8 ms·

What I find interesting when comparing the US the Canada on topics like these is that in Canada, there is self-interest in demanding workers be protected. Like

by mabbo 3y ago

What I find interesting when comparing the US the Canada on topics like these is that in Canada, there is self-interest in demanding workers be protected. Like beyond the fact that it's a good thing you do. Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher. There's incentives for our government to protect workers from risks that will cost a fortune to fix. In America, there's only the "because it's the right thing to do" reason, which is never enough for anyone to actually do anything.

bushbaba 3y ago
America offers Medicare so we still bear the cost. Just only if they live long enough to receive the retirement benefits. Yeah one heck of a perverse incentive.
- cj 3y ago
  Medicare for the elderly, but we also have Medicaid for people in poverty (< $15k/yr income for a single person w/o a family) which covers most basic medical/dental/ vision needs and is taxpayer funded. Someone taken out of the workforce may qualify for that if they don’t already qualify for disability insurance or similar payments (although I’m not 100% clear if those are funded via private disability insurance or public programs)
  - lotsofpulp 3y ago
    Medicaid is not at all comparable to Medicare. First, Medicare pays a lot more to healthcare providers than Medicaid. Medicare pays more for more medications than Medicaid, and has fewer prior authorization requirements for those medicines. Fewer providers will accept Medicaid, and people using Medicaid will receive less or worse healthcare than those in Medicare. Second, Medicaid is administered by each state, and there is a lot of variability on how easy the state makes it so people can actually get healthcare. Lots of states straight up refuse money simply to punish people of a certain socioeconomic class because it happens to win votes. Bottom line, Medicaid is so leaders can claim they are helping poor people get healthcare AND keep taxes low. Medicare is for actually delivering healthcare to people because that contingent makes up a huge proportion of votes. And yes, even Medicare is not delivering all healthcare, as it has multiple tiers to deliver differing amounts of healthcare to different socioeconomic classes.
    - thomastjeffery 3y ago
      The most obvious point: if they were equivalent programs, we would just include people under the poverty line with Medicare. Instead, we have a completely different program, managed by different people with different goals. Down to its very core, Medicaid is a political football.
      - lotsofpulp 3y ago
        Exactly, I guess my comment could have been much shorter. I love how there is even an Additional Medicare Tax. The political lines in the US are very much old v young, but some of the young, especially politically active ones, vote with the old since they are among the wealthy young, and the rest do not participate enough, or do not have sufficient knowledge about how resources are being meted out and how they will be affected now and in the future.
  - cma 3y ago
    Not in all states if you have no dependents.
- sologoub 3y ago
  Since the examples are in CA, there is Medi-Cal for those who are too poor to buy subsidized insurance and it’s not age-related unlike Medicare. It’s an expanded form of Medicaid. I’d bet CA taxpayers do shoulder the costs if the victims know to apply.
galangalalgol 3y ago
Incidentally this is also why everyone working in a nation has to receive these benefits (and any others guaranteed to citizens), otherwise you get migrant workers who suck up this, quite literally in this case, but don't receive healthcare.
- lm28469 3y ago
  Only illegal migrants aren't covered, legal ones are. If you make it available to everyone regardless of their legality to be on the soil you open up a whole bunch of other issues
  - morelisp 3y ago
    Like what?
    - lm28469 3y ago
      Like giving people an incentive to illegally come to your country ? If there are no difference between coming legally or illegally the choice is easy. Like I could just book a one way flight to LA and become a US citizen because reasons ?
      - duped 3y ago
        Like how most of our ancestors got here, you mean?
        lazide 3y ago
        Well, not since ~1882. https://www.uscis.gov/about-us/our-history/overview-of-ins-history/early-american-immigration-policies https://www.uscis.gov/about-us/our-history/overview-of-ins-h... That said, overstaying tourist visas (aka just hopping on a plane and then not going back) is a very popular form of illegal immigration into the US.
        AnthonyMouse 3y ago
yjftsjthsd-h 3y ago
> Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher. The taxes part is the same; only the healthcare half is different.
rafaelmn 3y ago
Not agreeing/disagreeing with this you but I wonder how you feel about obesity tax ? Low physical fitness tax ? There's plenty of evidence that exercise and diet significantly impact health (especially on population level) - like you said there's an incentive to keep those people healthy contributors instead of chronic burdens on the system. Sounds like a logical extension but doesn't seem popular/implemented widely.
- morelisp 3y ago
  If you take this view, any tax on current state is like a "cancer tax" - you're just doubly punishing the person. Sugar tax, coal tax, corn syrup tax, worked-your-employees-90h/week tax? Sure.
- pydry 3y ago
  I feel great about slapping a tax on the profits of companies that sell highly processed, sugary, addictive foods so that the market selects for healthier alternatives. Maybe subsidies for selling fresh fruit and veg also. I guess you could tax their victims instead though... they don't have a lobby so theyre probably easier to take advantage of.
  - echelon 3y ago
    > I guess you could tax their victims instead though... they don't have a lobby so theyre probably easier to take advantage of. Nobody is the victim of choosing to eat a cake.
    - ImHereToVote 3y ago
      When you live in poverty and have no prospects for the future. Some mass produced cake from the supermarket might be the only thing keeping you together. As soon as the work of the laptop class is automated by next generation agentic LLM's, you will probably understand.
      - filoleg 3y ago
DoreenMichele 3y ago
Last I checked, Canada doesn't share a border with Mexico and some portion of these Latino "day workers" are illegal immigrants. Day workers are often paid under the table and when I have read other stories about them, they tend to include medical horror stories like "So, this guy cut 3 of his fingers off and they didn't even take him to the ER. They just returned him to the place where they had picked him up." This is not exactly the best use case for arguing about Canada versus US healthcare policies.
- Tao3300 3y ago
  More policy preaching from ultra-white northern countries that don't let anyone in. It's such a tired trope...
  - kamilner 3y ago
    Canada doesn't let anyone in? Over a fifth of their population was born outside of Canada. Edit: Actually over a quarter.
  - swagempire 3y ago
    Canada is pretty heavy on immigration I hear-- its how they partially make up for a declining birthrate.
    - chiefalchemist 3y ago
      It's not only Canada that uses immigration - legal or turning a blind eye to illegal - to make up for falling birthrate. Look at Germany. Look at France. Look at what's happen to Japan because such an option isn't as viable. It's simply not politically feasable to say, "Without immigrants, our economy is f'ed."
      - arcticbull 3y ago
        American too, birth rate is 1.6, well below a replacement rate of 2.1
      - 3y ago
ChumpGPT 3y ago
>What I find interesting when comparing the US the Canada on topics like these is that in Canada, there is self-interest in demanding workers be protected. Like beyond the fact that it's a good thing you do. Is there any evidence of this? That the Canadian Gov cares more about workers than the US Gov? >Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher. What evidence do you have that this is the case? >In America, there's only the "because it's the right thing to do" reason, which is never enough for anyone to actually do anything. Is this your opinion or is this the reality. I don't know if you have ever walked by a construction site in Toronto to see guys cutting cement or stone. None of them have masks. Sometimes they will have a wet saw when cutting cement on the street but that is to reduce dust for traffic and pedestrians and not so much for their health. The Canadian Postal Union fought the Federal Gov for years to provide an environment where paper dust was considered a health hazard and workers need to be protected. Many postal workers suffered from COPD because paper dust was too fine for the Lungs to filter. What about farmers and dust? I'm sure they suffer just as much as American farmers. I've come to realize Canadians suffer from an inferiority complex and have to constantly try and make comparisons to make themselves feel better, it's a strange phenomena. - Expat....
- Aeolun 3y ago
  I don’t think cutting in the open air and cutting in tiny sweatshops are at all comparable.
  - ceejayoz 3y ago
    Exposure won’t be anywhere near zero outdoors unless there’s a serious breeze. Over decades that’ll add up.
  - ChumpGPT 3y ago
    Then you have never seen someone cut stone in open air. Because it creates such a cloud of stone dust you could hide a house in it.
Anon1096 3y ago
Perhaps unexpectedly, people dying are usually _cheaper_ for a healthcare system than healthy people. This has been studied a lot with smokers, basically people in old age cost far more than young people and thus a true cost-minimizing system would not be how you expect. Of course, we aren't trying to minimize cost so the premise is flawed.
- DoughnutHole 3y ago
  This is very dependent on the illness. From a cost perspective it’s best that people die suddenly. If I live a fairly healthy life into my 80s and die of a heart attack, I might not necessarily have cost my insurer that much, as opposed to if I suffer from a chronic illness for 10, 20, 30 years. Cancer is now usually not a sudden death sentence - treatment is good enough now that most cancers caught early can be treated and patients often go through multiple remissions before it or a complication from treatment finally gets them. Insurers very much do not want their customers getting cancer, because it is invariable an extraordinarily expensive condition to treat and treatment can go on for years.
  - haldujai 3y ago
    > Cancer is now usually not a sudden death sentence - treatment is good enough now that most cancers caught early can be treated and patients often go through multiple remissions before it or a complication from treatment finally gets them. Small clarification - early detection is most often curative and cheap. The really expensive part is that several advanced stage cancers (even IV with widely disseminated metastatic disease) now survive for many years on treatments costing low to mid 6 figures/year. It actually provides a pretty good incentive for insurers to cover screening and early detection beyond what is mandated by law.
    - CrazyStat 3y ago
      > Small clarification - early detection is most often curative and cheap. > It actually provides a pretty good incentive for insurers to cover screening and early detection beyond what is mandated by law. The evidence in favor of mass screening programs in the hope of early detection is actually weak to non-existent [1]. > In total, 2 111 958 individuals enrolled in randomized clinical trials comparing screening with no screening using 6 different tests were eligible. Median follow-up was 10 years for computed tomography, prostate-specific antigen testing, and colonoscopy; 13 years for mammography; and 15 years for sigmoidoscopy and FOBT. The only screening test with a significant lifetime gain was sigmoidoscopy (110 days; 95% CI, 0-274 days). There was no significant difference following mammography (0 days: 95% CI, −190 to 237 days), prostate cancer screening (37 days; 95% CI, −37 to 73 days), colonoscopy (37 days; 95% CI, −146 to 146 days), FOBT screening every year or every other year (0 days; 95% CI, −70.7 to 70.7 days), and lung cancer screening (107 days; 95% CI, −286 days to 430 days). There are large institutions, both nonprofit and commercial, which stand to gain by convincing people that mass screening is useful and important. The available scientific evidence does not support their position. [1] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2808648 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
lazide 3y ago
How do you explain the massive push to ban/stop Smoking? The US is pretty much the only country to successfully reduce it, near as I can tell (perhaps Canada has had success too?).
- steve_adams_86 3y ago
  Canada worked to discourage and regulate smoking more aggressively around 20-30 years ago, and in 20 years we’ve gone from around 1 in 4 people smoking to more like 1 in 10. It steadily trends down. https://uwaterloo.ca/tobacco-use-canada/adult-tobacco-use/smoking-canada/current-smoking-prevalence https://uwaterloo.ca/tobacco-use-canada/adult-tobacco-use/sm...
- mitthrowaway2 3y ago
  I'm curious about how you got that impression. In Canada, smoking is down from 26% in 2001[1] to 15% in 2019[2]. (Cannabis consumption is probably trending upward though). I have no reason to believe that this decline is particular to the US and Canada. Japan has been trending down from 33% in 2000 to 20% in 2020[3]. I expect this will have accelerated since the government made a strong anti-smoking push during the Tokyo Olympics. In fact, this seems to be a trend across the entire developed world, see this chart[4] showing that cigarette sales per adult per day peaked by the 1980s in every developed country surveyed, and all have been trending downward for decades. The US shows up as exceptional mainly in how extremely high its cigarette consumption habits were in the '60s and '70s. [1] https://www150.statcan.gc.ca/n1/pub/82-624-x/2012001/article/11676-eng.htm https://www150.statcan.gc.ca/n1/pub/82-624-x/2012001/article... [2] https://www150.statcan.gc.ca/n1/pub/82-625-x/2020001/article/00003-eng.htm https://www150.statcan.gc.ca/n1/pub/82-625-x/2020001/article... [3] https://www.macrotrends.net/countries/JPN/japan/smoking-rate-statistics https://www.macrotrends.net/countries/JPN/japan/smoking-rate... [4] https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day https://ourworldindata.org/grapher/sales-of-cigarettes-per-a...
  - lazide 3y ago
    Ah, it was just a much larger shift in the US, especially demographically. It went from 44% of adults (stats not gathered on younger folks, but anecdotally it was ‘cool’ and a lot of highschool age kids smoked) to 13.8% for adults (anecdotally many quite old) and only 8.8% for younger folks. Traveling outside the US to Europe or Asia (eastern/southern Europe or China in particular) it’s very visible, where in the US outside of a few locations it’s almost invisible now and notably uncommon. Especially for educated or higher income folks, too.
AnthonyMouse 3y ago
> Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher. The US healthcare system uses private insurance, implying that more use of the healthcare system raises everyone's premiums. And people without insurance then go to emergency rooms which are in turn still passing the cost onto private insurers. So voters already have the same incentive in order to avoid their premiums going up.
- thomastjeffery 3y ago
  That incentive is obfuscated, though. Every insurer exists as an invisible boundary where cost is not passed to others. On top of that, insurance is optional. There is no guarantee a person will get affordable care. That's the entire point of the system! If there were a guarantee, it would be indistinguishable from Canada (and practically every other country's) single payer healthcare system.
  - AnthonyMouse 3y ago
    > Every insurer exists as an invisible boundary where cost is not passed to others. How does that affect issues like this where an increase in overall costs would reasonably be expected to apply to all insurers? > On top of that, insurance is optional. More than 90% of the population has health insurance, which is well over the majority required to bring about legislation. > If there were a guarantee, it would be indistinguishable from Canada (and practically every other country's) single payer healthcare system. That certainly isn't true. Serious problems with the US healthcare system include AMA lobbying to maintain a doctor shortage, various patent laws and FDA rules that limit competition and increase costs and a malicious lack of cost transparency. None of that would be improved merely by routing the premiums through the government.
mhb 3y ago
We already have the government involved - OSHA. Why would having it more involved be better if its current involvement is not solving the problem? It's pretty to think that the government has some sort of self-interest and if it can save money in the long run by spending money in the short run, it will do that. But that's not how things work, is it? A more plausible conclusion from observing the results of an entity's involvement in something is that if it is incompetent with the thing you gave it to do, don't give it more stuff to do.
- bastawhiz 3y ago
  > if it is incompetent with the thing you gave it to do, don't give it more stuff to do. When my code doesn't work, I don't sunset the code, I fix it. Why would the best course of action be to stop trying instead of fixing the root of the problem?
  - mhb 3y ago
    When your Maytag dishwasher breaks after a month, do you think the best thing to do is to buy a Maytag washing machine?
    - bastawhiz 3y ago
      I don't say "I'm not using a dishwasher anymore" I figure out how to get the dishwasher that's in my kitchen fixed.
      - mhb 3y ago
        Fine. So advocate for fixing OSHA instead of revamping the entire health care system.
        bastawhiz 3y ago
        It's almost as if we should do both!
  - 3y ago
haldujai 3y ago
Canadian data is relatively poor quality (mostly from the 90s) outside of Alberta (I expect QC and BC probably have the highest rates) but historically and estimates are that we have slightly higher incidence than the US. https://onlinelibrary.wiley.com/doi/full/10.1111/resp.14242 https://onlinelibrary.wiley.com/doi/full/10.1111/resp.14242 > There’s incentives for our government to protect workers from risks that will cost a fortune to fix. There are many examples where this is inaccurate but let’s keep it simple and delve a little deeper into the silicosis problem presented in this specific study. From the JAMA article: Although a substantial number of the patients, including some of those who were uninsured or with restricted-scope Medi-Cal, likely had an undocumented immigration status, we did not directly collect information about whether individuals were undocumented immigrants. Note that public health system in Canada is not “free”. Legal immigrants, documented workers, citizens and refugees have access to provincial or federal health insurance which pays for care. Undocumented or illegal immigrants have neither (and also would not get WSIB which would be the payer for most silicosis cases) and actually have better coverage in California. Additionally: Ten patients (19%) were uninsured, 20 (38%) had restricted-scope Medi-Cal, 7 (13%) had Medi-Cal, 8 (15%) had private insurance, and 7 (13%) had workers’ compensation. So 34/52 had some form of government provided or mandated insurance. As an aside while restricted-scope Medi-Cal and uninsured rates are the surrogates for undocumented immigrants in this study, those over the age of 50 (or 19-25) are also eligible for full scope Medi-Cal but were not identified in this study. Medi-Cal will also be expanding in January 2024 to cover undocumented immigrants aged 26-49. Even if we assume Canada’s silicosis incidence is lower, all of the above strongly suggests your public health system cost-savings incentive hypothesis is incorrect.
- pupppet 3y ago
  > Canadian data is relatively poor quality Sure, no axe to grind here. Do tell us your impartial take.
  - haldujai 3y ago
    Perhaps you are unfamiliar with medical research but stating that available data is poor quality is an objective assessment. I provided a brief explanation in parentheses which you excluded for some reason. I also provided a reference that is open access but here is the relevant section for you: In Canada, there are no national data on the incidence or prevalence of silicosis. In the province of Alberta, where silicosis is a notifiable disease, health insurance data revealed 861 cases with at least one reported diagnosis of ‘silicosis’ during a period of 10 years from 2000. These results were based on raw data and not a secondary review of primary imaging and clinical information. Data from 2000 through 2009 showed that only 29 workers' compensation claims were accepted for silicosis in Alberta. Data from Quebec's compensation system revealed 351 compensated cases of silicosis between 1988 and 1998. Of note, workers who participated in regular surveillance had milder disease at the time of compensation. The JAMA study is from 2019-2022. Data that is 20-30 years old is relatively poor quality. Changes in medicine, workplace safety rules and occupational trends makes it hard to compare to silicosis rates in Canada to the US in order to assess the claims of the comment I replied to therefore I think the relative incidence described in this review article (from 2022) is inaccurate. If you want to disregard my quality assessment, the discussion ends with the review article showing silicosis rates are 3x higher in Canada. Can you elaborate on how any of this shows I have an axe to grind or that I’m biased?
dghughes 3y ago
Then again my Dad who died of a lung disease said the government agency (Coast Guard) he worked for turned a blind eye to what he and his co-workers had to do. Dad would tell me even as the late 1990s his job was to take a powder, wet it, form it into big mats. They were filters for the boiler water. The powder used was or maybe just contained asbestos. He said the workers on the dock were covered in it he said the place looked like it had snowed. Dad knew but he was stuck in the past of "It had to be done" mentality. And really as a high school drop out he really may not have understood the danger. For years he and my grandfather had a painting business with the paint at that time containing lead.
frozenport 3y ago
Does Canada have a different policy on engineered stone?
ilyt 3y ago
The problem is that you generally have to force people to keep their own safety. Else the el cheapo company shitting on any work safety will be cheaper and quicker, coz workers don't know any better, and thus more competitive, at worst killing the companies trying to do it properly.
paulddraper 3y ago
> Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher. That is true with or without publicly funded healthcare.
- grecy 3y ago
  You could argue that more sick people is good for the US economy, and it helps rich people get richer.
  - paulddraper 3y ago
    Also, broken windows
    - grecy 3y ago
      To the tune of billions of dollars, yes.
cjbgkagh 3y ago
I have ME/CFS and the fact that we're expensive to the general public seems to be the only reason there is any public money spent on treatments and cures at all. However, Canada and others are finding that medically assisted suicide offers an even cheaper alternative solution. So instead of money spent on treatments and cures we get subtle and not so subtle encouragements to kill ourselves, and I expect the problem to keep getting worse. I.e. I don't think the actual emergent behaviour for shared healthcare costs is as altruistic as you appear to except.
dang 3y ago
Please don't take HN threads on generic nationalistic flamewar tangents. I'm sure you didn't intend it, but that's what this leads to, in the statistical case. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Edit: we've had to ask you not to do this on HN more than once before. Please avoid it in the future. https://news.ycombinator.com/item?id=34492512 https://news.ycombinator.com/item?id=34492512 (Jan 2023) https://news.ycombinator.com/item?id=34073107 https://news.ycombinator.com/item?id=34073107 (Dec 2022)
- mabbo 3y ago
  Sorry Dang. I hadn't realized it was coming off that way, but I'll be my best to check myself in the future. I can see how what I said would be construed that way.
  - dang 3y ago
    Appreciated!
- slumpt_ 3y ago
  He was drawing a pretty reasonable comparison between economic incentives in the respective countries and how it has downstream affects for regulatory response. Don't make it something it isn't.
  - dang 3y ago
    You make a good point, enough for me to realize that I misunderstood the comment. Still, the last sentence of the GP comment veered into nationalistic putdown. Flamebait in a comment has to do with the most inflammatory thing it contains, not the most interesting thing. When a house is on fire, people don't admire the décor.

by mabbo 3y ago

bushbaba 3y ago

America offers Medicare so we still bear the cost. Just only if they live long enough to receive the retirement benefits. Yeah one heck of a perverse incentive.

cj 3y ago
Medicare for the elderly, but we also have Medicaid for people in poverty (< $15k/yr income for a single person w/o a family) which covers most basic medical/dental/ vision needs and is taxpayer funded. Someone taken out of the workforce may qualify for that if they don’t already qualify for disability insurance or similar payments (although I’m not 100% clear if those are funded via private disability insurance or public programs)
- lotsofpulp 3y ago
  Medicaid is not at all comparable to Medicare. First, Medicare pays a lot more to healthcare providers than Medicaid. Medicare pays more for more medications than Medicaid, and has fewer prior authorization requirements for those medicines. Fewer providers will accept Medicaid, and people using Medicaid will receive less or worse healthcare than those in Medicare. Second, Medicaid is administered by each state, and there is a lot of variability on how easy the state makes it so people can actually get healthcare. Lots of states straight up refuse money simply to punish people of a certain socioeconomic class because it happens to win votes. Bottom line, Medicaid is so leaders can claim they are helping poor people get healthcare AND keep taxes low. Medicare is for actually delivering healthcare to people because that contingent makes up a huge proportion of votes. And yes, even Medicare is not delivering all healthcare, as it has multiple tiers to deliver differing amounts of healthcare to different socioeconomic classes.
  - thomastjeffery 3y ago
    The most obvious point: if they were equivalent programs, we would just include people under the poverty line with Medicare. Instead, we have a completely different program, managed by different people with different goals. Down to its very core, Medicaid is a political football.
    - lotsofpulp 3y ago
      Exactly, I guess my comment could have been much shorter. I love how there is even an Additional Medicare Tax. The political lines in the US are very much old v young, but some of the young, especially politically active ones, vote with the old since they are among the wealthy young, and the rest do not participate enough, or do not have sufficient knowledge about how resources are being meted out and how they will be affected now and in the future.
- cma 3y ago
  Not in all states if you have no dependents.
sologoub 3y ago
Since the examples are in CA, there is Medi-Cal for those who are too poor to buy subsidized insurance and it’s not age-related unlike Medicare. It’s an expanded form of Medicaid. I’d bet CA taxpayers do shoulder the costs if the victims know to apply.

galangalalgol 3y ago

Incidentally this is also why everyone working in a nation has to receive these benefits (and any others guaranteed to citizens), otherwise you get migrant workers who suck up this, quite literally in this case, but don't receive healthcare.

lm28469 3y ago
Only illegal migrants aren't covered, legal ones are. If you make it available to everyone regardless of their legality to be on the soil you open up a whole bunch of other issues
- morelisp 3y ago
  Like what?
  - lm28469 3y ago
    Like giving people an incentive to illegally come to your country ? If there are no difference between coming legally or illegally the choice is easy. Like I could just book a one way flight to LA and become a US citizen because reasons ?
    - duped 3y ago
      Like how most of our ancestors got here, you mean?
      - lazide 3y ago
        Well, not since ~1882. https://www.uscis.gov/about-us/our-history/overview-of-ins-history/early-american-immigration-policies https://www.uscis.gov/about-us/our-history/overview-of-ins-h... That said, overstaying tourist visas (aka just hopping on a plane and then not going back) is a very popular form of illegal immigration into the US.
      - AnthonyMouse 3y ago

yjftsjthsd-h 3y ago

rafaelmn 3y ago

Not agreeing/disagreeing with this you but I wonder how you feel about obesity tax ? Low physical fitness tax ? There's plenty of evidence that exercise and diet significantly impact health (especially on population level) - like you said there's an incentive to keep those people healthy contributors instead of chronic burdens on the system. Sounds like a logical extension but doesn't seem popular/implemented widely.

morelisp 3y ago
If you take this view, any tax on current state is like a "cancer tax" - you're just doubly punishing the person. Sugar tax, coal tax, corn syrup tax, worked-your-employees-90h/week tax? Sure.
pydry 3y ago
I feel great about slapping a tax on the profits of companies that sell highly processed, sugary, addictive foods so that the market selects for healthier alternatives. Maybe subsidies for selling fresh fruit and veg also. I guess you could tax their victims instead though... they don't have a lobby so theyre probably easier to take advantage of.
- echelon 3y ago
  > I guess you could tax their victims instead though... they don't have a lobby so theyre probably easier to take advantage of. Nobody is the victim of choosing to eat a cake.
  - ImHereToVote 3y ago
    When you live in poverty and have no prospects for the future. Some mass produced cake from the supermarket might be the only thing keeping you together. As soon as the work of the laptop class is automated by next generation agentic LLM's, you will probably understand.
    - filoleg 3y ago

DoreenMichele 3y ago

Last I checked, Canada doesn't share a border with Mexico and some portion of these Latino "day workers" are illegal immigrants. Day workers are often paid under the table and when I have read other stories about them, they tend to include medical horror stories like "So, this guy cut 3 of his fingers off and they didn't even take him to the ER. They just returned him to the place where they had picked him up." This is not exactly the best use case for arguing about Canada versus US healthcare policies.

Tao3300 3y ago
More policy preaching from ultra-white northern countries that don't let anyone in. It's such a tired trope...
- kamilner 3y ago
  Canada doesn't let anyone in? Over a fifth of their population was born outside of Canada. Edit: Actually over a quarter.
- swagempire 3y ago
  Canada is pretty heavy on immigration I hear-- its how they partially make up for a declining birthrate.
  - chiefalchemist 3y ago
    It's not only Canada that uses immigration - legal or turning a blind eye to illegal - to make up for falling birthrate. Look at Germany. Look at France. Look at what's happen to Japan because such an option isn't as viable. It's simply not politically feasable to say, "Without immigrants, our economy is f'ed."
    - arcticbull 3y ago
      American too, birth rate is 1.6, well below a replacement rate of 2.1
    - 3y ago

ChumpGPT 3y ago

>What I find interesting when comparing the US the Canada on topics like these is that in Canada, there is self-interest in demanding workers be protected. Like beyond the fact that it's a good thing you do. Is there any evidence of this? That the Canadian Gov cares more about workers than the US Gov? >Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher. What evidence do you have that this is the case? >In America, there's only the "because it's the right thing to do" reason, which is never enough for anyone to actually do anything. Is this your opinion or is this the reality. I don't know if you have ever walked by a construction site in Toronto to see guys cutting cement or stone. None of them have masks. Sometimes they will have a wet saw when cutting cement on the street but that is to reduce dust for traffic and pedestrians and not so much for their health. The Canadian Postal Union fought the Federal Gov for years to provide an environment where paper dust was considered a health hazard and workers need to be protected. Many postal workers suffered from COPD because paper dust was too fine for the Lungs to filter. What about farmers and dust? I'm sure they suffer just as much as American farmers. I've come to realize Canadians suffer from an inferiority complex and have to constantly try and make comparisons to make themselves feel better, it's a strange phenomena. - Expat....

Aeolun 3y ago
I don’t think cutting in the open air and cutting in tiny sweatshops are at all comparable.
- ceejayoz 3y ago
  Exposure won’t be anywhere near zero outdoors unless there’s a serious breeze. Over decades that’ll add up.
- ChumpGPT 3y ago
  Then you have never seen someone cut stone in open air. Because it creates such a cloud of stone dust you could hide a house in it.

Anon1096 3y ago

Perhaps unexpectedly, people dying are usually _cheaper_ for a healthcare system than healthy people. This has been studied a lot with smokers, basically people in old age cost far more than young people and thus a true cost-minimizing system would not be how you expect. Of course, we aren't trying to minimize cost so the premise is flawed.

DoughnutHole 3y ago
This is very dependent on the illness. From a cost perspective it’s best that people die suddenly. If I live a fairly healthy life into my 80s and die of a heart attack, I might not necessarily have cost my insurer that much, as opposed to if I suffer from a chronic illness for 10, 20, 30 years. Cancer is now usually not a sudden death sentence - treatment is good enough now that most cancers caught early can be treated and patients often go through multiple remissions before it or a complication from treatment finally gets them. Insurers very much do not want their customers getting cancer, because it is invariable an extraordinarily expensive condition to treat and treatment can go on for years.
- haldujai 3y ago
  > Cancer is now usually not a sudden death sentence - treatment is good enough now that most cancers caught early can be treated and patients often go through multiple remissions before it or a complication from treatment finally gets them. Small clarification - early detection is most often curative and cheap. The really expensive part is that several advanced stage cancers (even IV with widely disseminated metastatic disease) now survive for many years on treatments costing low to mid 6 figures/year. It actually provides a pretty good incentive for insurers to cover screening and early detection beyond what is mandated by law.
  - CrazyStat 3y ago
    > Small clarification - early detection is most often curative and cheap. > It actually provides a pretty good incentive for insurers to cover screening and early detection beyond what is mandated by law. The evidence in favor of mass screening programs in the hope of early detection is actually weak to non-existent [1]. > In total, 2 111 958 individuals enrolled in randomized clinical trials comparing screening with no screening using 6 different tests were eligible. Median follow-up was 10 years for computed tomography, prostate-specific antigen testing, and colonoscopy; 13 years for mammography; and 15 years for sigmoidoscopy and FOBT. The only screening test with a significant lifetime gain was sigmoidoscopy (110 days; 95% CI, 0-274 days). There was no significant difference following mammography (0 days: 95% CI, −190 to 237 days), prostate cancer screening (37 days; 95% CI, −37 to 73 days), colonoscopy (37 days; 95% CI, −146 to 146 days), FOBT screening every year or every other year (0 days; 95% CI, −70.7 to 70.7 days), and lung cancer screening (107 days; 95% CI, −286 days to 430 days). There are large institutions, both nonprofit and commercial, which stand to gain by convincing people that mass screening is useful and important. The available scientific evidence does not support their position. [1] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2808648 https://jamanetwork.com/journals/jamainternalmedicine/fullar...

lazide 3y ago

How do you explain the massive push to ban/stop Smoking? The US is pretty much the only country to successfully reduce it, near as I can tell (perhaps Canada has had success too?).

steve_adams_86 3y ago
Canada worked to discourage and regulate smoking more aggressively around 20-30 years ago, and in 20 years we’ve gone from around 1 in 4 people smoking to more like 1 in 10. It steadily trends down. https://uwaterloo.ca/tobacco-use-canada/adult-tobacco-use/smoking-canada/current-smoking-prevalence https://uwaterloo.ca/tobacco-use-canada/adult-tobacco-use/sm...
mitthrowaway2 3y ago
I'm curious about how you got that impression. In Canada, smoking is down from 26% in 2001[1] to 15% in 2019[2]. (Cannabis consumption is probably trending upward though). I have no reason to believe that this decline is particular to the US and Canada. Japan has been trending down from 33% in 2000 to 20% in 2020[3]. I expect this will have accelerated since the government made a strong anti-smoking push during the Tokyo Olympics. In fact, this seems to be a trend across the entire developed world, see this chart[4] showing that cigarette sales per adult per day peaked by the 1980s in every developed country surveyed, and all have been trending downward for decades. The US shows up as exceptional mainly in how extremely high its cigarette consumption habits were in the '60s and '70s. [1] https://www150.statcan.gc.ca/n1/pub/82-624-x/2012001/article/11676-eng.htm https://www150.statcan.gc.ca/n1/pub/82-624-x/2012001/article... [2] https://www150.statcan.gc.ca/n1/pub/82-625-x/2020001/article/00003-eng.htm https://www150.statcan.gc.ca/n1/pub/82-625-x/2020001/article... [3] https://www.macrotrends.net/countries/JPN/japan/smoking-rate-statistics https://www.macrotrends.net/countries/JPN/japan/smoking-rate... [4] https://ourworldindata.org/grapher/sales-of-cigarettes-per-adult-per-day https://ourworldindata.org/grapher/sales-of-cigarettes-per-a...
- lazide 3y ago
  Ah, it was just a much larger shift in the US, especially demographically. It went from 44% of adults (stats not gathered on younger folks, but anecdotally it was ‘cool’ and a lot of highschool age kids smoked) to 13.8% for adults (anecdotally many quite old) and only 8.8% for younger folks. Traveling outside the US to Europe or Asia (eastern/southern Europe or China in particular) it’s very visible, where in the US outside of a few locations it’s almost invisible now and notably uncommon. Especially for educated or higher income folks, too.

AnthonyMouse 3y ago

> Because we have a public health care system, funded by taxes, having a large number of young men out of the work force (not paying taxes) and using the health care system effectively means my taxes, everyone's taxes, are higher. The US healthcare system uses private insurance, implying that more use of the healthcare system raises everyone's premiums. And people without insurance then go to emergency rooms which are in turn still passing the cost onto private insurers. So voters already have the same incentive in order to avoid their premiums going up.

thomastjeffery 3y ago
That incentive is obfuscated, though. Every insurer exists as an invisible boundary where cost is not passed to others. On top of that, insurance is optional. There is no guarantee a person will get affordable care. That's the entire point of the system! If there were a guarantee, it would be indistinguishable from Canada (and practically every other country's) single payer healthcare system.
- AnthonyMouse 3y ago
  > Every insurer exists as an invisible boundary where cost is not passed to others. How does that affect issues like this where an increase in overall costs would reasonably be expected to apply to all insurers? > On top of that, insurance is optional. More than 90% of the population has health insurance, which is well over the majority required to bring about legislation. > If there were a guarantee, it would be indistinguishable from Canada (and practically every other country's) single payer healthcare system. That certainly isn't true. Serious problems with the US healthcare system include AMA lobbying to maintain a doctor shortage, various patent laws and FDA rules that limit competition and increase costs and a malicious lack of cost transparency. None of that would be improved merely by routing the premiums through the government.

mhb 3y ago

We already have the government involved - OSHA. Why would having it more involved be better if its current involvement is not solving the problem? It's pretty to think that the government has some sort of self-interest and if it can save money in the long run by spending money in the short run, it will do that. But that's not how things work, is it? A more plausible conclusion from observing the results of an entity's involvement in something is that if it is incompetent with the thing you gave it to do, don't give it more stuff to do.

bastawhiz 3y ago
> if it is incompetent with the thing you gave it to do, don't give it more stuff to do. When my code doesn't work, I don't sunset the code, I fix it. Why would the best course of action be to stop trying instead of fixing the root of the problem?
- mhb 3y ago
  When your Maytag dishwasher breaks after a month, do you think the best thing to do is to buy a Maytag washing machine?
  - bastawhiz 3y ago
    I don't say "I'm not using a dishwasher anymore" I figure out how to get the dishwasher that's in my kitchen fixed.
    - mhb 3y ago
      Fine. So advocate for fixing OSHA instead of revamping the entire health care system.
      - bastawhiz 3y ago
        It's almost as if we should do both!
- 3y ago

haldujai 3y ago

Canadian data is relatively poor quality (mostly from the 90s) outside of Alberta (I expect QC and BC probably have the highest rates) but historically and estimates are that we have slightly higher incidence than the US. https://onlinelibrary.wiley.com/doi/full/10.1111/resp.14242 https://onlinelibrary.wiley.com/doi/full/10.1111/resp.14242 > There’s incentives for our government to protect workers from risks that will cost a fortune to fix. There are many examples where this is inaccurate but let’s keep it simple and delve a little deeper into the silicosis problem presented in this specific study. From the JAMA article: Although a substantial number of the patients, including some of those who were uninsured or with restricted-scope Medi-Cal, likely had an undocumented immigration status, we did not directly collect information about whether individuals were undocumented immigrants. Note that public health system in Canada is not “free”. Legal immigrants, documented workers, citizens and refugees have access to provincial or federal health insurance which pays for care. Undocumented or illegal immigrants have neither (and also would not get WSIB which would be the payer for most silicosis cases) and actually have better coverage in California. Additionally: Ten patients (19%) were uninsured, 20 (38%) had restricted-scope Medi-Cal, 7 (13%) had Medi-Cal, 8 (15%) had private insurance, and 7 (13%) had workers’ compensation. So 34/52 had some form of government provided or mandated insurance. As an aside while restricted-scope Medi-Cal and uninsured rates are the surrogates for undocumented immigrants in this study, those over the age of 50 (or 19-25) are also eligible for full scope Medi-Cal but were not identified in this study. Medi-Cal will also be expanding in January 2024 to cover undocumented immigrants aged 26-49. Even if we assume Canada’s silicosis incidence is lower, all of the above strongly suggests your public health system cost-savings incentive hypothesis is incorrect.

pupppet 3y ago
> Canadian data is relatively poor quality Sure, no axe to grind here. Do tell us your impartial take.
- haldujai 3y ago
  Perhaps you are unfamiliar with medical research but stating that available data is poor quality is an objective assessment. I provided a brief explanation in parentheses which you excluded for some reason. I also provided a reference that is open access but here is the relevant section for you: In Canada, there are no national data on the incidence or prevalence of silicosis. In the province of Alberta, where silicosis is a notifiable disease, health insurance data revealed 861 cases with at least one reported diagnosis of ‘silicosis’ during a period of 10 years from 2000. These results were based on raw data and not a secondary review of primary imaging and clinical information. Data from 2000 through 2009 showed that only 29 workers' compensation claims were accepted for silicosis in Alberta. Data from Quebec's compensation system revealed 351 compensated cases of silicosis between 1988 and 1998. Of note, workers who participated in regular surveillance had milder disease at the time of compensation. The JAMA study is from 2019-2022. Data that is 20-30 years old is relatively poor quality. Changes in medicine, workplace safety rules and occupational trends makes it hard to compare to silicosis rates in Canada to the US in order to assess the claims of the comment I replied to therefore I think the relative incidence described in this review article (from 2022) is inaccurate. If you want to disregard my quality assessment, the discussion ends with the review article showing silicosis rates are 3x higher in Canada. Can you elaborate on how any of this shows I have an axe to grind or that I’m biased?

dghughes 3y ago

Then again my Dad who died of a lung disease said the government agency (Coast Guard) he worked for turned a blind eye to what he and his co-workers had to do. Dad would tell me even as the late 1990s his job was to take a powder, wet it, form it into big mats. They were filters for the boiler water. The powder used was or maybe just contained asbestos. He said the workers on the dock were covered in it he said the place looked like it had snowed. Dad knew but he was stuck in the past of "It had to be done" mentality. And really as a high school drop out he really may not have understood the danger. For years he and my grandfather had a painting business with the paint at that time containing lead.

frozenport 3y ago

Does Canada have a different policy on engineered stone?

ilyt 3y ago

The problem is that you generally have to force people to keep their own safety. Else the el cheapo company shitting on any work safety will be cheaper and quicker, coz workers don't know any better, and thus more competitive, at worst killing the companies trying to do it properly.

paulddraper 3y ago

grecy 3y ago
You could argue that more sick people is good for the US economy, and it helps rich people get richer.
- paulddraper 3y ago
  Also, broken windows
  - grecy 3y ago
    To the tune of billions of dollars, yes.

cjbgkagh 3y ago

I have ME/CFS and the fact that we're expensive to the general public seems to be the only reason there is any public money spent on treatments and cures at all. However, Canada and others are finding that medically assisted suicide offers an even cheaper alternative solution. So instead of money spent on treatments and cures we get subtle and not so subtle encouragements to kill ourselves, and I expect the problem to keep getting worse. I.e. I don't think the actual emergent behaviour for shared healthcare costs is as altruistic as you appear to except.

dang 3y ago

Please don't take HN threads on generic nationalistic flamewar tangents. I'm sure you didn't intend it, but that's what this leads to, in the statistical case. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Edit: we've had to ask you not to do this on HN more than once before. Please avoid it in the future. https://news.ycombinator.com/item?id=34492512 https://news.ycombinator.com/item?id=34492512 (Jan 2023) https://news.ycombinator.com/item?id=34073107 https://news.ycombinator.com/item?id=34073107 (Dec 2022)

mabbo 3y ago
Sorry Dang. I hadn't realized it was coming off that way, but I'll be my best to check myself in the future. I can see how what I said would be construed that way.
- dang 3y ago
  Appreciated!
slumpt_ 3y ago
He was drawing a pretty reasonable comparison between economic incentives in the respective countries and how it has downstream affects for regulatory response. Don't make it something it isn't.
- dang 3y ago
  You make a good point, enough for me to realize that I misunderstood the comment. Still, the last sentence of the GP comment veered into nationalistic putdown. Flamebait in a comment has to do with the most inflammatory thing it contains, not the most interesting thing. When a house is on fire, people don't admire the décor.