[helene_t]

Aberlour10, on May 20 2009, 09:38 AM, said:

Isn't there in the USA the statutory minimum wage by +- $ 6,50 ?

Amazing. I earned the equivalent to $13 per hour by cleaning offices during my hischool years 25 years ago. Must have gone up a little in the meantime. Btw it was considered a low salary for unskilled work.

[luke warm]

Aberlour10, on May 20 2009, 03:38 AM, said:

Isn't there in the USA the statutory minimum wage by +- $ 6,50 ?

not for wait staff... i believe most get about $2.50/hr. plus tips... if the job is one where there are no tips, min wage applies

[Codo]

helene_t, on May 20 2009, 06:20 PM, said:

Aberlour10, on May 20 2009, 09:38 AM, said:

Isn't there in the USA the statutory minimum wage by +- $ 6,50 ?

Amazing. I earned the equivalent to $13 per hour by cleaning offices during my hischool years 25 years ago. Must have gone up a little in the meantime. Btw it was considered a low salary for unskilled work.

Wow, here it is quite common nowadays to pay around 10 €/hour for cleaning.

25 years ago it had been around 3 or 4 €.

[PassedOut]

Richer countries can afford higher wages than the US. Over time we may catch up.

[JoAnneM]

Ever wonder why everything is so expensive in San Francisco? Waitstaff, by city law, earns the same minimum wage as everyone else in SF, which is $9.79. On top of that employers must provide medical benefits.

This has so angered many restaurant owners that many show a "medical benefit surcharge" as a separate amount on the check, hoping you won't include it on the tip.

I have mixed feelings about this, the Bay Area has a very high cost of living and housing, especially, is very expensive. Still, the restaurants are always busy.

[Phil]

onoway, on May 20 2009, 01:57 AM, said:

I'm confused. Why is a monster tip from someone who can afford it creepy? I bet the cocktail waitress didn't think it was! Why should people only give generously to charities, many of which waste a good deal of it or skim off the top anyway? I don't understand the logic that says it's ok to give a bunch of millions to an organization but not over some undefined limit to an individual.
Seems a really wealthy person is caught in the middle..if he gives the usual he is a cheap s.o.b. but if he gives more he is creepy! So is $1099.99 ok but $2000 not? Where is the tipping point where generosity becomes creepiness? It isn't the amount anyway, it's the scale...paying off the mortgage to him, might be the equivilent of a $100 tip for some other people. And I'm fairly sure she likely wasn't the only sexy waitress who ever served him. (Besides, she likely would have to take out a new mortgage to pay the`taxes on the gift). If someone is moved to show appreciation of efforts made to make life happy for him and he can afford it, more power to him. I think both of these examples simply show a generosity of spirit.

Because a lot of people, including me, think there is some scale between the size of the bill and the size of the tip. There is little, if any, relationship to the person's financial statement and the tip. Some of the richest people I've ever known were miserly SOB's that would haggle over a $.50 increase in a dry cleaner's rates,

I've tipped up to 30-40% when the service was flat out great, or the staff did something really, really out of the ordinary. Like when a waitress went across the street to get a Starbucks for my daughter (I don't remember why). Sure they were slow, but it was pretty cool. Clearly there's a Q.P.Q. here.

I have no problem when George Foreman comes into a steakhouse and tips 100% of the bill. $500 bill + $500 tip - wow - thats generous. Excessive, but generous.

I think its very odd when people flaunt their wealth and give gigantic tips for no apparent reason. I also think this is why some of the most exclusive clubs have a strict 'no tipping' policy. Otherwise, things would turn into a circus.

Quote

Where is the tipping point where generosity becomes creepiness?

The tipping point is when your bill is presented or when the valet brings the car to you.

[jdonn]

Sorry if no one liked my story, it seemed on topic to me. I've never seen to many buzzkills in one thread. But I certainly don't find anything creepy about it. Whoever implied he did it because his waitress is hot, maybe he did it because she opened up to him about her trouble making mortgage payments?

I hope if I let some teenagers wash my car for $5, and one starts telling me about his family's trouble making mortgage payments and I'm dumb enough to believe it, Phil wouldn't think I'm creepy for tipping $20 just because it goes over his arbitrary 100% threshold.

[PassedOut]

JoAnneM, on May 20 2009, 10:24 AM, said:

Ever wonder why everything is so expensive in San Francisco? Waitstaff, by city law, earns the same minimum wage as everyone else in SF, which is $9.79. On top of that employers must provide medical benefits.

This has so angered many restaurant owners that many show a "medical benefit surcharge" as a separate amount on the check, hoping you won't include it on the tip.

I have mixed feelings about this, the Bay Area has a very high cost of living and housing, especially, is very expensive. Still, the restaurants are always busy.

Yes, the SF restaurants are busy anyway.

In my opinion, a good business person can always succeed working within a set of laws that help workers, so long as all direct competitors must follow the same laws.

A problem that US businesses face in international competiton is that we compete with businesses from nations in which the government takes responsibility for the people's health care. Most US businesses could compete more effectively if the US government followed suit.

[helene_t]

PassedOut, on May 20 2009, 05:35 PM, said:

A problem that US businesses face in international competiton is that we compete with businesses from nations in which the government takes responsibility for the people's health care. Most US businesses could compete more effectively if the US government followed suit.

I don't think it matters much. In Denmark I got a higher pre-tax salary than I would get elsewhere, partly because the health care is financed by taxing income, so employers pay less taxes and can afford to pay high salaries while employees pay high taxes and demand high salaries. In NL it's similar except that the mandatory health insurance is not called "tax", but what's in a name ...

In UK I get a lousy salary but pay less taxes, I suspect this is partly related to more taxes (or whatever they call it) being payed by employers.

US health expenses are extreme, which is probably (among other factors) related to the fact that it's a rich country and health care is what economists call a luxury commodity, i.e. rich people spend a higher fraction of their income on it than poor people do. For some reason, U.S. employers pay their employees' health insurances directly instead of paying it via a general tax, or via higher gross salaries subject to higher income tax. Of course the way the burden is shared between high-salary workers and low-salary workers has some implications, but other things being equal I wouldn't expect it matter much how it is implemented.

[Phil]

jdonn, on May 20 2009, 11:08 AM, said:

Sorry if no one liked my story, it seemed on topic to me. I've never seen to many buzzkills in one thread. But I certainly don't find anything creepy about it. Whoever implied he did it because his waitress is hot, maybe he did it because she opened up to him about her trouble making mortgage payments?

I hope if I let some teenagers wash my car for $5, and one starts telling me about his family's trouble making mortgage payments and I'm dumb enough to believe it, Phil wouldn't think I'm creepy for tipping $20 just because it goes over his arbitrary 100% threshold.

Josh, I didn't ever say 100% was my threshold. I simply used George Foreman as an example of someone being generous within acceptable limits. I would go so far to say that my personal line between being generous and being weird depends a lot upon the amount of the bill. If a dot.com zillionaire took his staff to a resort for a week and tipped the hotel 100% of the bill I would find that a little strange, wouldn't you?

I have no problem with you tipping someone $20 for a carwash. Hell, if its for a charity, give them a blank check.

What seems to be happening in this discussion is that people are confusing the concepts of 'service' and 'need'. If the waitress' daughter needs an operation, then, sure, help her out. Pay It Forward - I get it.

But this has nothing to do with how quickly she brings you your meal.

[luke warm]

helene_t, on May 20 2009, 11:50 AM, said:

For some reason, U.S. employers pay their employees' health insurances directly instead of paying it via a general tax, or via higher gross salaries subject to higher income tax. Of course the way the burden is shared between high-salary workers and low-salary workers has some implications, but other things being equal I wouldn't expect it matter much how it is implemented.

i don't know either, but it seems to me that paying for health care as a tax increases the cost on everyone... paying a tax creates a middle man (or 10), eh?

[JoAnneM]

Josh, that was an example of the "men will do anything if they are looking at a pair of ...... mentality" Not all women think like that.

In fact, was it here that I heard about the couple that stopped to help a car on the highway out in Wyoming in Colorado? The fellow asked for their name and address. Some time later their banker asked them to come down to their bank. They thought they had done something wrong and went down there. He informed them Bill Gates had paid off their mortgage. Don't know if this is an urban myth.

Anyway, there are nice people in the world.

[Trinidad]

luke warm, on May 20 2009, 11:59 AM, said:

helene_t, on May 20 2009, 11:50 AM, said:

For some reason, U.S. employers pay their employees' health insurances directly instead of paying it via a general tax, or via higher gross salaries subject to higher income tax. Of course the way the burden is shared between high-salary workers and low-salary workers has some implications, but other things being equal I wouldn't expect it matter much how it is implemented.

i don't know either, but it seems to me that paying for health care as a tax increases the cost on everyone... paying a tax creates a middle man (or 10), eh?

No. In this case, paying tax takes out the middle man (hundreds of them). Or more accurately: It takes out hundreds of inefficient middle men and puts 10 efficient ones in their place. It just says that the government (or something similar) should do something that the government can do better than private enterprise.

Look at a US hospital. How many people are doing nothing but sending bills and keeping track of what doctor/technician did what to whom and what health insurance to bill for that? Does this insurance even cover these costs or does the patient need to be billed? Will the patient be able to pay? Or even worse: How much time does a highly qualified doctor spend on paperwork? At what hourly rate? Are these doctors handy at taking care of paperwork? These are all "middle men".

If you take care of health care through taxes, you will, of course, need some central people to manage that. This means that you put 10 "middle men" in. But the hospitals can go back to taking care of people and the bulk of the administrative costs for hospitals are saved. And that takes hundreds of middle men out of the system. That makes health care through taxes (or another central health care system) so much cheaper.

Why do you think the health care cost in the USA are the highest in the world?

Just an aside: Like many Europeans, we travel around during Summer. Normally that is not a problem. Our health care system pays everywhere in the world. The only catch is that they pay, at most, the amount that the treatment would have cost in our home country. No problem within Europe. All medical costs are roughly the same. If there are relatively small differences, the health care system covers that too. Turns and roundabouts. No problem in Australia, Africa or Asia, either.

But this Summer we will travel to the US. This means that we have to get an extra health insurance for traveling to the US, since the medical costs are so much higher there that the health care system can't cover these costs. And what makes these costs so much higher? The fact that each individual hospital needs so many "middle men" to run the health care system.

Rik

[PassedOut]

Trinidad, on May 21 2009, 07:39 AM, said:

Look at a US hospital. How many people are doing nothing but sending bills and keeping track of what doctor/technician did what to whom and what health insurance to bill for that? Does this insurance even cover these costs or does the patient need to be billed? Will the patient be able to pay? Or even worse: How much time does a highly qualified doctor spend on paperwork? At what hourly rate? Are these doctors handy at taking care of paperwork? These are all "middle men".

Responsible US businesses also have people spending far too much time on healthcare insurance issues, time that could be better spent furthering the core business. The cost to employers of the inefficient US system is very high, and is rising quickly.

Except for companies that profit directly from the inefficiencies of the US system, we'd all be better off if the government would accept its responsibility in this area, as other governments have done.

[helene_t]

There are many things that make the US health care system expensive. I am sure an inefficient insurance system is one of them, but there are others.

GPs in most European countries keep the master record of "their" patients. People are generally listed with one and only one GP. As far as I have understood, people in the US tend to visit various physicians depending on where they are and what the problem is, and sometimes go "shopping" or seek second opinion. Correct me if I am wrong but this sounds as if it must make GP services very expensive. Online patient records would help so at least physicians would not have to spend time obtaining the records (and performing the same test again if the record couldn't be obtained or the handwriting was unreadable). But even with full use of online records, it is still an enormous advantage that the GP knows the patient. Not everything is written in the records.

Then there are all the costs related to medical malpractice lawsuits, probably the largest being unnecessary exams etc. that are made only to prevent lawsuits.

[PassedOut]

helene_t, on May 21 2009, 08:47 AM, said:

There are many things that make the US health care system expensive. I am sure an inefficient insurance system is one of them, but there are others.

GPs in most European countries keep the master record of "their" patients. People are generally listed with one and only one GP. As far as I have understood, people in the US tend to visit various physicians depending on where they are and what the problem is, and sometimes go "shopping" or seek second opinion. Correct me if I am wrong but this sounds as if it must make GP services very expensive. Online patient records would help so at least physicians would not have to spend time obtaining the records (and performing the same test again if the record couldn't be obtained or the handwriting was unreadable). But even with full use of online records, it is still an enormous advantage that the GP knows the patient. Not everything is written in the records.

Then there are all the costs related to medical malpractice lawsuits, probably the largest being unnecessary exams etc. that are made only to prevent lawsuits.

Although I have one primary physician (as do most folks in the US, I think), it is very common for her to refer me to a specialist when I come up with something outside her direct expertise. Because there is no central database, each specialist provides a form for new patients to fill in by hand, giving the patient's "medical history."

When you get anywhere close to my age, you find it hard to remember all of your medical history, so I always print a document from my own computer giving my complete medical history from childhood, and attach it to the new patient form. The new physician always likes that, but almost invariably laments the lack of that information with most new customers. I know Obama wants to fix that problem.

As for shopping for physicians, I can say that I do that when someone in my family needs surgery that is not completely routine. In that case, I will find a surgeon (usually at the Mayo Clinic in Minnesota) who has a lot of experience with the procedure and a good record.

(As an aside, let me say that dealing with the Mayo Clinic is a real pleasure. They truly run their business well in terms of competence, efficiency, and customer service.)

[luke warm]

PassedOut, on May 21 2009, 09:09 AM, said:

helene_t, on May 21 2009, 08:47 AM, said:

There are many things that make the US health care system expensive. I am sure an inefficient insurance system is one of them, but there are others.

GPs in most European countries keep the master record of "their" patients. People are generally listed with one and only one GP. As far as I have understood, people in the US tend to visit various physicians depending on where they are and what the problem is, and sometimes go "shopping" or seek second opinion. Correct me if I am wrong but this sounds as if it must make GP services very expensive. Online patient records would help so at least physicians would not have to spend time obtaining the records (and performing the same test again if the record couldn't be obtained or the handwriting was unreadable). But even with full use of online records, it is still an enormous advantage that the GP knows the patient. Not everything is written in the records.

Then there are all the costs related to medical malpractice lawsuits, probably the largest being unnecessary exams etc. that are made only to prevent lawsuits.

Although I have one primary physician (as do most folks in the US, I think), it is very common for her to refer me to a specialist when I come up with something outside her direct expertise. Because there is no central database, each specialist provides a form for new patients to fill in by hand, giving the patient's "medical history."

When you get anywhere close to my age, you find it hard to remember all of your medical history, so I always print a document from my own computer giving my complete medical history from childhood, and attach it to the new patient form. The new physician always likes that, but almost invariably laments the lack of that information with most new customers. I know Obama wants to fix that problem.

As for shopping for physicians, I can say that I do that when someone in my family needs surgery that is not completely routine. In that case, I will find a surgeon (usually at the Mayo Clinic in Minnesota) who has a lot of experience with the procedure and a good record.

(As an aside, let me say that dealing with the Mayo Clinic is a real pleasure. They truly run their business well in terms of competence, efficiency, and customer service.)

i can see the logic in having a centralized database, but there is a real problem with phi (especially given the hipaa laws)... just recently there were some medical databases hacked, i can't imagine the same not happening if there was one centralized one, and i imagine then that there would be some sort of backlash

[Lobowolf]

Given the veering over toward healthcare, this seems like a good place for an interesting re-post of a link to an interesting article on healthcare problems and potential fixes from an old friend of mine who has the new president's ear. Very general and superficial, but a good outline, and amusing read, and a good look and how and why workable solutions might not be as easy to spot as the current problems.

http://www.slate.com/id/2169454/

[PassedOut]

Lobowolf, on May 21 2009, 05:54 PM, said:

Given the veering over toward healthcare, this seems like a good place for an interesting re-post of a link to an interesting article on healthcare problems and potential fixes from an old friend of mine who has the new president's ear. Very general and superficial, but a good outline, and amusing read, and a good look and how and why workable solutions might not be as easy to spot as the current problems.

http://www.slate.com/id/2169454/

Good article. Thanks for the link.

[mike777]

PassedOut, on May 21 2009, 08:27 AM, said:

Trinidad, on May 21 2009, 07:39 AM, said:

Look at a US hospital. How many people are doing nothing but sending bills and keeping track of what doctor/technician did what to whom and what health insurance to bill for that? Does this insurance even cover these costs or does the patient need to be billed? Will the patient be able to pay? Or even worse: How much time does a highly qualified doctor spend on paperwork? At what hourly rate? Are these doctors handy at taking care of paperwork? These are all "middle men".

Responsible US businesses also have people spending far too much time on healthcare insurance issues, time that could be better spent furthering the core business. The cost to employers of the inefficient US system is very high, and is rising quickly.

Except for companies that profit directly from the inefficiencies of the US system, we'd all be better off if the government would accept its responsibility in this area, as other governments have done.

First time I can remember that one argues that usa government can manage/more efficient a multi billion/trillion buck program better than private sector...If true expect to see government handle much more.

Last time I checked medicare is deep in a hole but....look forward to hearing more facts that prove government is better.

Bottom line as I posted in an other thread if the government is smarter than free markets in managing/allocating capital in a program that is a powerful argument for more government.


In this case if government is better in regards:
1) innovation/technology in medical care
2) rationing