possible, though.
But you pay interest on your leverage. So if your asset isn't appreciating faster than inflation + your interest rate then I don't think you're actually realizing any gains.
We Vancouverites are spoiled. I just finished an 18 month stint in the Bay Area. One of the biggest inconveniences was the driving time (especially with traffic) to get to the mountains.
In Seattle now and it's a great compromise. Similar wages to the Bay Area but similar geography and outdoor access as Vancouver. And even with the exchange rate housing is cheaper than Vancouver.
One thing that stood out to me is that immigration from Canada nearly stopped altogether in the mid 1890s. I wonder if the klondike gold rush was a factor here. I know it spurred a mass migration to the North.
As a collateral effect, even Vancouver's population skyrocketed growing from around 13,700 in 1891 to over 100,000 in 1911.
The more time I spend in this industry the more I realize how many software engineers leave salary on the table.
It's great to see a tool like this which both encourage software engineers to negotiate their salary, and help them strengthen their bargaining position.
It's an interesting hypothesis but unfortunately a cohort study with no randomized control and n=236 isn't really meaningful. There's no control at all here and the sample size is tiny.
I'm a big fan of personal experimentation but it's important to always be skeptical of your own n=1 conclusions.
In this particular case, coinciding the interventions of your diet change and exercise regiment make it very difficult to know the respective contribution of each to your results.
The unit cost of healthcare is so much higher than in other developed countries.
In British Columbia, physicians bill at total of around $31 CAD ($23 USD) for a standard office visit. They pay all their overhead out of this fee. Typically doctors keep 65% of their billings and the offices take 35% for overhead. From what I can tell, a similar visit in Washington State will run between $60 and $200 USD when billed to insurance.
Why is this the case? What are the factors in the American system that prevent reasonable pricing?
http://www2.gov.bc.ca/assets/gov/health/practitioner-pro/med...