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Posthaste: Canada’s top 10% of earners pay 54% of taxes — but here’s the kicker, many are just middl
The top 10% of Canada’s earners make 34% of the country’s income, but are paying 54% of income taxes, says a new essay that questions the premise that the “rich” don’t pay enough tax.
Prior to reading the article: I have seen for myself, extensively, that the cost of living in Canada is what we might very well call "exorbitant." And there's no tax deduction for mortgage interest. And the typical mortgage is "nuts" in terms of the cost of a very simple home with maybe a postage-stamp lawn. Food is high. Taxes are high. And there are costs that would insult anyone's sensibilities, on either side of the border: I was on the phone with my best friend in British Columbia last night. He was telling me that in his region, the Medical Plan is administered by an outfit called "Interior Health." ("Inferior Health," to the locals.) My friend said that he heard an interview in which a spokesman for Inferior Health actually attempted to justify charging people money to just park in the hospital parking lot. That's bullshit. No excuses. ... My friend tells me his car lease (bad idea, as opposed to buying) has payments scheduled every two weeks. The lovely people in the Marketing Depts. for all the car-makers found out that if they advertised the real cost of the vehicles and MONTHLY payments, it would be so high, no one would want to buy them. And loans are commonly for SIX years, now. ......... The big (BIG) trade-off is that medical costs are covered with maybe a small co-pay. (Despite the CRIMINAL practice of paid parking lots at the hospitals. And people refuse to pay, and so they get ticketed. Then they refuse to pay the tickets. Do you think the privatized parking-lot outfit might like to see some of that cash???) ... The MUCH lower medical costs are a big bonus. Which is why costs across the economic strata are, I dare say, much more equitable North of the US border.... (BTW, I just got hooked-up for a couple of prescriptions from an outfit in coastal B.C. Instead of over $400 USD, I'm paying $78--- for THREE of those items, rather than just ONE. Yeah!)
@catch22 The $400+ figure I quoted is what my (WellCare) Medicare drug plan charges me for that particular COPD inhaler BEFORE deductible is reached. AFTER that, that particular inhaler costs $170+ EACH (2019 cost.). ...Checking the Good Rx website for my zip code, the cost is in that very same neighborhood, even with the "Free Discount" with Good Rx. (Atrovent HFA.) That is to say, $400+. ***************************************** ... (Checking the Advair cost on Good Rx now:) Advair cost is $121 "with free discount" (coupon?). Not much of a bargain! ********************************************** My own prescriptions are BOUGHT through "90DayMeds." They are located in Surrey, B.C. (Vancouver suburb.) but one of them is SHIPPED from Britain, and the other one from Turkey, from the looks of the handy identifier-symbol. Red background, crescent moon, with the star in it. I might be wrong.
But I'm also getting a volume discount for buying three units of each, and a 1st-time, $20 US customer discount. So, $70 plus $78 = $148, but next time, it will be more. But not MUCH more.
Hope this is informative. 1-800-828-4889. The stuff is sent by USPS. It can be tracked, too, prior to delivery.
My doctor just had to use their fax number to send the scripts. Some other outfits require that you fax your own ID and a paper, physical copy is required to be sent, soon after. But I encountered none of that shit with 90DayMeds. And the agents on the phone speak proper Canadian English, not the fractured Filipino call center version of "Heenglish."
There are many different online pharmacies (and referral services) with nearly the identical Surrey addresses. For example, 90DayMeds is at 7360 137 St, #338, OnlinePharmaciesCanada is at 7360 137 St #381, QualityPrescriptionDrugs.com is at #245, MapleLeafMeds.com is at #232.
One needs to be careful when dealing with online pharmacies. I did a fair amount of cross checking a few years ago when a doctor of mine suggested getting a prescription he wrote filled at a Canadian pharmacy. FWIW, 90DayMeds is validated by PharmacyChecker.com but not CIPA. The others are validated by both. But AdGuard says that MapleLeafMeds.com "has been reported as a malware page."
My observation on pricing, FWIW, is that except for manufacturer-issued discount cards for their individual products, you're not going to get much of a discount on drugs that have no generic. For example, GoodRx is showing around a 10% discount on Eliquis (which lists for around $500). Brand name drugs are sold more cheaply outside of the US, so one is often better price-wise going the import route if it's brand name vs. brand name.
Often a brand name goes off patent outside of the US first. Then it's no contest, the international generic is much less costly than the domestic brand name even with GoodRx or equivalent.
When a brand name drug first goes off patent, production of the generic may be limited to one manufacturer. Even after that short transition period ends, it can take some time for the generic drug price to drop. After a year or two the generic should get much cheaper. Until then, the international import still wins on price. That may be what's happening with Advair. The first generic was approved just under a year ago.
When it comes to mature generic vs. mature generic, I expect US prices to be competitive. Either because the generic is covered with a reasonable co-pay under your insurance, or a GoodRx-type coupon will bring it down to a sane price, or a pharmacy like Costco will sell it at a fair price. So far that's been my experience.
I used my AMEX card. And yes, I'm getting generic versions: Ipratropium Bromide inhaler 20 mcg dose. (Versus the 17 mcg dose on the branded domestic Atrovent.) And Seroflo Multihaler generic for the Advair.
I could not even begin to imagine how they make this happen. Purchase is over the phone on an ostensibly US toll free number. Though I suppose the phone number could be arranged to be valid both in Canada and USA. But they are marketing to the USA. It was delivered by USPS and can be tracked. 90DayMeds even provides a link. But the postmark was from The Royal Mail. Anyhow, none of this will go to meet my drug deductible for 2020, but I'm still coming out ahead. The monthly premium I pay for my drug policy went from $13.90 in 2019 to $17.30 in 2020. On a percentage basis, that's f****** robbery. I do get some of my stuff for zero copays.
Since 2011 health insurers, even drug plan insurers, have had to comply with the medical loss ratio (MLR) requirements created by the ACA. CMS issued rules in 2013 saying that this law applies to Medicare plans and that they have to spend at least 85% of premiums must be used for actual health care, i.e. drugs. (The rest goes toward overhead and profits.)
So increases in Part D premiums are not due to insurers boosting profit margins but reflect quickly rising drug prices. These rapid price increases are across the board: new niche drugs (including me-too drugs that add little value), existing brand name drugs (even off patent drugs like insulin), and generics.
Regarding the original article, what's the problem?
The arithmetic of a progressive income tax is that the more you make the higher the percentage of your income you pay in tax. So the top 10% of earners pay 1.6x the average rate (54%/34%).
In the US, the top 56% of American households pay 100% of income taxes (that's 1.8x the average rate).
If the top 10% of Canadian earners paying 1.6x the average rate is too much, then the top 10% of Americans paying 1.8x (or more) the average rate is outrageous. We need to have the poor contribute to relieving this onerous tax burden on the upper class! Not.
Maybe if they paid the poor enough wage money so that they could pay taxes rather than having them waste their money on the struggle to survive they'd be happier. Oh who am I kidding.
Comments
How does the Canadian drug pricing compare to the GoodRx program pricing, discussed here previously, for your location?
*****************************************
... (Checking the Advair cost on Good Rx now:) Advair cost is $121 "with free discount" (coupon?). Not much of a bargain!
**********************************************
My own prescriptions are BOUGHT through "90DayMeds." They are located in Surrey, B.C. (Vancouver suburb.) but one of them is SHIPPED from Britain, and the other one from Turkey, from the looks of the handy identifier-symbol. Red background, crescent moon, with the star in it. I might be wrong.
But I'm also getting a volume discount for buying three units of each, and a 1st-time, $20 US customer discount. So, $70 plus $78 = $148, but next time, it will be more. But not MUCH more.
Hope this is informative. 1-800-828-4889. The stuff is sent by USPS. It can be tracked, too, prior to delivery.
My doctor just had to use their fax number to send the scripts. Some other outfits require that you fax your own ID and a paper, physical copy is required to be sent, soon after. But I encountered none of that shit with 90DayMeds. And the agents on the phone speak proper Canadian English, not the fractured Filipino call center version of "Heenglish."
One needs to be careful when dealing with online pharmacies. I did a fair amount of cross checking a few years ago when a doctor of mine suggested getting a prescription he wrote filled at a Canadian pharmacy. FWIW, 90DayMeds is validated by PharmacyChecker.com but not CIPA. The others are validated by both. But AdGuard says that MapleLeafMeds.com "has been reported as a malware page."
My observation on pricing, FWIW, is that except for manufacturer-issued discount cards for their individual products, you're not going to get much of a discount on drugs that have no generic. For example, GoodRx is showing around a 10% discount on Eliquis (which lists for around $500). Brand name drugs are sold more cheaply outside of the US, so one is often better price-wise going the import route if it's brand name vs. brand name.
Often a brand name goes off patent outside of the US first. Then it's no contest, the international generic is much less costly than the domestic brand name even with GoodRx or equivalent.
When a brand name drug first goes off patent, production of the generic may be limited to one manufacturer. Even after that short transition period ends, it can take some time for the generic drug price to drop. After a year or two the generic should get much cheaper. Until then, the international import still wins on price. That may be what's happening with Advair. The first generic was approved just under a year ago.
When it comes to mature generic vs. mature generic, I expect US prices to be competitive. Either because the generic is covered with a reasonable co-pay under your insurance, or a GoodRx-type coupon will bring it down to a sane price, or a pharmacy like Costco will sell it at a fair price. So far that's been my experience.
MasterCard and Visa long ago acquiesced to the US government's request not to assist importation of drugs. They will not process payments to Canadian pharmacies. So I am curious that 90DayMeds says that it accepts all credit cards.
https://www.pharmacycheckerblog.com/visa-policies-curtail-consumer-access-to-safe-medicines-online-reminiscent-of-china-or-north-korea
https://emerchantbroker.com/blog/fda-puts-the-squeeze-on-pharmacies-your-pharmacy-merchant-account/
I could not even begin to imagine how they make this happen. Purchase is over the phone on an ostensibly US toll free number. Though I suppose the phone number could be arranged to be valid both in Canada and USA. But they are marketing to the USA. It was delivered by USPS and can be tracked. 90DayMeds even provides a link. But the postmark was from The Royal Mail. Anyhow, none of this will go to meet my drug deductible for 2020, but I'm still coming out ahead. The monthly premium I pay for my drug policy went from $13.90 in 2019 to $17.30 in 2020. On a percentage basis, that's f****** robbery. I do get some of my stuff for zero copays.
So increases in Part D premiums are not due to insurers boosting profit margins but reflect quickly rising drug prices. These rapid price increases are across the board: new niche drugs (including me-too drugs that add little value), existing brand name drugs (even off patent drugs like insulin), and generics.
https://health.usnews.com/health-care/for-better/articles/2019-02-06/why-are-prescription-drug-prices-rising
The arithmetic of a progressive income tax is that the more you make the higher the percentage of your income you pay in tax. So the top 10% of earners pay 1.6x the average rate (54%/34%).
In the US, the top 56% of American households pay 100% of income taxes (that's 1.8x the average rate).
If the top 10% of Canadian earners paying 1.6x the average rate is too much, then the top 10% of Americans paying 1.8x (or more) the average rate is outrageous. We need to have the poor contribute to relieving this onerous tax burden on the upper class! Not.