High Cost of Medical Care in the U.S.
There is a very interesting article in today's New York Times discussing medical treatment costs. Lot's of numbers to show where the money goes.
http://nyti.ms/1cnl5w6
RAD Read it and also found it interesting. I don't know why medical care and orthopedic implants in particular are so much more expensive in US.
A good dayImplants are hardly the only thing. Look at how many drugs are so much more expensive, and I don't mean the out of pocket part. Insurance companies are being billed 10 times more than other countries for no other reason than they can and it will get paid.
I needed a special medication for about 3 months about 4 years ago. Because I was just out of the hospital I was in a position that I had to have it right away and could not wait for insurance approval. So I discussed with the pharmacy paying for it first and then getting my insurance to reimburse me. I found out that it was $2400 per month. That translates into $80 per pill even though it's actual cost to produce is about 80 cents, yet the insurance company pays $8 and in other countries the price is about $2. Why? Opportunity. There really is no particular limit to what is collected, it's all about what ever is possible.
GC What to do? Buying drugs on the Internet or crossing a border to buy also have risks. Not everyone can fly to another country and there are risks associated with having procedures so far from home- in particular managing follow up care .
I think the article makes it quite clear why the costs are sohigh in the US. Some factors, no competition from outside the US, intensive lobbying, lawsuits, many middleman, etc. They say that the big 5 manufacturers do not talk to each other regarding price but some have been charged with price fixing. I would say there is colusion within this industry. This is a classic example of whats wrong with our current medical system.
kb2755 In every industry you'll have a "price leader" (if you haven't heard the term you can google it) that sets the standards for profits. When your price leader sets a high price, and gets it, the "price followers" will follow *until* more people shop for the lower price and give market share to the follower. IOW, it is market share competition driven by the receiver of goods that dictate whether or not a price leader will gouge their customers.
In the case of health care though, there are a couple of wrinkles with this normal process. 1) We all use a middle man - the insurance companies - who is also working to make a profit, and 2) price leaders for specialty drugs (and specialized implants like the ones described in the article) have little to no competition, no one that will create the incentives to lower prices. Except where there is government intervention, which has its own set of unintended consequences that interfere with competition.
Those are the first two things I would like to see discussed and addressed.
justintime Many of these problems can not be fixed, or even improved upon, right now. There is too much really big money being spent to keep as many Americans as possible ignorant and scared. It's the "government is the problem and not the solution" crowd along with the idea that we would all be better off if the government stays out of our lives and away from our medical cDare - none of them there death panels for us! Well just look around and see where that took us. Unfettered capitalism is not something that's good for anyone that's not at least in the top 1%.
You just need to follow the money to see who is behind all this stuff from right wing ideologs like the Kock brothers to the device and pharma companies, the insurance lobby, and so on keeping us dumb and scared!
The solution to the high cost of medical care can be found in the first story of the article. The patient had to pay out of his pocket so he shopped around for the best deal.
Imagine if everybody shopped around for the best price for medical care like they do for a television. High priced caregivers would lose out to lower priced caregivers and magically prices would start to come down because of competition. It's called market forces.
The problem with the healthcare model today is that the customer (patient) doesn't pay the bill directly. Therefore the customer doesn't care about cost of service, only the cost of their premium or copay.
Secondly, insurance is not really insurance anymore. Insurance should not be used to pay for every single little medical need. Traditionally insurance was meant for catastrophic costs. Not birth control or stuffy noses.
Third, people have grown into a mindset where nobody feels they should have to pay for their own healthcare. Something or somebody else should pay for anything having to do with medical costs and it's my right that everything should be covered somehow. How or why this mindset developed is a mystery. But if this doesn't change then nothing will change.
There should be no expectation that healthcare be at reasonable market prices when there are no market forces in play. Now with Obamacare, it will be a manufactured, artificial, government engineered market. When was the last time that things became cheaper with the government in charge. Hint: never.
RJ RAD, we can both play the game you just played. If you want to believe the likes of Michael Moore who blame capitalism, then fine. But it is capitalism that results in innovation and the enhancement of society, not government. But let's not play the game, OK? I'd rather not add you to the list of people that I try hard not to engage in discussion.
So, I fall into the category of "too much government". Not zero government, just too much government doing the wrong things.
You are correct that "unfettered capitalism" is not good. So to "fetter" capitalism you can do a few things. One, make sure laws are written and enforced to protect people from those intent on causing harm (amazingly enough, that's the precisely why we have a Constitution). In that context, I'll ask if you think the majority of laws in Congress are passed with that view in mind? The contrary question, then, is what kind of laws does Congress pass?
For instance, in your opinion does *any* political lobbying organization act to prevent harm to US citizens, or do you think that they act to "get stuff" that would be in their best interest? Following that line of thinking, what would be the consequence of banning lobbying groups in Congress? Certainly, pushing for limiting the influence of lobbyist is a viable goal, right?
@justintime: You attributed things to me that I clearly didn't say and then wandered off topic to lecture on the Constitution and ask questions about lobbying. I didn't bad mouth lobbying, didn't criticism capitalism, and don't particularly like Michael Moore. Maybe you could just put me on your list now rather than later.
So how should I have interpreted your words RAD? Reread them and I think my response was pretty spot on.
Justy:
You missed a third point and it's a hum dinger: it's healthcare and in healthcare for a major portion of the buying market, you don't get to shop for quality and prices. You're sick. It's an emergency; price is not an object. When the ambulance picks you up, you don't get to pick where to be dropped off.
So you might divide the health care market into two parts: mandatory care and elective care and I think you might find some price differences. Unfortunately most of the market is mandatory and very little is, like the knee replacement article, elective.
Second, what's a specialty drug?
Last, on the topic of insurance middlemen; remember we let the fox into the hen house. And the fox is there because the system is so, so, so messed up that we needed a "Guido" to strong arm the hospitals, doctors, big pharma, etc. put a cap on price increases. We don't accept government control so well so insurance companies were a natural. And there was so much "fat" or profit in the system, it could be easily done and make us feel better by doing it. Remember, before that we let the HMO's etc. in with their fancy promises and used-car-salesmen-Eron-like management protect us from medical prices that can be 2 times, 4 times, heck over 100 times higher in order to provide services to the uninsured indigent and heathcare gamblers who can't pay the uninsured-price bill (a ridiculous charge that is then passed to us as an adder in our lower insurance-bargained-for prices). When the HMO hackers turned on us, the insurance companies stepped in, like a good neighbor.
So, you have a market that will NEVER be competitive just by the nature of immediate and emergency need to gain service. And customers who will not use a normal buying criteria that creates a competitive market/ And a health care system process that is, and has been, severely broken for decades and is careening out of control with all the lobbying forces you mentioned and more. And most important IMHO, the need to offer fair and just basic healthcare to all hardworking American citizens so one does not go down the financial chatty chute just because they get sick.
What do you do? Medicare govt control. Free market insurance middleman. More and more regulations? What alternatives do you have to reach your goal?
My point Justy is that healthcare is NOT a free competitive capitalist market and it NEVER will be due to the nature of the transaction and the buyer selection process of most of the goods and services. So sure, reduced lobbying would be grand but one can not really expect normal market forces in a market that is not normal to begin with.
And RJ, how does ObamaCare which tips the scale of the currently 85% insured in America to 100%, a lousy 15% ObamaCare increase, how does that really tip the scales of your paranoia? Use your math RJ, use your math. And how is the government in charge of the free market insurance companies? (Wasn't Justy just saying it was the other way around?)
Good thread, tough subject, in a market where normal rules just don't apply.
mistergoogle It may be a protected activity BLD, but is it wrong to understand the consequences of lobbying? The direct result of lobbying *always* results in giving one group of people an advantage over another group. That's the whole point of doing it! Do you deny that's true?
There is nothing competitive about the govt making choices as to who gets favored status in the marketplace. The argument for it is usually to protect "critical" industries like banking, but what do we wind up with? Too-big-to-fail does NOT happen in a competitive environment, it happens when laws are written to benefit one group over another.
While Obamacare-friendlier states like New York have reported major rate reductions as a result of the health care law, Ohio insurance commissioner Mary Taylor says Obamacare’s mandated benefits and rating rules are driving up the cost of insurance in a state with historically lighter regulation.
“The bottom line is the [Affordable Care Act] is driving up premiums across the country,” said Taylor, who’s also the state’s lieutenant governor.
Of course, it all depends on who’s doing the math. Supporters and detractors of the health law are both using some creative arithmetic to tilt state rate announcements in their favor.
Ohio’s announcement is just the latest sign of how the fight over the law is being played out over calculators and spreadsheets.
Read more: http://www.politico.com/story/2013/08/ohio-premiums-rates-going-up-95067.html#ixzz2b1t9Mtso
BrotherDog BDog, we covered Ohio in previous thread. Look at the NEW Expensive rates that Ohio has and tell me if you wouldn't be happy to pay that?
By the by, part of the reason that rates are going up is that Ohio will actually have to insure sick people now. Tends to drive cost up when you actually use health insurance.
http://www.nbc4i.com/story/23033568/lieutenant-governor-says-health-insurance-rates-going-up
JIT - You can wax poetic about free markets preventing monopolies, but when it comes to a life saving drug, Mr G is right. If you have kidney transplant and need anti-rejection drugs for the rest of your life at $30,000 a month, free market is out the window. You'll pay, you'll get your insurance company to pay, and you'll sell your house to do it if you have to.
GC, and as important in the health care scenario is that often you do not have time to do competitive research or comparative shopping. You go where the ambulance takes you and you get the drugs the Doctor orders for you.
Heck, the drug companies only got taken to task a few years back for lavishing spiffs, n lunches, n stuff to the DRs and their offices in return for favorable treatment. So, you take what they offer and they were getting greased for giving it to you.
Of course you'll pay GC - because that's what it costs! Did you put the research in to develop the drug? Did you risk millions of dollars to develop the drug? Why would you put the work into developing the drug if you won't get paid for for your efforts?
But I do understand your view and the view of others. Some of those prices are crazy! Using your example about anti-rejection meds, what is the size of the market of people who need the drug? In the grand scheme of things it's very, very small. So if you are a company trying to address a deadly but small problem the cost will necessarily be high. I don't understand why anyone would think it wouldn't be. However, once the drug has been developed then it's just a relatively simple matter of producing it (which usually can be done very cost effectively).
In the example you used GC, you are correct that competition wouldn't help *unless* there is a change in patent laws. The protection given by patent laws is a major contributor in price determination, and that is an area that the government has full control over. Given that patent laws intentionally stifle competition for a period of time, why not eliminate or significantly reduce the protections guaranteed by them?
The other view is to subsidize the costs of drug development, significantly reducing the risk that these companies face while doing their research. Basically taking competition out of the mix and replacing it with guaranteed funds provided by the government. And that works just fine on paper as well. But if that's what we want then it has to be done 100% socialistic rather than trying to fit it into a capitalist system like we've been doing. As much as I would fight against socializing the development of medicine at least it's a logical solution to reduce our *individual* costs to spread it amongst the rest of the population. But always remember that the research still needs to be done, the people doing it still need to be paid, and in the end the money is still spent. So back to what I've asked before, it all comes down to how you would pay for it.
And don't forget that the social components of our economy already dominate the federal budget. How much more can anyone expect the "providers" to pay when we are already being squeezed to a maximum? As you know the government only has what it takes from someone else first, so again, where will the money come from?
Looking at the problems of health care strictly from a "what we want to see" view isn't enough. We really do need to discuss the nuts and bolts of how the current system works and what we can do at a fundamental level to change it.
Justy, you can just look at the profit line of Big Pharma to know they are raking it in big time. Perhaps not robber barons (see the other posts for margins but pharma is way up there in the margin game (Microsoft is envious) and pharma ceo's lead the pack in the top 100 ceo payoffs). Whether a pharma is good or bad, creative or not, their profit margin is HUGE.
Nuts n bolts wise, pharma has us by the bolts.
"and you'll sell your house to do it if you have to."'
"Of course you'll pay"
In reality there are people who make other choice, good or bad - we are not in a position to judge them - because they don't want their kids be homeless and live in poverty.
Lena 
JeffersonRepub I was shocked recently when I went to pick up prescription medication to treat my teenager's acne. There were four prescriptions whose total came to $2100!!! I couldn't believe it. Thankfully, I do have insurance, but if I did not, I would have to decline the medication. I can't imagine spending 10-12K a year for acne medication. I could use that money to pay for a semester of college. I could use that money to even buy a good used car. Shoot, for that money I could buy Clearsil every month for the next 150 years. Thankfully, this is a non-life-threatening condition, and I do have coverage. But I can't help but think about those who don't have insurance, those who have to pass up on medication even when it is for a life-threatening condition. Those who don't have good medical insurance typically don't have high-paying jobs either. Many good people simply can not afford to pay full price for their prescriptions. Why should they (or their children) be denied the same or similar medical care that I receive? The system is not right, and something should really be done. If we could only hurry up with the "right" solution.
thankfulyetconcerned http://s3.amazonaws.com/tuftscope_issues/pdfs/12/TuftScope_-_volume_8_issue_1.pdf
Page 12 seems to be a good summary of the patent issue discussed earlier in this thread.
Health Care Law Raises Pressure on Public Unions
Cities and towns across the country are pushing municipal unions to accept cheaper health benefits in anticipation of a component of the Affordable Care Act that will tax expensive plans starting in 2018.
The so-called Cadillac tax was inserted into the Affordable Care Act at the advice of economists who argued that expensive health insurance with the employee bearing little cost made people insensitive to the cost of care. In public employment, though, where benefits are arrived at through bargaining with powerful unions, switching to cheaper plans will not be easy.
Cities including New York and Boston, and school districts from Westchester County, N.Y., to Orange County, Calif., are warning unions that if they cannot figure out how to rein in health care costs now, the price when the tax goes into effect will be steep, threatening raises and even jobs.
“Every municipality with a generous health care plan is doing the math on this,” said J. D. Piro, a health care lawyer at a human resources consultancy
“I think it was misguided all along,” Robert B. Reich, the former labor secretary, said in an e-mail. When the law was being written, he said, he worried that the tax was “a blunt instrument that could too easily become a bargaining chit for cutting back benefits of workers.”
http://www.nytimes.com/2013/08/05/nyregion/health-care-law-raises-pressure-on-public-employees-unions.html?hp&_r=1&
JR --- you hit the nail on the head, health care is not a right. But IMHO it should be a right, an entitlement, that we, as a people, join together to provide to all hard working Americans with the sole intent that no hard working American goes down the chatty chute just because they got sick. ObamaCare, Medicare, Canadian Plan, English Plan, etc. --- you pick the way, but get er done.
And if you don't believe it's a right, then have the gumption to turn the sick who can't pay away from ERs, from free healthcare that we all pay for, so we don't have to suffer that forced tax either. Put em in the streets.
But wait, what other things do we do that are not a right nor in the Constitution?
1. The Constitution does not specify retaining a standing Army, matter of fact it calls for no funding to extend beyond 2 years. What would a Constitutional Army look like? Ron Paul says: http://www.dailypaul.com/138400/what-would-a-constitutional-military-look-like
2. Education is not a right.
3. Social Security is not a right.
4. Medicare is not a right.
5. FEMA to support the NJ shore is not a right.
6. Police and Fire protection are not rights.
And so on and so on.
So JR, you hit the nail on the head that health care is not a right, it's a luxury for some, a choice for others, a no-brainer for the rich. Today, without ObamaCare, health care is not as important as defending the nation, protecting your house from fire, your streets from crime, making sure the old have a basic level of support, that our kids can read and write or that we join together to provide relief during disasters.
We are the only industrialized nation in the world not to have health care as a right. We stand alone in not defending our citizens from disease and financial ruin from disease. So you hit the nail on the head but unfortunately IMHO, you are just driving into your own cross.
Otherwise, let's go Ron Paul and cancel the standing Army, kill FEMA, end SS/Medicare, disable the fire departments (tax supported), police departments, and quit spending bucks to educate our kids. Reading and writing is not a rite (heh, heh).
"Healthcare is not a right. /thread."
So why “plain US citizens” are not allowed to buy medicine from abroad? When we didn’t have medical insurance and my DH needed prescription steroid to shrink his stage 4 cancerous tumor, I shopped around and one pill was sold for $15-$25 at local pharmacies. The same pill was a part of his treatment in a hospital and we were charged $85 per pill. The same pill in India, New Zealand and Russia is sold for 50 cents, in Canada - $1. So why we cannot buy it from abroad? Don’t tell me because FDA/doctors/government/etc. are worried about the quality of the pill. It’s BS because this same pill was manufactured in one of the listed countries and sold here in US after simple re-packaging. So why my right to buy medicine from the place I can afford is taken from me? Why consumer protection law doesn’t work for prescription drugs? Because someone is protecting billions that will be lost by pharma corporations here in US if we would have really open pharmaceutical market.
Lena,
Fact is fact. Healthcare is not a right. Look it up.
I'm all for regulation (someone mentioned monopolies; I'm for anti-trust laws started by T. Roosevelt), however healthcare is not the right of an American citizen. You are not ENTITLED to it. That was my only point. It has nothing do do with being able to or not being able to buy healthcare from another country.
And with OC, stage 4 cancer may be given a pain killer instead of a steroid. http://www.bizpacreview.com/2013/07/31/howard-dean-admits-sarah-palin-was-right-on-death-panels-80721
It's a sad state of affairs in these United States that this is actually a debate. Most of Western society has succesfully figured out health care, with both better patient results and significantly lower costs, and it looks like this - http://www.pnhp.org/sites/default/files/Funding%20HR%20676_Friedman_7.31.13_proofed.pdf
Then again, this is a paper by highly educated individuals and we all know that that means they are ELITISTS!!!! Smh.
realitycheck JR,
1. I'm not sure how health care being a right or not is relevant to the conversation.
2. Saying that Dean admitted that Palin was correct about death panels is a big stretch of the imagination.
Gadfly JeffersonRepub, Prescription steroids are not given to cancer patients as painkillers only, they are given mostly as a cancer treatment to shrink the tumor.
Lena, you missed my point... under OC, there will come a time when SOMEONE (not you) decides it would be a "waster of money" to try to heal the patient, and therefore only pain meds will be given. You will have no choice in the manner. Obama himself said it:
http://radioviceonline.com/obama-to-heart-patient-take-a-pill/
And, it's already happened in a state that already has the so-called "universal healthcare". It should be called universal healthcare RATIONING, because that's what it is:
http://spectator.org/archives/2009/08/18/the-ultimate-cost-saver/print
"Under OC, there will come a time when SOMEONE (not you) decides it would be a "waster of money" to try to heal the patient, and therefore only pain meds will be given."
I had and have this situation with medical insurance - all tests and procedures should be pre-approved by insurance. Nothing new here.
Barbara had terminal cancer. The expensive drug recommended had an 8% chance of extending her life 4 - 6 months with a 92% chance of no effect or worsening symptoms. 19% develop toxic side effects. So 8% get 6 months and 19% suffer a worse fate.
She got the drug, it did not help, hospice might have been the better choice (covered by insurance)
JR --- Beyond the terrible letter (OHP now telephones patients versus sending letters) how is what happened to Barbara any different than what happens to us under normal insurance, everyday? How does Universal Health Care cause any more rationing than non-Universal Health Care?
And how would people who are "forced" into buying insurance by OC fare worse than they do today?
Does not ObamaCare provide many REGULATIONS that force insurance companies into greater coverage versus less coverage?
Does not ObamaCare have REGULATIONS defining standard insurance appeal processes mandated by OC for all insurance companies to have versus the liaise-fare approach we have today?
So what is the point here JR and how is OC more terrible than life without OC in this regard?
Lena,
So we agree then.... OC is not the solution.
Altho, at least in pre-OC, if you had the money (not necessarily insurance- just if you were able to pay for the med care you wanted), you could pay and get it. Under OC, that will be against the law.
Wait, a revelation...... JR says under OC it will be against the law to pay outside of insurance for healthcare......
WRONG
I can guarantee, that if you have money - you are always will be able to pay for the med care you want. I really doubt that rich people will be prosecuted for doing so. People who could afford the best always had what they wanted and always will have what they want.
They (the rich people) will have to go out-of-country for it. For doctors here, from what I have read, it will be a crime to accept money (not OC or insurance) for medical practice once OC is fully in place. Why do you think so many doctors are leaving the ranks, or planning to?
I'm just hoping OC is not funded, it'll give us a chance to repeal the monster before it becomes un-repealable.
I agree with everyone that the medical system is in need of serious reform, in need of fixing. But OC isn't the answer. I don't know what IS, but OC isn't it (and neither is letting things continue status quo as before OC).
"Dean admitted that Palin was correct about death panels is a big stretch of the imagination."
except that he did say it, last week in an interview. Howard Dean admitted that Plain was right about government bureaucrats deciding medical health decisions instead of trained doctors. in other words 'death panels', right out of his own mouth Dean said that Palin was right about this, and it looks like she was ahead of the curve, no wonder liberals are scared of her.
it is what it is my friend, and there is no shame in admitting that she (and Dean) are right about this issue.
let's have an honest conversation about this
I doubt that all doctors will "leave the ranks, or planning to". Greedy will leave and honest will stay and treat us. I meet both types of doctors and greedy ones are not the best, at least from my experience.
Greedy? LOL My sister is an opthamologist, and she only gets paid $8 from medicare to give someone an eye exam. Sure... greedy... lol
...it might be $18, but my point still stands.
So now, imagine, EVERY SINGLE PATIENT, eventually, is on OC.... and you're doing exams all day long for $18 a pop. How do you expect a doctor to keep a practice open, pay overhead, pay employees, pay payroll taxes, pay malpractice insurance, pay workers comp, then pay DOUBLE payroll taxes for themselves... and be able to make enough money to take home to pay their OWN mortgage, bills, etc.
You people who have never owned a business quite frankly have no idea what you're talking about when you call people "greedy" because in your mind you have some idea (based on nothing) of what the service you want SHOULD cost.
Well JR, thanks for admitting that you don't have a clue and whatever it is, you're against it. Where or where does OC say you can't spend your own money on health care services? This is idiocy that you can't prove.
On Howard Dean: perhaps to have an honest conversation, one should listen to Howard who, while critical of the IAPB implementation for AHCA or Medicare (want to do away with that too?), he also said (and FOX left out) "Although I've been critical of many components of the law, there is still much to applaud."
His criticism on the IAPB (Death Panels as you like to call them although that is a ridiculous term) is on cost containment, not denial of service.
Perhaps actually reading what he says instead of BreitBarfing it up to us might illuminate you.
http://online.wsj.com/article/SB10001424127887324110404578628542498014414.html
Honest talk? What, from a bunch of fear-mongering branders. Oh, the Death Panels are coming, the Death Panels are coming. Give me a break.
Howard's conclusion is telling on the real problem in America: "To date, 22 Democrats have joined Republicans in the House and Senate in support of legislation to do away with the IPAB. Yet because of the extraordinary partisanship on Capitol Hill and Republican threats to defund the law through the appropriations process, it is unlikely that any change in the Affordable Care Act will take place soon."
That's right JR and BDog, some honest talk. Your own party will obstruct any possible improvements or progress to the AHCA. They are more interested in doing nothing than doing anything else. And nothing will be done until at least the next Presidency. Nothing.
I say for the next Congressional election, use a simple litmus test for tenured Congresspeople: production. How many laws did you author, co-author, sponsor, co-sponsor and how many passed. Who cares what they are, a simple productivity litmus test will tell you quickly whether the jerk is worth employing.
Opthalmologists get more than $8 for an exam. Especially if you need a prescription for eye glasses. They can legally charge you for writing a script. Medicare does not cover this cost and you MUST pay for it or they will not give you the prescription for a new pair of glasses. The fee can range from $20 to $50 extra. PLUS the patient has to pay the 20% co pay for the visit. So $8 is really not the true payment.
Christine Having never been on medicare/medicaid, I have no idea if there is a co-pay, or if so what it is. But my sister told me she gets $8-$18 (I forget) for the exam from the government. She's not lying.
Then, if she writes a Rx, the patient... goes away. And comes back 9 months later, wanting to buy glasses. Eye Rxs aren't good for that long. My sister won't sell you glasses with a Rx that's a year old, because your eyes could easily have changed. People get pissed when she won't honor the OLD Rx, but then if she did, would have no problem coming in after getting their new glasses bitching about how "they can't see."
The facts:
Ohio (the state she is in) Medicaid has NO COPAY for the patients. The doctors ONLY get paid from Medicaid for the exam. Medicaid pays the doctors $27 for the first exam, and $17 for every subsequent exam, as long as the patient is on medicaid (forever). This is ALL the money the doctor receives for the exams.
The doctor can elect to NOT TAKE Medicaid, and that would eliminate those patients... but that's the point: with OC, they NOT BE ALLOWED to opt out.
If business is not profitable - why to have the business?
Also eye doctors don't do eye exams only, they treat eye medical conditions and it falls under medical treatment category.
"If business is not profitable - why to have the business? "
Exactly. Which is why many doctors are going to be getting out if OC goes full-scale. It will no longer be profitable enough to stay in business, AND pay off student loans, AND pay malpractice insurance, AND take lower payment for EVERYTHING they do, and and and...
http://www.forbes.com/sites/marcsiegel/2012/08/12/will-your-doctor-quit-obamacare-foretells-mass-exodus-from-patient-care/
http://www.washingtontimes.com/news/2013/feb/7/doctors-feel-ill-winds-blowing-as-they-look-closel/?page=all
Just showing that OC is not the correct answer. With doctors dropping out, no new doctors going in, you don't think care will decrease and wait times will increase? We've had this debate on this forum before, many times over. Start digging deeper into all the angles of OC to see if it is actually going to give you what you think it is.
There is nothing to dig. From the point of working person who has medical insurance with premium that is almost 20% of family income and who still needs to wait to see a specialist 2-3 months, then beg an employers to take unpaid time off to visit a doctor, then pay huge deductible and ask insurance for pre-approval of tests and procedures, or someone who has no medical insurance at all while working full time or 2-part times jobs, I don't see an issue with shortage of doctors in US as a main problem because of OC. Medical schools don't have problems with getting students. If some doctors will decide to retire - well, no bigy, they can enjoy retirement. Young generation will come and replace them.
Lena,
Good luck. You're going to need it, if you think 2-3 month wait is a long time to see a specialist.
Lena, if the practice of medicine becomes a lot less lucrative monetarily, do you think that our smartest and most talented young people will still want to put in the long hours and hard work that becoming a doctor entails?
Or, will they be more likely to take an easier road with more money at the end, like Wall Street? Smart people tend to go where the money is...
ianimal JR I think your math is fractured, there's a fly in the ointment somewhere.
If Doctors were forced to live only on Medicare, they would take a 8% to 33% pay reduction according to the Urban Institute and the Medical Group Management Association for the Medicare Payment Advisory Commission (MedPAC).
And so, according to the study, the average physician would drop from $272,000 to $240,000. I feel an alligator tear welling up over this injustice.
Amazingly (as if I have not been telling you), specialists fare worse than regular doctors like the neurosurgeon drops 33%, internal medicine and pediatrics only 8%. Guess where the fat is.
Now that's medicare. But OC is INSURANCE, not medicare so your paranoia once again is misplaced, misguided, anecdotal, and silly. And remember, we are, and have been, and always will be talking a 15% game. 85% of us are covered mate ---- no change. No change. We are just adding the other 15%, most of whom will be convered like the 85% are today. It's more of the same, not something completely different.
Lastly, I get my eye exams for free so $28 seems like a HUGE rip-off.
JR Medicare and medicaide are 2 different insurances. Your first statement (which I responded to) said Medicare. Then you gave an explanation for medicaide. I was quoting medicare for NJ.
No, Iman, I think 83% (who are thinking about quitting according to Forbes) will drop out of health care, the largest growth industry in America with the BIGGEST profit margins around, and instead will be real estate agents.
Brotherdog, I'm all for an honest conversation. Before I posted my comment, I read the op Ed piece that Dean had in the Wall Street Journal. My opinion is that it's a gross exaggeration to say that "Dean says Palin was right about death panels". You're telling me that I'm incorrect and that "it came from his own mouth" in an interview. I've searched the web and cannot find that interview. Im sure that youve seen it. Can you please provide a link to the interview?
i also was unable to locate a link, but from the WSJ here is what he said :
"What ends up happening in these schemes (which many states including my home state of Vermont have implemented with virtually no long-term effect on costs) is that patients and physicians get aggravated because bureaucrats in either the private or public sector are making medical decisions without knowing the patients. Most important, once again, these kinds of schemes do not control costs. The medical system simply becomes more bureaucratic."
dean is validating what Palin said years ago. And his statement that "bureaucrats in either the private or public sector are making medical decisions without knowing the patients." is describing how 'death panels' work. and dean is on record as being opposed to them. (just like palin). that's good stuff if you ask me.
Dean is right about this, and by saying it in this way, he is verifying that he and Sarah Palin are on the same side of the debate.
looks like a great example of bi-partisanship , and i think it bodes well for our country,
can't we all just get along?
Bdog.. Was there an interview in which Dean said Palin was right about "death panels" or not? Because, from your last post it sounded like you had read or heard an interview in which Dean say that. It obviously wasnt the editorial bc you can't mistake that for an interview. Honestly, was there an interview or did you base your comment entirely on an article from a conservative website that had "death panel" in the title?
Howard Dean wrote an editorial for the Wall Street Journal. In that opinion piece, he makes a very reasonable case that the Independent Payment Advisory Board won't be effective in lowering prices. Instead, he claims that it will just create more be bureaucracy. He sums up his position with the following conclusion:
"The IPAB will cause frustration to providers and patients alike, and it will fail to control costs.".
The statement that the conservative muckrakers have latched onto has to do with so-called rationing. Dean states that the board would be able to prevent certain treatments by setting the rates such that providers wouldn't offer them. Does Dean mean that the panel gets to decide who is worth saving or who gets treatment? No! He means that the panel may set unfavorable rates for certain treatments - most likely treatments that are new and have not been proven to be effective.
He goes on to say that his beliefs are based on similar panels that have a 40 year history in "many states, including [his] own state of Vermont". By the way, have you heard much about the Vermont "death panels"?
In contrast to Dean's reasonable critique about wheather rate setting will actually work, Palins comments were good old fashioned distortions and fear mongering. Aside from using the term "death panel", she also suggested that these death panels will get to decide whether her child with down syndrome deserves to receive medical care. Here's a statement from Palin as reported on Huff Post:
"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil."
To claim that Dean has said that Palin was right about the "death panels" is a vast distortion of his statement. Unfortunately, such distortions are the bread and butter of conservative web-based media such as breitbart. Even worse is that many readers don't vet their media sources enough to figure out that most such sensational stories, that appear only on fringe websites, are all smoke and no fire.
By the way, if you want to learn more about the actual issue that Dean was addressing (cost control measures, not nonsense about Palin), this is a very good counterpoint.
http://www.bloomberg.com/news/2013-07-30/critics-are-wrong-about-the-medicare-payment-board.html
And here's another intelligent analysis:
http://www.publicintegrity.org/2013/08/05/13126/opinion-making-tough-health-care-calls
I posted the NYT Dean Op Ed link above. He does not mention the word "Death Panels" nor does he endorse anything that Palin said. That's just BreitBarfing it. He said the IAPB's will not lower costs and should be abolished because they don't lower costs. He said he is an advocate of the AHCA but there are things that could be better, could be fixed, like that IAPBs.
And he said the real problem is Congress who is more interested in politicking than making any substantial progress on any issue.
My comments and the link are above but suffice it to say that Dean agreeing with Palin is a stretch that only a FOX could make. Read it.
I think it's pretty safe to say that no sane person has ever said that Sarah Palin was right about anything, let alone death panels... of course that doesn't exactly rule out Screaming Howie, does it? (-;
http://online.wsj.com/article/SB10001424127887324110404578628542498014414.html?mod=WSJ_article_MoreIn_Opinion
The Affordable Care Act's Rate-Setting Won't Work
Experience tells me the Independent Payment Advisory Board will fail.
"One major problem is the so-called Independent Payment Advisory Board. The IPAB is essentially a health-care rationing body. By setting doctor reimbursement rates for Medicare and determining which procedures and drugs will be covered and at what price, the IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them."
"The IPAB will cause frustration to providers and patients alike, and it will fail to control costs. When, and if, the atmosphere on Capitol Hill improves and leadership becomes interested again in addressing real problems instead of posturing, getting rid of the IPAB is something Democrats and Republicans ought to agree on."
Sounds an awful lot like what Palin said to me.
Let's face it, Palin is hated because she's not an ugly lesbian and had the nerve to not abort her Down Syndrome child.
He must have an amazing beside manner :>)
He is not a proponent of Vermont's version of AHC either which leads the nation in trying to solve the problem although early results are mixed and argumentative.
His own ideas seem interesting but would not have a chance of passing into law in any state in the Union, including Vermont.
There have to be death panels, no matter what one calls them, or Obamacare can't work. The only way to contain costs is to make hard decisions regarding end of life and terminal illness care.
Take this to the bank - the government panel will not let your medical exchange spend $300,000 so that grandma can live an extra month, or spend $1.2 million so that your 2 year old can have a heart operation that has only a 20% chance of success.
Don't like that? Go file an appeal, they will get to it in the order that they're received.
This is what it is going to come to. It has to. There is no other way for it to work.
Save this thread, for once again, Reggie Voter is right.
Reggie Voter Reggie,
Altho I THINK everyone is smart enough (?) to know money doesn't grow on trees, no worries- we can EASILY pay for all this, simply by taxing the rich and the evil corporations.
Oh, wait... you mean like the evil corporations who are being allowed to OPT OUT of Obamacare (McDonalds)?
It can't be paid for. It never could. It's not sustainable. If it goes into full affect, not only will taxes have to go up DRASTICALLY to pay for it, but medical care quality and supply will dwindle. Need an operation? No problem. We got you on the list... we'll give you a call... in a few years... if you're still alive...(wink wink nod nod)
So I take it JR and Reggie, you are canceling your health insurance since that's how it works today. Think of what you can do with the money you save.......until.....
Hope all goes well brave men.
Interesting that Obama Just gave Congress a pass on Obamacare. They are not required to buy it like the rest of us are. Once again, Do as I say not as I do.
This is abysmal and probably illegal to do. Let them eat cake!
The Repubs don't care if the law, as written, screws their staff since they hate the law more than they like their staffs.
The Dems who are afraid their staffs will quit can't change it through legal legislation since they can't trust the Republicans not to try to gut the whole thing. It probably should not be changed at all if you believe what's good for the goose is..... But to back door it as The White House is trying it stands a good chance of being illegal.
And it shows the Dems forgot to read the law too, liking the law only if NIMBY.
Should have gone with the first draft that ended the Congressional kick-backs for everyone.
JR. Is that really what you think happened? That's disappointing even for you. It's amazing that you're willing to make comments (obnoxious comments, no less) when you clearly have no idea what happened. Not even the basic facts.
Oh it's not quite as cut-and-dried as it sounds, but it is indeed true: congress will continue getting their superior healthcare FAR AND ABOVE what anyone on Obamacare will receive. Disgraceful.
BTW, when googling, look at stories from the last few days. What I am discussing is a NEW turn of events- not something from months ago. I'd post links, but I'm in my phone.
No JR, it's not true. You base your comments on headlines, but have idea about what actually happened. You make complicated assertions about what will happen a year from now, but you don't even bother to find out what ACTUALLY HAPPENED a few days ago before you spout off fallacies about it.
You read a headline that "Obama gives congress exemption from Obamacare" and assume that means they don't have to buy it. But, youre wrong. You have no idea what actually happened.
Gadfly, YOU'RE wrong. Go read some news stories from the last few days.
Besides, Would it really surprise you that it was true? Do you really trust government that much? Certainly even you aren't that naïve.
You would actually believe That Congress would agree to LOWER Their healthcare standards To that of the peasantry? Come, now....
While there is no actual wording that literally says "Congress is exempt from the plan", it does indeed amount to the same thing. They will continue to get their premium benefits, PAID FOR BY US, while everyone else must eventually end up on the single-payer system, which is what OC really is, in the end. And pay for the privilege, or get fined.
Not Congress... nothing is too good for them:
Just one link:
http://www.reuters.com/article/2013/08/07/usa-health-congress-idUSL1N0G820F20130807
JR, How do you expect someone to debate you when you post links that disprove your own thesis. Have you even read it?
from the link:
"In a ruling issued on Wednesday, U.S. lawmakers and their staffs will continue to receive a federal contribution toward the health insurance that they must purchase through soon-to-open exchanges created by President Barack Obama's signature healthcare law."
congress is mandated to buy insurance on the exchanges, but this modification will allow for their employer to pay for part of it.
my question is how much is the contribution and will it cover most of the cost for the staffers so that they are income revenue neutral ? time will tell. this still leaves a bad tast in my mouth.
they never have to really live with the consequences of their actions.
also from the link:
"The OPM said the federal contributions will be allowed to continue for exchange-purchased plans for lawmakers and their staffs, ensuring that those working on Capitol Hill will effectively get the same health contributions as millions of other federal workers who KEEP THEIR CURRENT PLAN." - which means they stay on the golden-parachute govt healthcare plan, NOT go on OC.
"These recent maneuverings inside the beltway are precisely why the American people rightly despise Congress," said Vitter, of Louisiana. "Perhaps if White House appointees and Congress have to live under these same Obamacare rules, things would be changed quickly for the better."
Ok, here are the cliff notes on what actually happened. Before the Afforable Care Act was passed, Senator Grassley, a republican, wrote an amendment that required congressional staff to get their health insurance though the new ACA health care exchanges. The rationale was "if we want the public accept these plans, then congress should have to accept them too".
Apparently no one thought about the fact that there was no legal mechanism for their employer (the federal government) to redirect its contribution to these private plans. It was a mistake. The intention wasnt to eliminate these people's employer contribution. Since this problem came to light, elected officials and staff on both sides of the aisle have been calling for a solution. Now the Office of Personnel Management has made a decision that the existing employer contribution can go toward the policies that congressional members and staff will now buy through the exchanges.
In JRs first post he claimed that "congress does not have to buy them (plans from the exchanges)". That is incorrect, they do have to buy policies through the exchange programs.
In his second post, he doubled-down: "congress will continue getting their superior healthcare FAR AND ABOVE what anyone on Obamacare will receive". Wrong again, congress and it's employees will buy the same plans available to everyone through the exchange.
In his third post, he triples down, saying I'm wrong and "naive", and asking, "do you really think that Congress would agree to lower its Healthcare standards to that of the peasantry?". Yes, that's exactly what they did if you mean they have to accept the same plans that the public will be offered in the ACA exchanges.
In the fourth post, JR finally gives up on the assertion that congress and it's employees don't have to buy plans through the ACA exchanges. But of course he doesn't admit he was wrong.
The ACA, including Grassley's amendment, was not intended to obliterate Congress's health benefits. It was meant to simply require them to get their benefits through the ACA exchanges. The OPM decision simply corrected the mistake. You can argue that the correction should have been made by some other mechanism, but its disingenuous to not recognize that it was clearly a mistake. To argue repeatedly that congress is no longer required to buy plans through the exchange just shows you haven't made an effort to understand the issue.
Remember, the "exchanges" are not the plans themselves. They are the mechanism through which everyone will access their plans - the bottleneck that allows for the collection and identification of everyone in the system and the supposed "standardization" of health coverage for US citizens.
From my understanding the exchanges have nothing to do with the actual coverage people choose to get. Rather, they will organize the different plans and regulate participation. In the case of the federal government, they will still have access to their "high-value" plan coverage but there will now be another middle-man to get in the way - the exchange itself. So we will have us, our doctors, our insurance companies, and the ACA exchanges. Of those four, who's the payer and who's the payee(s)? Without addressing the actual cost side of things that still looks like a no-win in the long run to me...
http://www.commonwealthfund.org/Publications/Fund-Reports/2010/Jul/Health-Insurance-Exchanges-and-the-Affordable-Care-Act.aspx
"Market or regulator? The ACA delegates to exchanges a number of regulatory responsibilities. Exchanges must certify health plans for participation and can exercise regulatory authority through this power. An important implementation choice will be whether exchanges should, on the one hand, maximize plan participation by minimizing certification requirements or, on the other hand, use their certification authority to limit exchange participation to high-value plans."
So I think both JR and Gadfly have valid points. But isn't it funny how the implementation of this system has created yet more ways to conflate the real issues in the L vs R "forever-fight" universe, all while *adding* yet another layer to the cost of good health?
When we step back and look at the big picture it's not always what we think it is...
JIT-
for me, it's not "Left vs right". It's US (the people) vs them (the govt and the people ignorant enough to believe them.)
Jr- you've got a lot of gall to call people ignorant when you either won't take the time to read about these issues or don't have the reading comprehension skills to understand them.
BTW, I was notified by my insurance company yesterday that they are giving me a rebate of a portion of my 2012 premium due to the ACA. Apparently The ACA requires that insurers use a minimum of 80% of premiums directly on health care. My company failed to do that, so I'm getting a check.
jit, thanks for the laugh with 'they both have valid points' rationalization. jr has been posting blatant lies and misinformation. gadfly and several other posters have called him out time after time. sorry, but only one of them has a valid point.
You guys let me know when it's been VERIFIED that congress and all govt employess will be on THE SAME plan as the rest of us.
I'll wait...
Yeah JR and you're not pickin a LvsR fight by calling one group "ignorant."
JIT: We have a system that can not be a free-market system no matter what we do due to the very buyer's model that constitutes the basis of the system. Because there is little to no buyer power, buyer's are powerless to exert any controls in the market. This market is totally broken and no where near approaching what could be called a free market system.
Our system is so broken that we have "hired guns" that we pay for called insurance companies to try to ride herd on an industry with an inflation rate of 7.5% (next year to be 6.5%). Not only do these groups insure us but they also lobby for better prices for all goods and services exerting the only buyer control in the market. We outsource our buyer's control in this market unlike most free enterprise markets.
The pricing system for this market ranges between insured and uncovered at differential rates that would be found illegal in most markets. Those who are charged the highest prices and can not pay are automatically paid for and covered by those who can pay. In no other market are non-payers allowed to freely purchase goods and services that they have absolutely no means of payment for.
Prices for new drugs are protected about 17 years before generic prices are allowed and drug manufacturers are the most profitable companies in America.
Just some of the parts of the system that are broken in a system that can never be free market no matter what you regulate, organize, etc. So the thought that we "band together" or regulate insurance companies to be able to advertise goods and services in a transparently comparative manner seems a lesser of many evils that plague this market. Why not make the hired guns (insurance companies) adhere to an advertised (transparent) certification minimum before they can sell their goods to us? I would rather argue about the certification levels than not have them as we do today.
What really amazes me is why Chris Christie feels he can not efficiently and effectively provide such a service with over two years of free federal funding because he does not trust their cost estimates. Can't he find his own estimates? Can't he figure out how to cost effectively run a web site that would benefit any NJ citizen who buys health insurance? Is he that bad a businessman? It's a website. Does he really not care about NJians looking to score some health insurance? Something else is more important?
I would like to see NJ stronger than this storm and feel that defaulting to the Federal ACA exchange is a real dis-service to New Jersey by Mr. Christie.
Once again you demonstrate that you don't understand the issue. Were talking about Congress and congressional staff. The ACA never required "all govt employees" to do anything.
And once again you're not getting the point. What's good enough for the people apparently isn't good enough for the government/politicians.
If OC is "so great", EVERYONE should be REQUIRED to have it as their health insurance. Period.
uh..... OC is not health insurance JR.....period.
While I agree that the mechanism being used to replace that which OC legally took away because lawmakers forgot to read the law is wrong and perhaps illegal, JR your lack of OC/AHCA understanding is appalling only complemented by your blind willingness to wholeheartedly accept any erroneous myth or lie about the law and the process.
r/c, now you're just being mean. Look at gadfly's post just before mine to see the context of what I wrote, context being the key word. When I commented about the "forever-fight" that's what I was referring to.
Gadfly and JR are messing around with semantics. JR's point, if I'm reading him correctly, is about the end-game of Congressional coverage. As he said, and I don't think the point has been disputed, Congress will essentially keep their health plan but have to go through the exchange to do so. IOW, Congress gives up nothing in the process, and can keep their "Cadillac" plan even though the press seems to be implying that Congress will be "sacrificing" something along with the rest of us. Gadfly says the earlier legislation was a mistake. Maybe, but rarely in Washington are laws passed that don't serve their intended purpose. I agree with those who question the original motive and the "solution" - especially when the solution changes nothing except to ensure participation in the added layer of an exchange. Oh, and it doesn't help that the press gets used to demonstrate how Congress is "just like us". Please.
Gadfly is pointing out the particulars as to why Congress *is* participating in an exchange, but largely ignores the point JR was making regarding the "no-change" level of care that Congress will continue to receive, even though it seems they agree on the point.
If we are too busy fighting each other it's easy to ignore the bigger picture.
JIT, just to clarify, this is more about Congressional staffers than it is about the actual Congressmen. Congress is mostly just trying to retain their benefits, to retain their "brain" pool by keeping benefits at the status quo levels since they are fearful of folks jumping ship over decreasing benefits.
I still say: let them eat cake ! I mean the rest of us can't even afford cake.
Perhaps a little retaliatory, but we all are taking cuts, paying more, tightening belts, so "teacher, leave those staffers alone......" And if they leave for supposedly better jobs, just let the Congressmen learn how to hire better for less, just like the rest of us.
It's not like America is going to lose Congressional productivity over this now is it? The have not produced anything in years anyway.
JIT,
Yes you're reading me right, and have said it better than I have. You have more patience than I, sir.
JIT, please take a closer look and I think you'll see that you are incorrect. I don't see why this is so hard to grasp.
Congress and congressional staff are required by ACA to buy health care plans that are available through the ACA exchanges programs. These are the same plans that will be available on the exchange to all of the rest of us. THE SAME PLANS. The only thing that the OPM decision accomplished was to allow the federal government to continue to contribute money toward those plans.
This is NOT semantics. JR has repeatedly stated over and over again that Congress and its staff will not be required to buy plans through the exchange or that they are some how keeping their special plans. That is not correct. The only thing that they decision does is allows them to keep the financial contribution toward the new purchased plans - something that was not intended to be eliminated by the ACA in the first place. The plans they purchase will be the same available to the public.
And JR, I didn't fail to notice that in your second to last post... "And once again...", you gave up on claiming that you were correct, and instead tried to claim that the whole point was always about how all government employees should have to participate in ACA exchanges. That, JR, is just being dishonest.
The reason we can't have an honest debate around here is because people consistently spout off on topics without learning the facts, and then refuse to admit that they were wrong.
go do your own research jr. try some non-neocon sites for once. maybe then you'll have less time to troll this forum.
jit, i for one do not think it is mean to call a spade a spade.
" These are the same plans that will be available on the exchange to all of the rest of us. THE SAME PLANS."
This may be the hangup gadfly. If this were true then every company in the US would have to change the entirety of their health plans, but from everything I've heard that simply isn't true. My understanding is that all insurers need to meet a minimum standard set forth by a standard "Summary of Benefits and Coverage" document they are mandated to provide to their customers, but the balance of the plan is theirs to decide. IOW, the *minimum* has been standardized, but not the *maximum*, so insurers can compete above and beyond the minimum requirements of the law. The plans are NOT the same, except on a minimum basis.
http://www.cms.gov/CCIIO/Programs-and-Initiatives/Consumer-Support-and-Information/Summary-of-Benefits-and-Coverage-and-Uniform-Glossary.html
there are two scenarios. there are those who have employee provided plans that will not be affected. then there are the exchanges for everyone else. these will be set up state by state, or if the state refuses then the federal government will set the exchange up for that state. with the district of columbia being...a district, i'm not sure if they will there own exchange or what. so, while the workers in D.C. may not have the same insurance offered here in NJ, they will be on the same exchange that covers the people in D.C. and don't worry, if they do get so called cadillac plans the ACA has an extra tax on those.
JIT,
I'm not saying that all of the plans identical to each other. The exchange is basically a marketplace, where consumers will be able to shop for health care plans from private companies. ACA mandates that Congress and its employees buy their plans through these exchanges. That means that the selection of plans will be the same for Congress as it is for Joe Blow consumer. So in other words, while the same plans are available to Congress and the consumer, not all of those plans will be the same.
JIT,
I'm not saying all the plans will be the same. I'm saying that the selection of plans offered in the exchange will be the same for the public and Congress. They will have have the option to choose from the same selection of plans. That was the intent of the Grassley amendment, and that has not changed.
So all government employees will be forced into the exchanges? Or is it just the Congress being forced into the exchange? I don't understand, if they already have health coverage then why would they be forced into the exchange?
r/c, the implication from your description, then, is that the exchanges will only be for the presently under- or uninsured?
My understanding was that all insurance plans would be registered somehow in an exchange, and that they were being forced to accept people that at present are excluded. Isn't that one of the primary points of the ACA?
how much is the 'contribution' ?
if it is a match to the value of their current plans (Cadillac level) then the question i have is this: will some congressional staffers be able to pocket the difference if the plan they buy from the exchange is one of the cheaper plans?
for example: if a Cadillac level family plan currently costs 27,0000 per year, will the CBO be adding to a staffers salary if the staffer chooses a plan that costs less than 27,0000 per year?
JIT,
RC is correct.
The exchanges are just marketplaces that will facilitate the consumers ability to "shop around", compare plans, and purchase one. Anyone could purchase a plan through an exchange, but people that have plans offered through employer will probably find that they have a better deal through their job. Why? Bc those plans are purchased as a group, plus their employer likely contributes to the cost. If those people choose the plan offer with their job, the are not involved in an exchange in any way.
The Grassley amendment that I described above was proposed to force congress and congressional employees into policies offered through the exchange. I believe Grassley was trying to make a point, something like, "if these plans are good enough for the public, then Congress should have to take them too.". So, yes, the ACA forces Congress into the plans even though they already had coverage. It was done to make a point and put congress in the position of "having some skin in the game". The ammendment did not impose this requirement on an other federal employee (or any private employee for that matter).
Bd, according to some of the articles linked above, Congress will have 75% of their premiums paid for by their employer, the same % that they previously received and apparently the same % received by other federal employees.
So the tax payer ("congresses employer") still as always has to pay 75% of their insurance. Oh goody. Things never change. So what is the big deal? Same old Blood suckers. What's in it for me? Don't answer. I know how to bend over!
auntiel I guess thats a valid complaint, but its a seperate question. Also, don't think it's unusual for a professional position. I work for a private organization and the employer contribution is 85%.
gadfly, thanks for the explanation. I hadn't heard it that way. Have you come across information specific to the exchange that Congress has been legislated to participate in?
I work in the Private Sector and no way is my company paying 85% of the cost. I am paying $12,000 out of my salary for family coverage for my wife, son and me. That includes a $500 deductible. So if you got a $20,000 plan you are only paying $3,000. Nice employer, wish I worked there.
The exchanges are set up by state and it goes by residency, but I think their is still some uncertainty surrounding staffers that temporarily live in DC, but maintain their previous residency.
If a person "thinks" = uncertainty, ( not sure, defintely not known, etc.) Your own words. Not mine.
Yes, Auntiel I chose those words specifically to indicate that I was not certain about how residency works with regard to the exchanges (a relatively minor detail). That's called honesty. Ive only read that information in one source, and im not certain. What's wrong with being honest when your not sure about something? Im not really sure what the point of your criticism is.
Some clarity.
Yes the AHCA was passed in such a way that Congress would be forced to use the insurance exchanges. Sort of good for the goose type thinking. The AHCA law does not provide a PROCESS for large companies or governments to make payments directly to the exchange. Thus there was no way to pay for the Congressional benefit anymore. That's what the OPM looked to remedy. There is some legality question as to whether they can actually do this as a legal PROCESS. That is the crux of the biscuit. There is no liberal versus conservative, it's just a process issue.
Currently Congress and Congressional aids are covered by the Federal Employees Health Benefits Plan which covers all federal workers. Up to 75% of the coverage is covered by the Fed. That's the benefit and there was no intent in the amendment to strip the benefit dollars from Congress. In the ACHA, Congress passed a Republican-authored amendment meant to embarrass Democrats who ended up embracing it. The amendment took Congress and Congressional staffs out of the FEHBP and put them into the AHCA exchange as a symbolic "good for the goose" type thinking. The intent was a process change not a funding cut. Cool. But the 75% funding PROCESS was not included in the amendment. The AHCA has no provisions or PROCESS to allow large companies (or governments) to pay for insurance. Not so cool. So the Fed has no PROCESS to provide funding to support Congress and Congressional aids to use the AHCA exchanges. Nor does any large business in America. It is the deleted funding PROCESS and the OPM actions to restore the funding that are stirring the controversy.
There is some question as to who applies: Congress is in, but are territorial delegates in (they have no exchanges). And are committee staffs, leadership staffs, and other Congressional employees included; there is debate here.
The AHCA exchange is at the state level (or district) either run by the state to be state-focused (about 50% of the states will, NY seeing HUGE discounts) or by the Fed to be Fed-focused-on-the-state :>) (NJ will be by the Fed ty Chris Christie for letting HUGE government control our healthcare fate). AHCA insurers can offer minimalist plans (as designated by AHCA) out to Cadillac plans. In the case of the district, you have to imagine that one or more offers at parity with today's Congressional offer but will each of the state's have a plan that matches today's FEHBP's plans? Who knows and how will OPM pay for any potential differentials in each of the 50 states. However, Congress will use the state exchange of their place of residence, many time their home state. This brings up the potential OPM disparity in payments; will they be geographically based to match the current plans and funding levels?
http://healthaffairs.org/blog/2013/08/07/implementing-health-reform-a-proposed-rule-on-congressional-exchange-participation/
And no, Reuters is not a conservative wonk publication. JR has just spun it as a conservative wonk.
A friend recently visited the ER in Hackettstown Med Center. The bill was about $6700.00 and insurance paid around 10 percent. This was due to a discount rate that the ins. Co. Had negotiated with the provider. The pt. was responsible for a small amount. What would happen if you had no insurance? Would you be expected to pay $6700.00?
Expected yes.
And if you don't pay or can't pay, then the $6,700 is taken as a loss and the loss is "rolled" into the pricing that we, the insured, pay.
And since it was ER, I am guessing that you didn't have a lot of time to shop for the best price or quality of service.
Only in healthcare are deadbeats accepted, covered, and paid for by customers. There is no denial of service due to ability to pay. In other businesses, service is denied. And only in healthcare do we see pricing differentials between classes of customers (covered and uncovered) with such differentials. In other markets, such pricing practices would be illegal.
The market is just not normal.
That's how capitalism works. You require a service, you pay for it.
I NEED water to live... but I am still required to pay HMUA for my water.
I NEED heat to survive the winter... but am still required to pay both Elizabethtown Gas and JCP&L for my heat.
I NEED food to live... but I still pay grocery stores for my food (and even if I were a vegan living out of a garden, there would still be cost involved and I would have to pay for that was well.)
I find it interesting that people for some reason think healthcare should be free because "everyone needs it"... everyone "needs" alot of things. An most of us actually pay for them. Seems to me people are forming their "opinions" on the matter strictly on emotional grounds. "I need it, therefore it should be free". Puzzling.
I notice alot of people don't have any problem at all forking over money for xboxes, flat-screen tvs, iphones, the list goes on and on and on. But ask them to pay for a doctor's highly specialized services, and they protest. Makes no sense whatsoever... as I said, based only in emotion (and quite possibly in the "entitlement" mindset the govt has worked so hard to create.)
Oh JR, I just spit my coffee into the keyboard at your hypocrisy. Once again JR, the AHCA is not a matter of whether or not you want free stuff. And what are you saying, you do realize that you pay for and take advantage of "free" stuff all the time. It's just a matter of where you draw the line. You take defense, roads, social security, unemployment insurance, medicare, police ---- all "free." But you somehow draw the line at healthcare and fully accept that if someone gets sick, tough luck if they lose everything because of it.
And you are willing to accept all comers at the hospital whether they can pay or not and then cover these costs in the very price you pay. Do car dealers accept all buyers and then pass the scofflaw losses on to the rest of us? Can I go to the market, load up, not be able to pay and let the rest of you cover me? I think you're insane if you think healthcare is a NORMAL open capitalistic market subject to the same demand and supply laws as other commodities we buy. The model is completely different and unique to a single market ----- the healthcare market. Look the at ER example above: is that a normal capitalistic market at work? Not bloody likely.
The best part is your examples, that's where the coffee flew. HMUA is a non-profit municipal service, essentially not capitalism but run by the government. It is as free water as you can get, a communal water supply if you will you hippy. Elisabeth Gas and JCPL are regulated utilities, even in deregulated markets their pricing and profits are overseen by the government. That's right, big brother is keeping your electric and heat prices down. Your own examples here are of markets where prices and profits are regulated. Pretty funny.
And the AHCA is not "free" anyway, it is not "euro socialism," it is capitalism at it's best and it's called the INSURANCE market. Of all your examples, this one fits the capitalist model the best. People buy insurance. They shop for insurance. They can pick and choose freely (or their company can on their behalf). 85% of us have it and AHCA does not change much of anything in the basic insurance model. The 15% that do not have insurance will buy insurance on the open capitalistic market. Most will pay hard cash. Only a small percentage, the poor, will get a hand-out, just like we hand out food, water, clothing, heat, etc. to those so unfortunate as to not be able to survive without a helping hand.
How "mandated" became "free" in your mind is one for the ages.
So AHCA is not free; no one is saying free medicine, socialized medicine. It's just your twisted argument fostering the myth so you can have yet another bogeyman to take the blame. Stick with the second amendment, it's a debate you can handle.
We can assume you have insurance thru your employer JR? We just want equal rights for everyone! At least I DO!
Pretty much half of my husbands paycheck goes to medical care. Insurance premiums and copays. How do we survive now? No entitlement for us.EQUALITY!
A good day - yes, you are. You just start negotiating with hospital and doctors offices. After payment plan agreement or settlement agreement is finalized you pay until settlement amount is paid, just like any loan. In general hospitals can be satisfied with 50%-70% of original invoice, doctors usually go for full amount or 90%. Also you will be reported to credit bureau as paying medical debts.
That's why people who always had decent medical insurance with mostly paid by employers premiums cannot understand people without medical insurance or people who cannot afford to buy medical insurance due to high premiums or cannot use it due to high deductibles.
Are you asking people to behave responsibly JR? You must have high expectations in our "modern" world where people avoid paying when at all possible LOL!
iJay3 JR - you buy food, heat, water from the same places as your neighbors and we all pay the same price for food or services (not counting coupons available for all willing to use them). But we all pay different price for the same medical services depending on if you have medical insurance, how much premium percentage your employers pays, how much premium you pay, what negotiated price for the service paid by certain medical plan is, etc. Frankly, if someone works for any governmental office (federal, state, local), they practically pay nothing for medical services, private employees total pay for medical services differs from employer to employer, self-employed can barely afford to have "emergency only" coverage. Why we all cannot have one basic "medical ShopRite" where everyone could get "food aka medical service" and pay the same price? If someone doesn't like this "medical ShopRite" they can go to "organic store" for better stuff and pay more. Just minimum for all, everything extra - pay extra.
A good day, I brought up your point many times in the past. The current "MSRPs" for hospital services are so padded to make up for those who do not pay. Say someone without insurance pays 50% which would be 5 times higher than insurance would pay in your example. However, the uninsured often pay nothing. In the end it averages out but it is not fair to some. Definitely, hospitals have to somehow be stopped from charging rates that are paid by insurance company negotiated rates at 10-20% face value. However, if everyone has insurance then these ridiculous MSRPs only mean something to non-citizens.
Lena,
The example you use sounds like an example for folks without sufficient assets to pay the bill. But if you have the cash, but don't have the insurance, good luck on bargaining.
As I keep trying to explain to JR, healthcare just ain't a normal market model. Here's the model from the government for pricing, discounts, medicare, etc.: https://oig.hhs.gov/fraud/docs/alertsandbulletins/2004/FA021904hospitaldiscounts.pdf
Could you imagine the same guildelines for your local auto dealership....
Now, the discount discussed talks to the uninsured unable to pay. The price differential might be from 2X to 5x between insured and uninsured. So, a $50,000 operation for the insured can run up to $250,000 for the uninsured. So I guess the poor can feel they go a deal if they get over 80% off.
And remember, in America with JR's capitalistic competitive healthcare market, this is on top of the prices we already pay at 50% to 150% more than the rest of the world for "adequate" health care on the average.
So sure, the uninsured with money can feel free to bargain and dicker, but good luck.
Why do hospitals do this. Bottom line is because the can. And then the insurance companies can look like heros by knocking up to 80% off and we, the insured, feel like winners not whiners.
It just ain't a normal competitive market JR and it never will be due to the nature of the purchase for mandatory items. Perhaps in the discretionary health care market like braces and pimples the market looks more competitive, but not for mandatory services.
And back to JITs point: competition, cost containment and the AHCA. While the AHCA does not lower hospital prices per se, it does change the game. Hospitals will no longer have a reason to charge the uninsured exorbitant rates, there will be no uninsured. This revenue stream will disappear. Hospitals will no longer get stiffed by the indigent; everyone will be covered, so this cost will disappear. Since less people will be uncovered, less people will wait till the last second when care is most expensive which will reduce revenue, cost, and waste.
How does this affect price? Who the heck knows.....Dems say down, Repub say up. But what it will do is make the pricing model transparent. No longer will hospitals have disparate revenue streams per procedure between the insured and uninsured. They won't be able to hide behind these phony prices making things more transparent and therefore readily comparative from facility to facility.
That just can't hurt.
Mistergoogle - "if you have the cash, but don't have the insurance, good luck on bargaining" - if you have cash you should buy medical insurance, at least "emergency coverage", if you didn't - consider it a tuition for life lesson. If you cannot afford to buy medical insurance - you fall under "folks without sufficient assets" so you can set a payment plan or reach some agreement. Even if you will be reported to collection agency, you will be able to reach payment agreement with it. Point is - nobody pays "MSRP" price (very good analogy iJay3!) for hospital services.
Ohio insurance commissioner Mary Taylor is also the Republican Lieutenant Governor of that State
Erik B. Anderson I have never said the healthcare market/industry isn't broken. What I have said, and what I continue to say, and be correct about, is that healthcare is not a right, it is not OWED to anyone, and "equality" has nothing to do with it.
And those of you who are saying it "isn't free" are right- all of us who pay taxes will be paying for it. (meaning ALL TAXPAYERS will be paying for it) .
Besides the fact the medical care quality will decrease and wait times will increase... you can argue these points all you want, but other countries' "universal healthcare" has shown this to be true.
Healthcare is not a right. Not of any kind. You don't "deserve" it, you aren't "owed" it, and "equality" has nothing to do with it... except to those who think major wealth re-distribution is a good thing, and who see the govt as Robin Hood "stealing from the rich to give to the poor"... altho this program will be taking from EVERYONE who pays taxes (which is mostly middle class)... After a decade of OC, come back and see mr and tell me how wonderful you think it still is.
I have never said the healthcare market/industry isn't broken. What I have said, and what I continue to say, and be correct about, is that healthcare is not a right, it is not OWED to anyone, and "equality" has nothing to do with it.
And those of you who are saying it "isn't free" are right- all of us who pay taxes will be paying for it. (meaning ALL TAXPAYERS will be paying for it) .
Besides the fact the medical care quality will decrease and wait times will increase... you can argue these points all you want, but other countries' "universal healthcare" has shown this to be true.
Healthcare is not a right. Not of any kind. You don't "deserve" it, you aren't "owed" it, and "equality" has nothing to do with it... except to those who think major wealth re-distribution is a good thing, and who see the govt as Robin Hood "stealing from the rich to give to the poor"... altho this program will be taking from EVERYONE who pays taxes (which is mostly middle class)... After a decade of OC, come back and see mr and tell me how wonderful you think it still is.
I would argue that society should provide basic health coverage for emergency situations that are truly life threatening. Now, we already have it right now since no one can be denied assistance although they might have to wait. The problem is when people abuse the system and use emergency health care for normal issues. Besides costing more than doctor/specialist visits, these folks do not pay their bills and the bills are high.
Not that I agree 100% with Obamacare, but that is part of it -- move people away from emergency rooms unless needed.
Now, my problem with Obama is that while he is doing this he does not address the legions of lazy folks that do not want to work. Hard work should be part of the solution but I don't see it anywhere...
Again JR, there are many things that are not rights that Americans have agreed to chip in taxes for and cover for the good of our citizens. We "deserve:" these rights because we have decided that we do. A partial list is above. You don't feel healthcare is in that category, I do. To me healthcare defense is just as important as national defense. It's fair that you don't think healthcare is in the same boat as other entitlements we join together to provide. It's fair that you don't have a problem with the uninsured going down the financial drain just because they get sick. No OK in my book, but fair for you to have the opinion.
As to taxpayers paying for it, who cares. We pay for it today anyway. "Robin Hood" as you call it with your tired and lame "rich pay for it all" argument is in full play already. We pay for it every time some uninsured person waits till the last and most expensive second to get care. We pay for it every time the ER charges 5x the normal price to the uninsured and they don't pay. Some think we pay so much for it already that changing the model from the one you agree with will pay for itself right then and there.
As to the quality going down and waiting lines going up, not necessarily. The U.S. today is middle of the pack in quality and many nations, all with healthcare plans, beat us in quality. Look it up. Lines too might happen, might not. For example, ER wait times will probably go down. And remember, we are talking about a maximum of a 15% increase in patients, not exactly a gold rush.
Your fears seem to outweigh the facts.
And Lena, "tuition for life" can mean total financial ruin for individuals and families and not sure it's a lesson America should enjoy. That type of thinking could apply for Social Security and Medicare ---- after all those ole folks shoulda known better, let them save or buy old-age insurance. Meanwhile, lots of people with cash to pay for insurance are kids who think they will live forever. They are really not making a bad choice, they really just don't know any better, not enough experience. Guess we can always blame the parents for yet another ruined life just because someone got sick. Not for me thank you very much.
I got an idea for congress. When they come back from vacation, they should try to repeal the Patient Protection and Affordable Care Act for the 41st time. Not very original idea, I know, but it's not like we don't have a million other pressing issues that are not being addressed.
Snake bite victim hit with $55,000 hospital bill
“I’m going to go buy a lottery ticket and a cheap bottle of wine,” said Jules Weiss, who at first thought she was stung by a bee when she was bitten by a snake. After a trip to the emergency room, she got another shock altogether.
http://www.today.com/video/today/52727203/#52727203
Mistergoogle - my family was the one who learned a very expensive lesson what can happened if you don't have medical insurance and you cannot wait until it kicks in. That's why I always suggest to anyone to have any kind of medical insurance or at try to participate in programs offered by clinics. The cost of insurance is still less than what uninsured will be paying for the same medical service right now.
JR continues to say (on multiple occasions) that "Healthcare is not a right. Not of any kind. You don't "deserve" it, you aren't "owed" it...".
He is, of course, wrong. Not sure why he continues to believe it but fortunately, in 1986, Congress passed the Emergency Treatment and Labor Act (EMTALA) that prohibits a practice commonly known as "patient dumping." The act gives individuals the right to emergency care regardless of their ability to pay. EMTALA was enacted as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA).
So, if you are sick or injured to do have a "right" to medical care.
Erik: You have to be careful now, there's a new Republican nuance in the works for their overwhelming hatred of providing HealthCare to all Americans.
Now the Republicans remain steadfastly against the AHCA aka Obamacare except for the good parts like pre-existing conditions and continuing child coverage until 26 and, and, well you know, all those other good things except for the AHCA and ObamaCare that they will tell you about after they kill it.
Because they are compassionate now (that they read the polls and the worm has turned) and will kill it and then bring the good stuff back again. Promise.
Lena: sorry and I hope not one more American will face this lesson.
Rad: nice factual spin. MG likes. And like I said, guess who pays for it? WE the insured people DO.
RAD,
My apologies, I should have been a bit more specific. You have no right to FREE healthcare. FREE meaning someone else besides you paying for it. It is correct you cannot be turned away if you are in need of medical care, but it is also correct that you are expected to pay for said medical care. Unless you are already on one of the current socialist healthcare plans already provided by the government.
So your point is that no one is entitled to free healthcare, except for the people with free healthcare? Just trying to understand the point you're trying to make....
@JR Maybe we are close to splitting hairs here, but if there is no right to FREE care then what does it mean that the the act cited gives individuals the right to emergency care regardless of their ability to pay. Doesn't "regardless of their ability to pay" essentially mean it's free if you can't pay?
It's pretty obvious that the same people getting free care today will get subsidized, not necessarily totally free, care under the AHCA. JR uses the same ole tired myths and stereotypes to foster fear and loathing by the almost-haves against the have-nots allowing the have-it-alls to skate away and continue their ever-increasing ownership of most of America's assets. He surrounds his fear mongering with umbrellas like "euro socialism" and "lazy bums taking free rides on your back" and all those tired myths and anecdotes.
Some simple facts:
- ACHA looks to cover an additional 15% or about 30-45M uninsured Americans so that NO AMERICAN will ever hit financial ruin just because they got sick
- ACHA will be accomplished via an insurance mandate, not a government takeover of the health care industry. 85% of us are covered in this fashion TODAY and I doubt we feel we are under the thumb of government tyranny.
- ACHA is not exactly free insurance in that " individuals and families will receive premium and cost-sharing credits up to 400 percent of the federal poverty level.... These premium subsidies will be offered on a sliding scale basis and will limit the cost of the premium to between (a) 3 percent of income for those at 150 percent of the poverty level to (b) 12 percent of income for those at 400 percent of the poverty level." So that's way less than free with less than 15% of America getting credits and those credits not necessarily providing 100% free service like they can get today by just not paying.
- Businesses will either be exempt (small businesses, part time rules and payroll size), will provide insurance co-coverage or can pay into a Health Insurance Trust Fund. Coverage will be 65% for family, 72.5% for singles of the minimal plan (almost just like the government plan......). Newly covered employees are NOT getting free insurance, just co-payments like the rest of us 85% of America.
- Businesses opting to pay into the trust fund will do so at a sliding scale. Under $.5M in payroll is exempt and depending on revenue, from 2% to 6% of payroll will be the payment.
The bottom line: "The Congressional Budget Office (CBO) estimates
that the AHCA Act will reduce the number of uninsured Americans by 36 million in 2019 at a net cost of $894 billion over 10 years. According to the CBO, 21 million people will obtain coverage through the Insurance Exchange. In addition, 15
million more people will enroll in Medicaid, and 6 million will obtain health coverage through their employers."
So yes there is a payment, yes there is a TAX, about 894B over ten years. But put it in perspective. First many aspects of the healthcare system might see improvement because of the ACHA. Higher competition for insurance might mean more competitive prices. Transparent pricing for services might mean more competitive prices even for ER and mandatory services. Others are listed in the cited source. Second, no American should go broke just because they got sick and no American should ride free (on our backs) by just turning up at the ER without any hope of payment. Third, at about 85B per year to support, that's about 10% of the current defense budget. Ask yourself, is defense for health coverage 1/10th as important as national defense? If we were really concerned about the cost, couldn't we just cut defense by 10% and cover all Americans to avoid catastrophic financial ruin just because a hardworking American got sick? 10% ---- we all cut that out from our household budgets every year to cover something that we think is important.
Remember, before you answer JR, you are not talking about strangers; you are talking about your neighbors right here on Hackettstown Life that will be benefited from the AHCA and without it might face financial ruin just because they got sick.
Here's a simple clear discussion without the fear and loathing JR and others would spew: http://willamette.com/insights_journal/10/spring_2010_4.pdf that describes the mechanics, payments, and systemic benefits of the AHCA.
RAD - "ability to pay" is not established by the patient. There is a lengthy evaluation procedure done by the hospital who decides if you are able to pay their bill (and how much) or not according to your family income and assets. The same goes to people applying for Medicaid or Medicare. If you are below curtain income level you can qualify for these programs or programs offered by clinics. So people "who cannot pay" are really people who live at poverty level or senior citizens living on Social Security income. You cannot just tell "I cannot pay my bill" and walk away. There are many ways to force you to pay including collections and deductions from your paycheck.
How I see OC - it gives people ability to decide if they want to have medical insurance thru their work (it can be extremely expensive, see example above, and from my family experience $10-12K per year premium paid by employee plus huge (up to $7.5K) deductibles is a norm at private sector jobs) or buy their own medical insurance from exchange. Right now they simply have no choice and sometimes decide not to buy medical insurance from employer and it can be really disastrous for their families in medical emergency cases. They are not falling under "poverty level people" so they will need to pay MSRP medical bills unless they are able to negotiate them with hospital and doctors.
When bill was just introduced I remember a discussion between my DH and his nephew who is ER doctor. The doctor was telling the same arguments you can read on this forum and my husband told that we are paying $11K premium for family plus $3.5K deductible. The nephew said that it's not that bad. And my DH replied - yes, if you make $250K per year. What if you make only $50-60-70K or less? The median family income for NJ is $71K and for US is $53K. Just simply compare. So they didn't discuss the topic ever after.
JR, I still don't see what point your trying to make. With the exception of cases in which the patient cannot pay, who is advocating for free healthcare?
i just got a bill from my surgeon who removed my gallbladder via laproscopy - $17,000. i'll be calling my insurance company in a few minutes to see why they didn't cover it. this ought to be fun. and this bill doesn't even include the hospital costs or gastroenterologist charges. crazy.
Poppy Girl - you forgot to mention anesthesiologist who is usually not participating in your insurance so you will be responsible for his/her bill. Good luck. Was in your shoes, know that.
Poppy, it's a new rage amongst DRs. to mail you a full or partial bill sometimes even as they submit it to insurance. Step one is to tell the DR to submit to insurance. Only a few will refuse.
Then it's up to insurance, in network or out. If out, some plans cover 80% post deductible. Depends on your plan.
And sometimes even after the DR has submitted to insurance and gotten payback, they will try to charge you for more than insurance says you have to pay trying to get some of the insurance discounted dollars back I guess.
The best part is when you get it 15-days into the 30-day grace period and the interest charges for late payment are HUGE. Most DRs never charge the penalty for 90 days or so since the system is so screwed up.
I've gotten to where if I ever receive any bill, no matter what it says I owe or insurance has paid, that I check my insurance web site to see what they paid (or not). If I see no info, I call the DR and tell them "send it to my carrier, I don't cover any bills myself until insurance has reviewed it."
No other business except health care can operate like this and if other industries tried it they would either be bankrupt or in jail.
And then lastly, and sorry to say, I would bet that many more bills are coming from the hospital, the anesthesiologist, the floor cleaner, whoever happened by as you were on the table. It appears that each entity that gets close to you sends you a separate bill, each with a new deductible, etc.
RAD,
I don't think it's splitting hairs at all- everyone must be treated at the ER if they require care; they cannot be turned away.
Being able to pay for it is a different matter. If you don't have the $1500 (or whatever the ER bill is), then the hospital will arrange a payment plan for you to reimburse them for the services they provided for you. The point being, just because it's something you need, doesn't mean you should get it for free.
And if you are so financially insolvent that there is no possible way for you to pay for it, we have medicaid. That is what it is for.
Again- I never said the current system wasn't broken, I recognize the clusterpluck the HC industry is, and I agree with everyone here that "something" needs to be done about it. But imo, OC is not the answer. Socializing or governmentalizing the entire healthcare system is not the answer. Just because I personally don't have an answer, doesn't automatically mean a bad idea (OC) is better than no idea.
The HC industry debacle goes much further than "expensive insurance"... but that's a whole 'nuther thread... all the "bad stuff" going on in HC today.
JR: The AHCA is not socialism or even socialistic. And the only "governmentalizing" is the mandate to buy insurance on the capitalistic open market.
Meanwhile, how can you personally not have a clue as to a solution? Every modern and industrial nation in the entire world beyond the US provides Universal HealthCare for their citizens. That's 32 out of 33 developed nations.
Seven of the 32 use the insurance mandate.
The first country to solve this problem did so in 1912. The last country, beyond the United States which has not solved the problem YET, to solve the problem did so in 1995.
There are 3 major overarching processes to choose from: single-tier, two-tier, and insurance mandate and up to 32 different variations of those system types to learn from.
And yet with every other developed country in the world offering a process to secure Universal HealthCare to care for their citizens, beginning in 1912 (it's over a century old now), 7 of which use the insurance mandate, and with the US being the only country not to be able to figure it out 18 years after the last country yelled "universal healthcare mission accomplished," you still don't have even a clue as to how to proceed?
You, and your kindred non-believers, should be ashamed to be that uninspired. Sorry, but I think you have crossed the "here's a buck, buy a clue" line.
http://truecostblog.com/2009/08/09/countries-with-universal-healthcare-by-date/
this is not a good development, it will be a very bumpy ride for those who can least afford it: from Frobes comes this:
Yet Another White House Obamacare Delay: Out-Of-Pocket Caps Waived Until 2015
First, there was the delay of Obamacare’s Medicare cuts until after the election. Then there was the delay of the law’s employer mandate. Then there was the announcement, buried in the Federal Register, that the administration would delay enforcement of a number of key eligibility requirements for the law’s health insurance subsidies, relying on the “honor system” instead. Now comes word that another costly provision of the health law—its caps on out-of-pocket insurance costs—will be delayed for one more year.
Annual limits on cost-sharing are specified by Section 1302(c) of the Affordable Care Act; in addition, starting in 2014, deductibles are limited to $2,000 per year for individual plans, and $4,000 per year for family plans.
(these will be delayed for another year, hurting the little guy, good show!, bd)
According to the law, the limits on out-of-pocket costs for 2014 were $6,350 for individual policies and $12,700 for family ones. But in February, the Department of Labor published a little-noticed rule delaying the cap until 2015. The delay was described yesterday by Robert Pear in the New York Times.
Notes Pear, “Under the [one-year delay], many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.”
The reason for the delay? “Federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs. In many cases, the companies have separate computer systems that cannot communicate with one another.”
The best part in Pear’s story is when a “senior administration official” said that “we had to balance the interests of consumers with the concerns of health plan sponsors and carriers…They asked for more time to comply.” Exactly how is it in consumers’ interests to pay far more for health insurance than they do already?
It’s not. Unless you have a serious, chronic condition, in which case you may benefit from the fact that law forces healthy people to subsidize your care. To progressives, this is the holy grail. But for economically rational individuals, it’s yet another reason to drop out of the insurance market altogether. For economically rational businesses, it’s a reason to self-insure, in order to get out from under these costly mandates.
Patient groups upset
While insurers and premium-payers will be happy with the delay—whose legal justification is dubious once again—there are groups that grumbled. Specifically, groups representing those with chronic diseases, and the pharmaceutical companies whose costly drugs they will use. “The American Cancer Society American Cancer Society shares the concern” about the delay, says Pear, “and noted that some new cancer drugs cost $100,000 a year or more.” But a big part of the reason those drugs cost so much is because manufacturers know that government-run insurers will pay up.
“The promise of out-of-pocket limits was one of the main reasons we supported health reform,” says Theodore M. Thompson of the National Multiple Sclerosis Society National Multiple Sclerosis Society. “We have wonderful new drugs, the biologics, to treat rheumatoid arthritis,” said Patience H. White of the Arthritis Foundation. “But they are extremely expensive.”
The progressive solution to expensive problems? More subsidies. But subsidies don’t reduce the underlying cost of care. They only excuse the high prices that manufacturers and service providers already charge.
It’s one of the many aspects of Obamacare that should be repealed, if we are to combat the rate shock that the health law imposes on tens of millions of Americans. But that will require Republicans to come up with a smarter strategy than shutting down the government.
http://www.forbes.com/sites/theapothecary/2013/08/13/yet-another-white-house-obamacare-delay-out-of-pocket-caps-waived-until-2015/
mg,
Yes... and story after story coming from those countries (Canada is a good example) are of people waiting LONGER to get the lifesaving medical care they need. LONGER wait times, not shorter.
So what- healthcare will now be essentially "free", (it will be free to those who pay no taxes, which is quite a chunk of the US), but they will have to wait so long to get the treatment they need they die, or the treatment becomes turned down because they are "too far gone"?
OC is going to create MORE demand for medical care, while providing LESS actual care, and increasing wait times. A result of paying healthcare providers less, giving away more care. It's simple math + human nature. If something is there for people to take advantage of, they do.
But I expect nothing less from our governmental leaders: create a majority class of people who is positively RELIANT on you for their very LIFE.... their food, their housing, their money, their healthcare.... then it's a cinch to keep getting re-elected.
...until the money runs out, which it will. It's just a matter of time. Hopefully Atlas will shrug before then, but I doubt it.
You know I don't have all the answers but I do know that Universal Health Care should be an US imperative if we care for each other as citizens of this great country. It is not a right, but it should be a privilege of being American as important as the military defense of the country.
And if you believe in that too, then the rest is merely process. And if you don't I would tell you to move elsewhere but sorry, they all have Universal Health Care.
Today we have the AHCA as the law being introduced to provide Universal Health Care. No one can find a better alternative having voted down single-tier and two-tier plans. A significant portion of the world uses the insurance mandate, they have made it work and some provide better health care to their citizens, on average, than we do.
But all you can do is say: "I'm against it, repeal it, and start over." Other countries have solved this for over a century and the last developed nation to do so beyond the US was well over a decade ago. But you don't have a clue what to do.
To say we are behind the eight ball would be an gross understatement. To say we don't have a clue what to do is frankly ------ stupid at this point.
So, according to the Forbes article, we realize what you are against:
= you are against ObamaCare but don't have a clue what to do
= you are against the delay in employer mandates that you are against having at all
= you are against irs enforcement as well as irs enforcement delays
= you are against out-of-pocket caps, therefore you must be for setting caps that when exceeded the insured can start paying through the nose (because they got sick)
= you are against any delays in the ObamaCare that you are against to begin with (let the pain start ASAP I guess)
But what are you for?
You are for letting people go down the financial toilet if they get sick. You don't believe that insurance should actually cover the unlucky sick except up to some capped level that the insurance company death panel decides..
You agree and align with the MS Society even though these the exact type of people you are really against since they are sick and want the caps.
But really, what are you for? Forbes has railed against the AHCA without any viable alternatives since the beginning as the lobby for gosh-knows-who. This article while factually correct makes no common sense whatsoever and literally twists around itself.
Ask yourself:
Are out-of-pocket caps something that insurance should offer or should policies be capped and when you get sick and hit the spending limit, thaaaaaaat's all folks? Hope you read the fine print. (And who runs those death panels to set the caps? Joe Insurance company guy?)
And if you place spending caps, don't you expect to pay for them? (Remember, you're the no-free lunch guys)
OK, here's the BIG question. If you have out-of-pocket caps and you get sick and use the caps versus being healthy where you just end up paying for the cap-coverage for nothing more than insurance ------------------ OK OK then who is actually the freakin lucky one in that scenario anyway? The sick guy or the healthy guy?
Twisted logic for sure from Forbes.
And once again you don't have a clue what to do while the US lags behind the entire world of developed nations in figuring this one out behind a century behind the first country and a decade behind the last (so now we will be last to solve it). The best you can come up with is.........ugh I dunno.
JR - I've been curious about this forever - why is your gravatar flag upside-down? It seems a bit unpatriotic, but maybe it's a statement that things are on their head in this country?
Rebecka Rebecka- sort of; the upside-down American flag is a sign of distress. I believe America is in great distress right now. And it's not just the current administration; alot of this stuff started before then. But it seems to becoming to a head.
mg-
that's an awful lot of diatribe to simply repeat what I said- "I don't have the answer." I notice you left out the second part of my statement- "just because I don't have an answer, doesn't mean a BAD solution is better than NO solution."
The bottom line is, you want UHC, I don't. You think it's a good idea, I don't. You think it'll all work out just fine, I don't. And please- put away your progressive/leftist "emotional sword" of "if you care about the citizenry"... please, go back to reading your Rules for Radicals.
While it is currently law, it seems it's getting changed constantly, parts of it are being delayed for implementation because faults are continually being found (GEE- maybe they should have READ THE EFFING BILL before they passed it, eh cryptkeeper pelosi?)
If conservatives can elect enough people to keep things tied up in congress as they have been (boy I know you HATE that that is how our governmental system works!) , we really don't know where all this is going to end up...yet. Guess we'll both just have to wait and find out.
Most of those developed countries do not have large populations and are all highly taxed. The combined populations of these developed countries is not even twice the populaion of the US. Canada's population is just north of 34 million people. Most of these countries are very progressive, month long vacations, parents being able to take a year off from work for new born children, etc. All great things but are you willing to pay 75% of your income for that lifestyle. Many would say yes but it would not work in the US for many reasons.
Well, I did research because the phrase "Healthcare is not a right" was bothering me. Apparently Article 25 of the Universal Declaration of Human Rights 1948 states that "Everyone has the right to a standard of living adequate for the health, and well-being of himself and his family...". The Preamble to the World Health Organisation's (WHO) constitution also declares that it is one of the fundamental rights of every human being to enjoy "the highest attainable standard of health".
Article 26 is the right to education. As a reminder there is free public education (including special education) to all kids living in US regardless of parent's income and taxes paid.
it's always the little guy who takes the hits first, read on:
The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.
Under the policy, many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.
Some consumers may have to pay even more, as some group health plans will not be required to impose any limit on a patient’s out-of-pocket costs for drugs next year. If a drug plan does not currently have a limit on out-of-pocket costs, it will not have to impose one for 2014, federal officials said Monday.
The health law, signed more than three years ago by Mr. Obama, clearly established a single overall limit on out-of-pocket costs for each individual or family. But federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs.
Advocates for people with chronic illnesses said they were dismayed by the policy decision on out-of-pocket costs.
“The government’s unexpected interpretation of the law will disproportionately harm people with complex chronic conditions and disabilities,” said Myrl Weinberg, the chief executive of the National Health Council, which speaks for more than 50 groups representing patients.
For people with serious illnesses like cancer and multiple sclerosis, Ms. Weinberg said, out-of-pocket costs can total tens of thousands of dollars a year.
http://www.nytimes.com/2013/08/13/us/a-limit-on-consumer-costs-is-delayed-in-health-care-law.html?partner=MYWAY&ei=5065&_r=1&
Great, now that we've established that Healthcare is an individual right, we can easily use the exact same logic to agree that the 2nd Amendment provides the individual right to keep and bear firearms. Glad we cleared that long-lived debate up. Thanks!
BTW- "free" education isn't free. It's payed for by taxpayers. Just like everything is. The government has no money- only the money they take from the taxpayers. Likewise, OC will only be "free" to those people who pay no taxes.
30 million more people are expected to join the ranks of those receiving healthcare, while doctor shortages (currently happening) are expected to INCREASE in coming years... does that sound like a good recipe to anyone?
JR, thanks for restating our positions. Sometimes I forget yours in your fog. But I think you cleared it up well when you state:"If conservatives can elect enough people to keep things tied up in congress as they have been (boy I know you HATE that that is how our governmental system works!)" Somehow you think that is the definition of working. So, yes, you have had your way. For over three years the party full of principles and promises has provided absolute zero progress on any issue except passing hot air. If they can't have it 100% their way, they will offer no middle ground, no alternatives, no compromise --- nothing. It's sad that so many proud conservatives have sunk to your level of empty principles JR. And still you do not have a clue what to do about health care. You state that you know the system is broken but you can offer nothing on how to fix it. Yeah, that's working all right. Not a clue what to do.
KB: you state: "Most of those developed countries do not have large populations and are all highly taxed. The combined populations of these developed countries is not even twice the population of the US. Canada's population is just north of 34 million people. Most of these countries are very progressive, month long vacations, parents being able to take a year off from work for new born children, etc. All great things but are you willing to pay 75% of your income for that lifestyle. Many would say yes but it would not work in the US for many reasons."
You are correct, the US is a large, complex place. However, the combined populations of the developed nations is indeed over twice that of the US. Well over at 678B vs. 314B. Your math is wrong. You are correct also that each country is smaller, like Canada. The largest is pretty darn big though at 33% of the US population. If we looked at the world as The United Countries of the World, then the US, in population, would be like NY or CA in our United States. However in healthcare, the US would look like Mississippi.
Taxes are a complex issue too; depending on what you are talking about --- individual, corporate, payroll, VAT/sales, etc.? Are you looking at rates or what people actually pay? In general, you are correct, the other countries providing health care have higher taxes. But 75% of their income is a fictional number. For the sake of argument, we'll use total tax paid as a percentage of GDP at all levels of taxation. The US pays 27%, the OECD nations (not an exact match to the healthcare list, but close) pay 36.2% (in 2008). And the highest individual tax rate at the max STATED level (not what they pay, but the stated rate --- remember Mitt Romney's stated rate is 35%, he only pays 14%), is 68% MAXIMUM for the Netherlands with a handful of countries at 55%, the rest below. Again, these are the stated MAXIMUMs, not what the individuals actually pay or the average of what everyone pays. Not even close.
So who wants to be a EURO Socialist and get "month long vacations, parents being able to take a year off from work for new born children," Universal Health Care (without paying for insurance) and according to KB, etc. etc. etc. (code words for much, much more!!!!)
The cost is only 9% higher taxes (but you save on health insurance).
MG - who cares about these 30 millions?
As soon as the connection between a right to bear arms and a right to healthcare was established there is no point to discuss anything about OC.
It was yet again another foggy argument given the second amendment is indeed, part of the Bill of Rights..... Not sure the connection to health care rights would be but he is a foggy guy.
I mean education paid for by taxes "isn't free," but health care mostly paid by employers and individuals to free-market capitalistic insurance companies will be free, socialized, "governmentalized" entitlements in JRs book. He a fog storm fer sure.
Just like the 30M added to the insurance rolls will be a pure addition even those those same 30M somehow magically get to see DRs today, paid or paid for by us. And somehow, less than a 15% potential, and the key word is potential, increase will bring the system to it's knees.
I say that's a good problem to fix if it even ever occurs which JR has not clue that it would even happen.
But he's in the fog without a clue with his own second amendment protected health plan.
All in all I would say the AHCA is moving forward with more clarity regarding the process everyday. I would love to see no more delays, would love to see loopholes and problems like the 50-person/part time rectified, but seems to me to be moving ahead every day and seems pretty good to me in many ways. Even Republicans are starting to say: "kill ObamaCare...except for the good parts." I am glad Obama and Pelosi had the courage and the leadership to see it through and hope it works on behalf of the nations as well as Social Security and Medicare have served the nation. I would think that the country that leads the world in medical innovation could figure out how to increase the quality and availability of health care better than any other nation in the world. It is time to lead, time to work together to make it work, not to " elect enough people to keep things tied up in congress"
NBC News Investigates:
Businesses claim Obamacare has forced them to cut employee hours
By Lisa Myers and Carroll Ann Mears
NBC News
Employers around the country, from fast-food franchises to colleges, have told NBC News that they will be cutting workers’ hours below 30 a week because they can’t afford to offer the health insurance mandated by the Affordable Care Act, also known as Obamacare.
“To tell somebody that you’ve got to decrease their hours because of a law passed in Washington is very frustrating to me,” said Loren Goodridge, who owns 21 Subway franchises, including a restaurant in Kennebunk. “I know the impact I’m having on some of my employees.”
http://investigations.nbcnews.com/_news/2013/08/13/20010062-businesses-claim-obamacare-has-forced-them-to-cut-employee-hours?lite
Bearing arms IS healthcare.
I wasn't comparing the two, btw, just a short tangent, because I'm betting many of those who believe HC is indeed a right also believe the 2nd Amendment not only ISN'T a right, but is also totally infringable. But I digress. Just like to point out hypocrisy when I see it.
No fog here, mg... you THINK you KNOW how OC is going to work out, as do I. Neither one of us actually knows, so I guess we'll just have to wait and see. It is incredible the amount of words you type to say the same thing over and over again... paragraph after paragraph ad infinitum. Is your position really so weak it takes a novella every time you reply to someone who disagrees with your BELIEF [in how OC will work out]?
I can understand how too many words confuses you JR given the best "fact" you can come up is to call me a hypocrite.
Of course just calling me names avoids you coming up with an actual solution beyond bringing guns as a topic into any discussion.
Short enough?
Went to a retirement planning session today. Seems the company gives a set amount to cover cost of health care premium post retirement. When it runs out (and it will) the retiree is responsible to pay 100 percent . Now I will acknowledge that this is better than many folks have but sooner than later we will all have to pay. Unless some other plan is put in place. I just don't think it is reasonable to use up all savings for expensive premiums, deductibles , out of pocket.
from the NYT's piece linked above:
"The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014. "
Under the policy, many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager. "
truly outrageous. that's 12,700 dollars of out of pocket expenses, i thought this new obamacare was supposed to help people, not hurt them.
Gadfly, have you seen this?
http://www.forbes.com/sites/theapothecary/2013/08/02/congressmen-rejoice-govt-to-subsidize-their-health-insurance-through-obamacares-exchanges/
Seems that there's always more to a given story. Isn't it funny how Congress can always find a loophole to get what they want?
Additional fodder...
http://www.insurance.ohio.gov/Newsroom/Pages/06062013ACAProposedRates.aspx
JIT, I'm not sure what you see as new here. This is pretty much the story as understood and explained it a few days ago.
the middle class is getting hit hard with these costs, and it is affecting their ability to work full time, this is a horrible unintended consequence of the health care government mandates
Socialists will be socialists. They want stuff, and don't care who pays for it. They are even stupid enough to be "ok" with govt that provides them with the stuff they want to have it better off than they do, so long as they get their stuff. Truly pathetic.
mg, at least you're learning brevity.
There's no point in posting links and facts that contradict the pro-OC people's stand on the issue; their mind was made up when they voted for Obama the first time. NOTHING can be said to change their minds. I hand it to JIT to have the patience to keep trying, but I gave up awhile ago... as their illustrious leader said, "you can't put lipstick on a pig."
OMGoodness people, can't you think before you post?
JIT --- not one iota of new news in your post so just read above for responses.
BDog --- Are you for or against the AHCA? Your posts defend it and blame it sometimes at the same time. Truly twisted. I would say you should clarify but if you add more words, you will confuse JR. You seem to be for out-of-pocket spending caps which would support the AHCA's intent and provisions but you are against the AHCA because it is delaying the AHCA caps. But then you blame AHCA as if it is adding new charges itself because of the delay.
"Hello, McFly, anybody home?"
You do realize that current average out-of-pocket expenses are higher than those specified in the AHCA, right? You do realize that without the AHCA, there are no out-of-pocket spending caps, don't you? Today it is basically anything goes, is that what you support? You do realize that the delay only delays the caps specified in the AHCA and continues the current system, right?
So are you supporting the AHCA spending caps or not? Because if you support out-of-pocket caps, then you support at least that part of the AHCA which is not in our current healthcare insurance system. Or are you just such a fervent supporter of the AHCA that any delays whatsoever are just frosting your cake since you want AHCA to start today ASAP?
nice try bd. the people affected by this one year exemption are already paying up to $12,700 out of pocket, depending on how many medical services they use per year of course, because of the way their employer has structured the insurance. specifically, some employers make employees have multiple insurers - one for medical, one for dental, etc., and each one of these plans can have a maximum $6350 out of pocket expense cap. again, that is how things are currently. the problem, which only affects workers in the above described situation, is that it is very tricky to calculate employer contributions, taxes, etc for these companies with multiple insurance providers so they petitioned the government for an extra year to work things out. in 2015 when this portion of the ACA kicks in it will have a positive effect on reducing the out of pocket expenses of workers offered insurance in the above described way, thus making their healthcare more affordable.
Omg I received additional bill information from Hackettstown hosp for an ER visit. On top of the first one for 6700.00 there are three new charges for I think Dr. Around 700.00, 800.00 And one less than 100. 00
Is this for real? Are they kidding?
Question:
What makes it "wrong" for a physician to charge "confiscatory" rates, but apparently OK for electronics manufacturers, automobile manufacturers, home remodeling contractors, lawyers, or anyone else? Why is it "ridiculous" that you have to pay for medical care, but NOT ridiculous that you have to pay for your iphone? Or your new bathroom? Or your divorce? Or your child's college education? (I'm quite sure that's next- "free" post-high school education...)
A service is being provided to you. It costs money. It's called an economy.
jr, you have posted so much bs in this thread ( and every other political thread). leave those of us who want to have an intelligent discussion alone already.
my my... touchy aren't we, rc? That's ok if you can't answer the question logically and intelligently- I didn't expect you to.
Just one question? Has the government ever made anything better when they got involved?
sam Excuse me, Sam, but that's a rediculous question. Are you so blinded by your partisan fervor that you can think of nothing the government has made better?
How about?
Education - quality and and universal access.
Emergency services - fire departments and EMT
Law Enforcement
Transportation - roads, bridges, tunnels
Environmental protection - no more dumping toxic waste into the aquifer. How do you like those cancer clusters caused by pre-EPA dumping?
Food safety - something that nobody even considers anymore
Providing a social safety net including Medicaid, Medicare, social security and even (gasp) welfare.
National Security - the military
You seem to believe that just because the government can't solve ALL of our problems that therefore it must not be able to solve ANY of our problems.
JR --- stick to guns where you can hide your snarky tirades behind the second amendment. Meanwhile, sure, I'm your Huckleberry....
JRs "Question:
What makes it "wrong" for a physician to charge "confiscatory" rates, but apparently OK for electronics manufacturers, automobile manufacturers, home remodeling contractors, lawyers, or anyone else? Why is it "ridiculous" that you have to pay for medical care, but NOT ridiculous that you have to pay for your iphone? Or your new bathroom? Or your divorce? Or your child's college education? (I'm quite sure that's next- "free" post-high school education...)"
A question from the no-duh, I'll except anything under the sun without thinking about it, researching it, or reading about it (except radical right tea party tomes) constituent base. This is so silly it's beneath response but....
A confiscatory rate is generally only a term applied to taxes but OK, let's just go with a rate that's high or any price for that matter since I don't have a clue what JR really means. And sure, the concept of capitalism is to charge what the market will bear. However price fixing, monopolies, even oligopolies that lead to price fixing are illegal.
So, JR is correct that these medical folks, in a competitive market, should be able to charge what the market will bear. And when it comes to discretionary medicine, a competitive market where consumers can take the time to compare, research, and compete, not a problem and that's probably how it generally works.
But where JR is incorrect in is thinking that mandatory, immediate, and emergency medical services reflect a competitive market. They do not. Not even close. You can't chose your ER unless you are a walk-in. If you need immediate treatment, you can't compare prices. You don't know what you have, how can you compare. And can you imagine calling the Dr and asking "what's is your rate for bronchitis?" And so the analogy to "electronics manufacturers, automobile manufacturers, home remodeling contractors, lawyers, or anyone else" is inaccurate. It is not a competitive capitalistic market to begin with.
Another example of how medical is not a competitive, capitalistic market, is where medical facilities can not turn away service and instead, perform free service and pass those charges on to the rest of us by way of higher prices. No "electronics manufacturers, automobile manufacturers, home remodeling contractors, lawyers, or anyone else" has to accept all consumers, all comers, whether they can pay or not, and then provide service and then pass the loss on to the rest of us by way of higher prices.
If a car dealer took all comers, took the loss, and then passed it on to the rest of us in price, they would last for a very short time against the rest of the dealers who just said no.
JR's current medical model is truly communism by capitalism, it is not a normal market. Even the electric company can turn off the lights and heat if payment is not received.
There are many non-competitive markets in America where prices are regulated; we have chosen not to regulate medical just like we have chosen to offer free service. How do these choice manifest themselves in making our medical market unique and different from " electronics manufacturers, automobile manufacturers, home remodeling contractors, lawyers, or anyone else"
- From Regent: "For 2009, The U.S. spent $7960 per person, compared to the next highest-spending country, Norway, at $5352 per person. Our neighbor to the north, Canada, spent $4363." FYI, Norway has had Universal Health Care for over 100 years since 1912. For the most part, we pay more due to waste: waste being defined as extra procedures, testing, mistakes, complexity of health plans, and prices higher than competitive levels including excessive variation in mandatory service prices.
In other words, we pay too much, we get stuff done that does not need to be, we can't figure out the paperwork to pay, and we charge non-competitive prices and continually get away with it. In JRs other markets you can try that but you probably won't get away with it for very long. Total expenditures can vary from $5,000 to $17,000 per person, per region. Does that sound like new car pricing differences? Heck, you would go to CA to get a new car at 70% off the NJ price if it did.......
This unnatural economic model has created the need for the Health Insurance market to monitor, police, and control pricing in order for these insurance to stay in business. Not to mention billing administration to limit losses due to medical administrative complexity. They sell insurance, not price maintenance, not billing administration. Can you imagine a life insurance company bargaining prices with the undertaker and then sending him partial payment?
We pay 2.5 times what other developed nations pay per procedure, probably the same or worse for prescriptions. Yet we can't import prescriptions. Is that just like other things we buy? Again, it is an unnatural economic model and nowhere close to other markets in our economy.
You can't answer JR's question logically because it was illogical to begin with. The medical market model is illogical and not a normal process for a free market economy.
Do the research JR, before you post.
Back on point: obviously the AHCA does not cure all of this, not much at all actually. However it will remove the freebies at ER, it will make insurance pricing more transparent and competitive, it will standardize many insurance elements (like out-of pocket expenses, pre-existing conditions, etc.). And some of the AHCA act effects will make the market more competitive, will lower prices, hopefully closer in competition to what other developed nation citizens pay for medical service.
Here's what JR's economy has "competed" us to: http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
"You seem to believe that just because the government can't solve ALL of our problems that therefore it must not be able to solve ANY of our problems."
That is an excellent point Gadlfly. And I would like to add to that, "just because you believe the government can solve SOME of our problems doesn't mean it must be able to solve ALL of our problems."
The point, Gadfly, is that there are other ways to accomplish the same things *without* direct government intervention. Simply enforcing laws without playing favorites would be a good start, unless you feel the government plays no favorites via the current legislate-through-lobbing methodology. I think the manipulation of the public's perception of how Congress is "just like us" and must participate in health care exchanges when, as has come out here, the reality is that absolutely no change or real-world pain or sacrifices will come to them, is them most telling part of our collective perception of this subject. Lie, mislead, conflate and obfuscate. And some here just love it. Wow.
So, to your list:
Education? Do you really feel that our country is better educated today that in years past? I don't think the stats demonstrate that at all, especially when you apply a cost-per-pupil number to the results. We spend sooooooo much more now and have low to no real-world gains? How can you possibly justify that in your mind????
Law Enforcement? For the most part, yes, good, but not when they nit-pick and enforce ridiculous laws just to increase revenues.
Transportation? Have you seen the numbers for our infrastructure lately? I don't have a link, but nationally there has been much more neglect than improvement because allocated transportation funds have been misdirected or, as is the case here in NJ, wasted by paving the same roads over and over again with inferior materials just to give contracts to favored businesses. Add "prevailing wage" to the mix and there's no possible way to claim that our government efficiently deals with infrastructure.
Social safety nets? Surely you have seen the percentage of the federal government budget for all of those! Are you saying that there is *no* other way to accomplish the same thing? Sheesh, given the size of the programs we should all be asking *why* they are so large and why people do not have the ability to save for themselves. Don't even try to argue that these programs arejust for those who've had a hard time, not at the size of the numbers we're talking here. No, we all put in and we ALL take out. Nothing efficient about that.
So look at the cost of those programs to put it into context. Government percentage of GDP is what now? Oh, and based on the current levels of debt and deficits I assume you feel the government has acted responsibly to accomplish that which you like to receive? There are other ways to achieve our common goals if only the government would stop playing favorites and simply enforce laws to make sure that we all have equality in the marketplace (as opposed to the inequality that is created by the government picking and choosing winners and losers on their own).
Look longer term and you might (and I say that very lightly) understand why others disagree with you. But since you're getting what you want *today* why worry about our kids and grandkids, right? Look to the trends...
Geeez JR --- you get agreement on this one. That's one!
Justy --- mixed bag, not many facts, pretty grumpy, not worthy of much of a response. Sorry (but you probably feel relieved). Think you need a nap.
But just a tad of a response: amazing in your tired tirade that you picked security nets and used percentage of the budget as the metric. When you look at the BIG slices, sure Social Security is a HUGE one at 23% of the budget. But it is a pre-paid INSURANCE account from our payroll --- i.e. --- we are just getting our own money back (sometimes some more, sometimes less just like insurance) from payroll deductions and not income TAX dollars. Likewise, the other HUGE one, medicare is the same kind of account at 13%, it's our own paid-in money. from payroll, not tax dollars. Again insurance, this time for retirement health.
Social Security is fully funded to 2033 and Medicare to 2026. Yes, both run deficits and both need help, Medicare worse. But they are not using income tax dollars.
So yes, huge portions of the budget, but it is INSURANCE that we have paid for.
And both of these programs are pretty damned efficient having cost metrics that beat many competitors and professionals in the same business. Insurance companies would love to get the Medicare cost profile out of the industry, it makes them look bad.
The other safety net budget items that ARE paid out of income taxes are 10% of the budget.
Personally, I have no problem with your desire to have people "save for themselves" in lieu of social security and medicare. But come on, you know that won't work and we will have to cover the stupid, the unlucky, and the wasteful. Be real.
Meanwhile, in your grumpy haste to waste our security net, gee you left out the defense budget.... Guess that's money well spend in your book. No conspiracy or power brokering in that line item that conveniently just fell off your radar. And at 20% of the national budget, these are income tax dollars, not payroll, that we spend every year. This is a real bad INSURANCE scam.
PS -- I agree with you on education --- there has got to be a way to get more for our buck here. But I would not spend less money, perhaps more. But we need to get greater productivity before we do.
JR. Don't tell me that I missed the point, when you can't even READ! I did not, and would not, say that govt can solve all of our problems. In contrast, the two posters before me did state (or imply) that the govt has never made anything better. Pure rhetoric, which is easy is disprove.
JIT, your post makes several desperate points, so ill address them separately. First, your return to the issue of congressional employees participation in the ACA. You clearly still don't understand the recent decision from the OPM and what it means. That's clear from your recent post on the other thread when you indicated that there was some new revelation. The fact of the matter is that congressional employees are in fact being affected more than other citizens. They have to buy a healthcare plan through an exchange even though they already had coverage through their employer. Others with plans through their employers do not have to change plans. The decision of the OPM that they would maintain their previous employer contribution was the correction of a mistake that Republican Senator Grassley made in his amendment that would have essentially resulted in a huge unintentional paycut.
Second....
Your criticisms of government's contribution are in the nature of "it could be done better", as opposed to "it would be better without government". I don't argue with that govt is almost always inefficient and could be improved, but that does not mean that things would be better without govt involvement.
I don't think that you can honestly argue that the examples I've listed would be better withou government involvement.
"....I assume you feel the government has acted responsibly that which you like to receive?"
"But since you are getting what you want *today* why worry about our kids and grand kids, right?"
This isn't the first time that someone on this site has implied that the liberals' position is based on personal gain. Let me assure you, that I receive as little or perhaps less than you in public benefits. With the exception of universal benefits, such as military protection and transportation, I receive none. And aside from a small college loan, I have received none.
As an interesting aside, the only people I know that have abused our public "entitlements" were libertarians, not liberals.
"The fact of the matter is that congressional employees are in fact being affected more than other citizens. They have to buy a healthcare plan through an exchange even though they already had coverage through their employer."
Who's facts Gadfly?
Does anything prevent their present insurer from enrolling in the exchange? Even if the current insurer doesn't offer a plan in the exchange, who's to say that there isn't a comparable plan being offered? I think it was you who explained earlier that the exchanges only manage the insurers but doesn't dictate who offers a plan in the exchange or the level of plan coverage. All the exchange does is mandate a minimum level of care be provided in order to sell into the exchange.
The fact is that you are making an assumption that they will receive a lower class of care. I choose to assume the opposite (still an assumption, but one based on the definition of the exchange that you provided). Since you've agreed that their costs will still be subsidized, and have no proof whatsoever that their care will be reduced, how do you come to the conclusion that I don't understand? I understand better now due to your assistance, thank you.
"I don't think that you can honestly argue that the examples I've listed would be better withou government involvement."
I've never said zero government involvement Gadfly. I just don't want the government in a dictatorial position in which the agencies responsible for "controlling" their respective areas are always seeking to justify their existence, the net result almost always being waste and abuse. Remember that the government is essentially a never-ending income stream for all who depend on it. Combine that with the incessant lobbying to gain access to those funds and we have the perfect inefficient and abuse-ready system. What I want is to constrain government involvement to prevent the abuses that are apparent to everyone.
As I'm sure you know JIT, we're all entitled to our own opinions, but we're not entitled to our own facts. Facts are what they are.
"Does anything prevent their current insurer from enrolling in the exchange?"
The exchanges will be marketplaces in which the public can purchase insurance plans. The Congress's current provider is the federal government. The federal government is not going to offer a plan for sale on the exchange.
"Who's to say that there isn't a comparable plan being offered?" Well, there may be, but it is likely that that plan would cost more than their current plan, given that these congressional employees would now be purchasing coverage as individuals.
I am not assuming that their level of care will drop, although i think its likely. However, i am asserting that they will be affected in a way that you and i will not. They have to change insurance plans even though they currently have a good one. They have to purchase a plan through an exchange.
I have a decent plan. My situation will not change and and so I am affected less than the congressional staff.
You're really grasping at straws gadfly. I would be very, very surprised to learn that any type of disruption is brought to the congressional staff. It hasn't happened yet, so neither of us know. But given the history of our government and Congress, the trend certainly favors perks over cuts by a wide margin.
Personally, I am affected somewhat regularly by changing healthcare costs and coverage, just as most of us are. We've had several threads in the past about rising insurance and healthcare costs, so if you've been immune you should be very thankful.
"I've never said zero government involvement Gadfly. I just don't want the government in a dictatorial position in which...."
Well good for you JIT, then you agree with my first post. You may not have said "zero govt involvement", but the two posters I was responding to essentially did say that. My entire point was to demonstrate that it is ludicrous to say that "government never made anything better". Therefore its illogical for you to say I'm incorrect just because the government's solutions could be improved.
Here's my point....
If you and I agree that government involvement is often helpful, though perhaps not always efficient, we have the basis for an intelligent discussion about how much (and in which areas) the government should be involved. In contrast, the statement that "the government has never done anything good" is just partisan baloney that only serves to prevent intelligent discussion.
Grasping at straws? I'm simply trying to correct your incorrect beliefs and assumptions about what the exchanges are and the implications of the recent OPM decision. It is simply a fact that congressional employees have a requirement through the ACA that is not shared by the general public. Maybe it won't be a big deal for them,I hope not. But it's still a requirement for them and not us. You seem like you won't be satisfied unless they have to bleed for it.
BTW, I have also experienced huge increases in my premiums...30% increases at a time that resulted in multiple changes in my employees choice of carrier. However, this was the result of the status quo, pre-ACA. Will that continue? I don't know, but can't see it getting much worse, and this is the first time I ever got a rebate from my insurer.
But they WON'T have to bleed for it Gadfly! That's what I'm trying to say! As I mentioned earlier, there's a very high percentage they will come out of this debacle unscathed. No, it's you who wants to paint them as if they will be forever scarred by dealing with a broken healthcare system like the rest of us have been doing for decades. You've been using the Congress' own marketing plan that tries to get the general public to feel bad for them, but there's not one reason why we should because there's nothing they will sacrifice!
Per your own links, the ACA does absolutely nothing to drive down prices *except* to attempt price controls by manipulating the rules of the exchange. But I have to ask, if insurance companies will *voluntarily* participate in the exchange, why would they do so if they can turn a better profit in the private sector? They will be still driven by profit. So, what's the only way the government can manipulate a companies profit margin? Via subsidy, that's how. Again, not one thing efficient about that whatsoever.
Now, if the conversation were about the root causes of the obviously high prices we see...
Gadfly, I didn't say you missed the point at all. You made a good point, I simply expanded on it. Stop being so defensive.
On a different point, I find your faith and trust in the government ... amusing, and unfortunate.
"But they WON'T have to bleed for it Gadfly! That's what I'm trying to say!"
Fine. That's not a point I have argued, I will argue.
" As I mentioned earlier, there's a very high percentage they will come out of this debacle unscathed. No, it's you who wants to paint them as if they will be forever scarred by dealing with a broken healthcare system like the rest of us have been doing for decades. You've been using the Congress' own marketing plan that tries to get the general public to feel bad for them, but there's not one reason why we should because there's nothing they will sacrifice!"
You need to learn to read a little better JIT. The whole discussion on the OPM decision has been me trying to explain why and how the intent of the law was followed, and that that congress did not receive some great, surprise exemption. I've never tried to make you feel sorry for anyone.
"But I have to ask, if insurance companies will *voluntarily* participate in the exchange, why would they do so if they can turn a better profit in the private sector?"
You still seem to have trouble understanding what an exchange is. It IS the private sector, but regulated. Think of it like eBay, where insurers would go to advertise and sell their plan.
"Per your own links, the ACA does absolutely nothing to drive down prices *except* to attempt price controls by manipulating the rules of the exchange."
I never said anything of the kind, and I didnt post such a link as far as I know. On the contrary, I have twice now brought up a very specific example of an ACA component that has already saved me money. The ACA requires every insurer to spend a minimum of 80% of the premiums they collect directly on healthcare. My company failed to do that this past year, and they are giving me a rebate.
JR, If someone else wrote that, I might have been offended by the condescension. Coming from you, it just made me chuckle.
Some people are so behind in the race that they actually believe they're leading.
If I knew what you were talking about, I would reply. "Race"? What race?
Perhaps you're just shocked (hopefully not embarrassed) that WE can actually AGREE...on anything. lol
There's alot more common ground between the "left" and the "right" than most sheople realize. Once you stop believing in party platforms, politicians promises, and government as benevolent, you start to see more clearly, judge each individual politician, judge, law, and issue, based NOT on what your party or news station tells you, but on all the facts... weighed with a heavy dose of past actions/governmental history. THEN you draw a conclusion.
Believe what the government tells you? Naiveté.
JIT: I agree they will get a comparable plan, that's the plan. It may be a tad better, a tad worse, but the plan is to have it be comparable. And they will get 72% covered like today, whereas the AHCA will regulate employer coverage for the rest of us at 65% per family, 72.5% per individual. But it will be a plan change and we all know the PITA that is. And unlike most employees of a firm, they will have less chance to discuss plans with their co-workers unless they are from the same state. But the concept was to use the exchanges like other Americans, not to change the benefit.
Still one iota of new news in your post so just read above for responses.
JR: we don't have blind faith and trust in government, it's just that we like to base our judgments on facts and findings not on a preconditioned notion that government is bad, controlling, inefficient, ineffective, stupid, and lazy. Mostly because there are plenty of examples where that is just not true. We like to trust, but verify. That's why we look up information before we post, unlike your unverified and proven-to-fail technique to throw stuff against the wall to see what sticks.
"we like to base our judgments on facts and findings not on a preconditioned notion that government is bad, controlling, inefficient, ineffective, stupid, and lazy. Mostly because there are plenty of examples where that is just not true"
Funny... you guys certainly didn't feel that way under Bush... did you? Be careful... your partisanship is showing...
I was no Bush "fan", I just accepted him as the lesser of two evils. I fully admit that, for example, there's alot of bad stuff in the Patriot Act. I admitted it then. But I haven't seen your side EVER admit ANYTHING "wrong" with the current administration, in either term.
While your side is suspicious of republicans/conservative, *I* (note I do not say "my side" as I am not a party guy anymore), am suspicious of everyone.
"Government is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master."
-George Washington (who did not believe in, and warned us against, political parties)
Bush was, based on the facts and findings, bad, controlling and stupid. But he probably was pretty efficient and effective at it.
So, it's based on the facts and findings, not party affiliation.
And while the basic premise of the Republican party seems OK, the actions of the current radical right controlling the party are generally wrong --- IMHO. Not to mention being obstructionist with a firm belief in either their way or nothing at all, no middle ground, no working together for a common goal, no compromise.
This is NOT Ronald Reagan's party today.
Our current Senate wannabee, Republican Steve Lonegan, is a prime example. This guy is a in-the-Koch-pockets nightmare. From Huffington: "The tweet, which was sent on the Lonegan campaign's Twitter account last week, showcased a map of Newark with various neighborhoods identified as Latin American, African and Islamic areas. The map was jokingly dubbed "Cory Booker's foreign policy debate prep notes.......""From my perspective, I would have fired the guy who did this," Christie said during a Monday news conference in Trenton. "Steve chose not to. I don't care if he is 21 years old or what his position is. That tweet shows a complete lack of judgment.""
From his recent victory speech:
"Mayor Cory Booker has an advantage. He’s been anointed by Hollywood. The Hollywood elite have descended from their penthouse apartments in the Bel Air Hotel, from the heights of the Hollywood Hills, to come to New Jersey to tell us who our next U.S. senator will be. They have decided, but to the Hollywood elite that have anointed Cory Booker the next U.S. senator – the third U.S. Senator from California – you are nothing more than another rating point in the Nielsen ratings."
"Mr. Booker – sort of like the British troops that were held up in Trenton on Christmas Day 1776 – they had superior funding, superior everything – they had the whole British crown behind them. But they lost to a ragtag group of rebels – the American colonies."
"Cory Booker – my opponent – has the support and the money of the Silicon Valley moguls who collect our data. They decided who their candidate is going to be. They’re going to have a party right around now. They’ll have their big crystal goblets, their martini glasses up with their fingers in the air, toasting their anointed candidate. But they’ve never been to New Jersey before. They don’t know what a real street fight is. They’re going to find out real fast"
"He wants to force Obamacare down your throats with its taxes, its fees, its mandates, its rationing and more bureaucrats than there will be doctors by the time they’re done."
" he will lead the way in the federal takeover of our education system where government bureaucrats will tell us what we will teach our children, how they will learn, and how they will be taught while collecting sweeping amounts of data on our children." " I will work hard and lead the effort to defund and put an end to Common Core curriculum standards in this country."
" I want to lead the effort to put an end and to dismantle the IRS as we know it."
Oh yeah, this one is going to be fun, fun, fun.
"Bush, based on the facts, was bad, controlling, and stupid."
Obama, based on the facts, is bad, controlling, and stupid.
Now, you prove that Bush was, and I'll prove that Obama is.
Ball's in your court.
lol Gadfly, at the end of the day I'm basically agreeing with you yet it is still an argument.
My understanding of the exchanges is a "work in process", so I'll yield a bit and forget what I know about how and why companies are in business (to make money, of course). If an insurance company can make just as much money by voluntarily participating in an exchange that is more regulated than if it operates outside the exchange I'll continue to seek the answer as to how that can be. As of right now, it makes no sense at all *unless* the exchanges are subsidized to allow insurer profitability at the expense of tax payer dollars while at the same time providing an illusion of lower costs.
Why isn't anyone screaming and complaining about the high cost of dental care in this country? Why are dentist's allowed to rape the American people and get away with it?! I call for dental reform !! The doctors in this country are taking the beating and dentists are charging outrages prices and nothing is done about it...That's BS!!! Dentists need to be kept in check just as much as doctors!
let's see - neo-cons voted in the fascist police state of the 'patriot' era and start two wars, liberals voted in as close to universal health care as was possible. hmmmmm, yeah, well, THE BALL IS IN YOUR COURT!
I'LL WAIT!!
While I don't know for certain, I suspect that insurance companies are somehow required to participate in the exchanges. Perhaps, they have to be in an exchange if they want to also provide group policies to employers. I don't know the answer, but I suspect it wouldn't take much digging to find out.
The exchanges will not be more regulated than other policies with the exceptions of whatever regulations deal with advertising and sale through the exchanges. The substantive regulations....such as coverage for young adult children, no pre-existing condition exclusions, no coverage limits, etc, will be the same for exchange and no exchange policies.
Regarding subsidies. I don't know about subsidies for the companies, but I do know that some members of e public will get assistance with their premiums based on income level,
I have personally experienced health are both times it was life or death with my father and daughter. Long story short, 2 different doctors at 2 different times for both of them, told us it would be best to fly back asap to the states because of many reasons for immediate care.
jerseygirl1111 rc,
Your memory is failing... the US didn't START that war. We responded to a massive attack/act of war on American soil. But if you think we started that war, I can at least understand now why you (wrongly) think the way you do. You are anything BUT in touch with "reality".
Just think about all of the healthcare that could be provided if the billions given to Middle Eastern countries and oil companies -- probably in the range of 30 billion per year?
Big oil wants to protect overseas interests but we import more oil from Canada than any other country, and domestic oil production is on the rise.
Or, take have of the 30 billion and further invest in renewable technology. Only problem is that it would destroy the profits of high influence multi-national corporation like ExxonMobil.
BTW, the medical care in Israel is superior to our medical care, and we give them 3 billion plus per year...
r/c, speaking for myself I'd say that we've oscillated between two lunatics hell bent on destroying our country, both assuming that our economic system can handle the stresses that they have imposed.
Parabolic curves are a bitch...
JR, start another thread --- Bush vs. Obama and I would love to participate, sounds like fun (and a cake walk). But responding here would take apart a good thread.
JIT --- exchanges vs. insurance company profits. Like many of the AHCA act fiscal elements, who really knows. First, insurance is regulated already at the state and federal level so this is more of the same. But the AHCA is complex and offers many pluses and minuses, where the total ends up only each side has the answer, diametrically opposed. It's the magnitude that's hard to guess. However, the fact that the insurance companies are not burning Washington down should give you a pretty good idea. Here are some of the profit changing factors:
- 30M new currently-uninsured customers should add a bit of profit at least in terms of margin dollars if not necessarily in terms of margin percentage points. That's a 15% increase overnight.
- As of the middle of 2012, over 3.1M young adults were added as insurance company consumers --- over 1.5% profit increase with very little cost (young adults mostly get sore throats) should make for some nice insurance Xmas bonuses.
- Exchanges force competition and price/product offer transparency which should lower margin percentages but not necessarily have any effect on margin dollars for those who can compete
- Many AHCA rules will increase profits like pre-existing conditions, no top ends on coverage payments, etc. since insurance companies can raise prices to cover costs
- out-of-pocket caps will also increase profits since again, insurance companies can raise prices to cover costs
Bottom line: I expect profit dollars to increase a lot, however, in a perfect world, profit margin percentages would stay the same or, due to increased competition and price/product transparency, get a bit smaller.
To me this is a good thing overall but 30M new customers pretty much assures a home run for the good insurance company's with quality products and competitive marketing.
And we become a healthier nation as the result.
jit - great line! even if you're right, i would much rather see the money spent domestically.
jr, tell me again about how we were attacked by iraq? f'n clueless, pal.
who's a neo-con and what do they have to do with the high cost of medical care?
stay on track here guys,
Snake bite victim hit with $55,000 hospital bill
http://www.today.com/video/today/52727203/#52727203
Mg, yup... That's what I thought.
Rc, I never specified Iraq. AFGANISTAN was warranted. I suppose you think it wasn't, now that I better understand your grasp on reality.
JR, I disagree. Afghanistan allowed "terrorists" to train on their soil. If we had any right to attack, it was against those directly responsible and targeted strikes IMO were warranted. You could argue (and you probably will lol) that the Taliban fully supported their actions and thus had direct culpability, and I might lean in your direction if any of the Taliban leadership were proven to be involved in planning the attack. As far as I know they weren't.
Regardless of which "side" you choose, the fact is the US invaded and disposed of two sovereign governments, provoked by an attack on the US that was not directed by either of those countries. We took advantage of a situation in which the public outrage was used as justification for preemptive war. Neither should have happened IMO.
JIT,
While I agree with the concept of "targeting just the training camps", real war doesn't usually work that way. Just as I abhor the necessity of dropping the bombs on Hiroshima and Nagasaki, I recognizer that it had to be done. In a time of war (and this was war), when it comes down to "us or them", I'll vote us every time. Collateral damage is an unfortunate part of war. Those bombs saved countless thousands of American lives, while destroying thousands of japanese lives. That's why they call it war. No one likes war, but when one needs to be fought, you damn sure better fight to win. (and there's a whole 'nother debate there, with how the action was handled, of course.)
And what "should" (shouldn't) have happened is quite irrelevant. The attacks DID happen. Thousands DID die. It WAS an act of war, and needed to be retaliated against.
and at the same time charge obama with murder for killing american citizens via drone strikes
this thread has been totally hijacked!!
and at the same time don't forget to charge obama with murder for killing american citizens with drone strikes.
this thread has been totally hijacked, what has any of this to do with high medical costs?
here you go bd - http://wallstcheatsheet.com/stocks/sebelius-misinformation-is-obamacare-enemy-no-1.html/3/
pretty much sums up this thread.
r/c, that article is just more propaganda. Surely you can see it? It's a "do it my way and don't question anything" perspective that does nothing but further the divide.
Where in the article did the author link to supporting information? It mentions resistance to implementing state-run exchanges but only marginally mentions why - the cost. She comes across as mad that the federal government has to take over some of the exchanges because the states won't voluntarily incur more debt (or higher taxes, which is what I suspect will happen). Last time I checked r/c, anyone with a budget needs to know where the money will come from to pay the bills, the states being no different.
Sebelus is taking a hard-line approach, stating the obvious that the law has passed and will be implemented. But she ignores, as most do, the other obvious part of the discussion which is where the money will come from to pay for it. The administration doesn't care to have that discussion. They seem to just want to play dictator.
how is it 'propaganda' to defend what the law actually does against the outright lies of those hellbent on stoping healthcare being available for 30-40 million people? sorry, that's just more of the same name calling that those who have no facts supporting their point resort to.
Who will pay for it? The states who are pushing the responsibility back onto the federal government are asking that question. What's the answer?
From Forbes:
"The new law will simplify eligibility for enrollment by eliminating the pre-existing categories that one must currently fall under to qualify for Medicaid. Moreover, before the ACA, the federal government shared Medicaid costs with the states, with the federal government paying roughly 57 percent of the total amount. If individual states accept this provision to expand Medicaid, the federal government will cover the total cost for Medicaid expansion for three years. States that consent to the Medicaid expansion will receive funds to pay their residents’ health care bills, which could also reduce the number of hospitals and physicians left with uninsured patient bills. The 100 percent match rate from the federal government will decrease after the first three years: in 2017, the federal government will pay 95 percent of the cost, and in 2020, the federal government will cover only 90 percent of the bill."
http://www.forbes.com/sites/bernardkrooks/2012/07/10/medicaid-expansion-under-the-affordable-care-act-what-happens-when-states-refuse-to-enlarge-this-coverage-to-its-residents/
... or is the cost of running the exchanges minimal relative to the cost of medicare?
The Medicaid costs will be subsidized for 3 years? After that?
My first post i was thinking more about the costs to run the exchange rather than the subsidies for the low end.
Did you read the whole paragraph I posted? The entire cost is paid with federal dollars for three years. After that the federal portion decreases, but it is still 90% in 2020. The pre-ACA status quo is that the federal government pays 57%.
Yes, it stated the cost for medicaid expansion would be covered at the percentages mentioned. Does this cover the costs associated with running the exchange?
It really doesn't matter that the feds pay the bill. "we" are the feds, so "we" are paying the bill in any of the circumstances.
Looks like the cost is being paid for by fees charged to the insurance companies based on the number of plans they sell through the exchange.
http://thehill.com/blogs/healthwatch/health-reform-implementation/270331-hhs-sets-new-fees-for-insurers-in-federal-exchange
The simple truth is that by and large states with Republican governors are refusing to run the exchanges and expand Medicaid, bc their leadership wants the President's plan to fail. The good news regarding the exchanges is that they will be more successful run by the federal government rather than state governments that want them to fail. The bad news is that the states that refuse to expand Medicaid are hurting some of their neediest citizens just to score political points.
Thanks for the followup Gadfly. Time will tell if the resistance is truly partisan or if the stuff behind the scenes is the issue. Frankly, this is a behemoth and I'm not sure that anyone really knows how it's going to turn out. I mean, reading through some of the details about actuarial values, risk adjustment, premium stabilization, cost-sharing, medical loss ratio, metal levels, payment transfer formulas and so on makes my head spin lol. No doubt, this will be a trial-by-fire program in more ways than one.
"It really doesn't matter that the feds pay the bill. "we" are the feds, so "we" are paying the bill in any of the circumstances."
I'll never understand how some people don't GET that.
And I agree with JIT (and have also said the same thing in this thread)... NO ONE knows 100% what they are talking about, and no one knows how all this is going to play out. Everyone is taking guesses, and using biased sources for their information. At least some of us ADMIT we don't actually know what's going to happen, which is to say we admit the truth.
Actually JR, you admit that the Health Care system is broken but after decades, your side and you don't have a clue what to do. In lieu of an idea, you believe nothing is better than something. But you and your side has absolutely nothing to offer to fix, to help, to pitch in. You are admittedly clueless.
JIT: who pays for the AHCA and how: http://obamacarefacts.com/costof-obamacare.php And there are more links within for supporting information
That's rich coming from one of the worst offenders of posting without the facts. Just keep pleading ignorance, JR, and you'll never be proven wrong again. However, it's more than a little silly for you to discourage people from actually researching an issue and posting facts and informed opinions.
Obamacare Strikes, and Forever 21 Cuts Employees' Hours
Explaining that the company “recently audited its staffing levels, staffing needs, and payroll in conjunction with reviewing its overall operating budget,” Associate Director of Human Resources Carla Macias informed employees that effective August 31, they will no longer be full-time employees of Forever 21.
Gadfly,
Baseless accusations... I've never "discouraged" anyone from not researching... au contraire, I ENCOURAGE people to research... just research ALL the facts, not just those from Huffington Post, CNN and the NYT.
Knowledge is power. Blindly believing what the govt and leftist news sources tell you to believe is willful ignorance.
Sure JR.... Bloomburg is a "leftist news source". Your credibility increases with every post.
Ha!! You're joking, right? Really... stop joking.
Next you'll tell me MSNBC is unbiased.
Pardon me, JR. I intended to write Forbes (not Bloomberg) as it was my second to last citation. Please explain to me why you feel that Forbes is a "leftist news source".
My point, Gadfly, is that an UNbiased news source does not exist, there is no such thing. So I would serve you well to watch many sources... be they CNN, Fox (gasp!), the NYT or the Washington Times. Be they Jon Stewart or Rush Limbaugh. Gather ALL the facts you can, then make an informed decision.
I, for one, base alot of my thinking on my watching political/governmental history unfold over the last 20 years with my own eyes... and that's only the last 20 years... government, by and large, cannot be believed or trusted.
"If you don't read the newspaper, you're uninformed. If you read the newspaper, you're mis-informed." –Mark Twain
gadfly, isn't it sad that some people just can't accept the facts and their only form of 'rebuttal' is name calling? they run from one misleading statement to another with no interest in learning what's going on. their only interest is derailing the conversation. one has to wonder if, after getting proven a liar in thread after thread, anyone takes posters like that seriously.
Forbes: I assume they are NOT leftist; as Steve Forbes is certainly more conservative than not. However- the 2 points you seem to be missing are:
1) don't take ANY one source's word for anything. Look at ALL sides... which includes HISTORY... (see #2)
2) don't believe what the government tells you out of hand- they have lied since their inception, and have gotten quite good at it. Regardless of which party is in power. Government needs to be watched like a hawk, lest the fox empty the henhouse.
Those that believed it when the govt told them the Patriot Act was "all good" , those that believed it when the govt told them OC is the "answer the healthcare", this list could go on and on.... were lied to, and willingly believed it, instead of doing the homework to find out the truth.
rc,
Nice try. Let me know if you want to have actual discourse. And for the record, I haven't called anyone any "names." Better get your FACTS straight. Put up or shut up.
As for Forbes, I also posted a link to doctors leaving the healthcare system BECAUSE OF OC, from Forbes. So, Forbes is right when it YOU GUYS want it to be right, but WRONG if it's something you don't agree with? Surely you can see the hypocrisy there.
see, there you go again. i never said your example from forbes was wrong. never. you make sh*t up over and over again, driving your bs narrative instead of discussing and learning. just a brief list of your name calling - 'ignorant', 'leftist', 'socialist'. actual discourse? you've proven yourself incapable of that.
CNN is reporting that Forever 21 is pushing full timers to part time status (29.5 hours per week maximum) to avoid the dictates of Obamacare
One man's story...from the Atlanta Journal- Constitution (I am not sure if they lean left or right)
A former Republican operative in Georgia who was diagnosed with cancer revealed last week that his medical struggles have made him a supporter of the new federal health care law known as "Obamacare."
Clint Murphy, who worked on John McCain's 2008 presidential campaign and Karen Handel's 2010 Georgia gubernatorial bid, wrote on his Facebook page that opponents to Obamacare are taking a position that's at odds with his best interest.
“When you say you’re against it, you’re saying that you don’t want people like me to have health insurance," he wrote, according to The Atlanta Journal-Constitution.
Murphy was diagnosed with testicular cancer in 2000 but, after four rounds of chemotherapy (covered by his insurance), it had gone into remission by 2004. He wasn't in the clear quite though. Because his sleep apnea qualifies as a "pre-existing condition," Murphy explained to the Journal-Constitution, he currently has no insurance.
The 38-year-old Murphy now works in real estate and said he will enter Georgia's health insurance exchange when it opens in 2014. He doesn't think Obamacare is perfect, but said that Republicans "are not even participating in the process" to suggest improvements.
“We have people treating government like a Broadway play, like it’s some sort of entertainment,” he told the Journal-Constitution.
yankeefan rc,
Again, get your facts straight. I never said YOU mentioned Forbes. That particular comment was in reference to the conversation gadfly and I are having. You were not directly mentioned in it. Run along and play now.
rc,
"ignorant" "leftist" and "socialist" aren't names- they are descriptions, and they are true. I'm not calling anyone NAMES- jerk, moron, etc. "leftist" and "socialist" are no more "names" than "fox news" is here on this forum.
You leftists and socialists should be proud of the fact! We conservatives are. Own it. Believe in yourself. We already know, you might as well come out of the closet.
I know someone whose husband is on disability and she doesn't work. She is looking.
She has a illness that requires 4 treatments a year and they cost $4000 each.
They went for help to pay for these treatments and they were told that they make $500 too much to qualify for any help. Really? The only income right now is her husbands disability and they make $500 too much? WTF is all I can say. NO ONE cares about whether you live or die. Its a damn shame.
botheredbyu yeah, calling someone ignorant is not name calling. great point. as for your labeling, i'm sure your little mind feels safe in a box but your 'labels' don't stick to me as i judge each situation individually and come to my own conclusions. in this case, expanding medical coverage to 30 million plus fellow Americans is the right thing to do and i'm glad it's finally happening.
Who did I call ignorant, specifically? Facts are your friends.
Saying "those who believe what the government tells them are being willfully ignorant" isn't name-calling.
If I had said, "go ahead and believe what the govt tells you rc- be a moron"... THAT would be name calling.
hey rc-
Why only 30 million? Don't you have a heart? Shouldn't EVERY SINGLE PERSON, including all the illegal aliens (after all, they're people too) get "free" healthcare?? And why is there still a co-pay? Why is there any kind of price? You should be able to just walk into any hospital or clinic anywhere and get whatever you need, free of charge. Come on, man- have some COMPASSION.
Oh, what's that? We can't afford it? Who will pay it? Easy- tax the rich. And ALL the businesses, because they're all rich anyway. And if that money runs out, we'll just tax the struggling middle class some more. Sounds like a plan to me.
JR You have got to be kidding me about being willfully ignorant you listen to all those right wing nut jobs and regurgitate whatever they say as fact and your calling somebody else willfully ignorant time to look in the mirror son
lol good thing you didn't use quotes oldred, 'cause you'd be wrong. Jesus never said that. He certainly taught charity, which is great- but that is different than the redistribution of wealth in this country that we are discussing- "forced charity", if you will.
Hmm... Jesus was a capitalist?
(disclaimer: I didn't write this)
Despite the best efforts of liberal evangelicals like Jim Wallis to turn Jesus into a flaming socialist, his own words tell a different story. In fact, the stories that Jesus told could have only come from a capitalist's capitalist.
For instance, in one of his most famous parables, the parable of the talents, Jesus commits a number of politically incorrect sins according to the worldview of Jim Wallis, who unfortunately is trying to recast Jesus in his own image as the Karl Marx of Christendom.
In the parable of the talents, Jesus refers to a man who called his servants together and "entrusted to them his property." Hold it right there! It was his own property! He owned the means of production - it did not belong to the community at large! The capital used in economic exchange was in private hands! And what he does with his wealth is clearly nobody's business but his own.
How can this be? This all makes the hero in Jesus' tale a criminal in Wallis' fevered imagination, guilty of greed and exploitation, and of grave offenses against an enlightened social order.
Further, the businessman distributed the talents "to each according to his ability." Sin number two. According to Wallis, Jesus should have had this man distribute his resources "to each according to his need." He should not be entrusting money to people based on ability, but rather should be extracting it from them based on ability. After all, in Wallis' world it is "from each according to his ability." Jesus turns that completely on its head by giving "to each according to his ability." Perhaps Rev. Wallis needs a remedial grammar lesson on prepositions.
Even worse, the enterprise run by the main figure in Jesus' story is a meritocracy from start to finish. Responsibility is awarded based on ability, not on some kind of ethnic or economic quota system. And promotion likewise is based squarely on achievement. The man with five talents earned five more, and was given more responsibility and authority as a result. Likewise with the servant who took two talents and turned it into two more.
There is not a breath here in this story of the importance of equality of outcome. In fact, quite the reverse. Jesus had no intention of having everyone wind up at the same level of income, authority or responsibility. This businessman believed in equality of opportunity but not in equality of result. Outcome was not dictated by government regulation but rather determined by individual initiative and skill.
Accountability in this story does not rest with some government agency. Rather it remains in private hands, with the entrepreneur who called his servants together upon his return and "settled accounts."
Jesus' businessman would surely agree with the Founders who said that one of our inalienable rights is the "pursuit of happiness." Notice that nowhere did they guarantee the achievement of happiness. The political structure, in their view, is there to create circumstances under which each of us, with minimal government interference, can pursue happiness based on ability, hard work, good judgment, perseverance, education, training and ambition, all of which will vary significantly from one individual to the next.
And last but not least, when the master returns and finds that one of his servants has buried the money in his back yard rather than investing it, he calls him "wicked and slothful." And rather than taking money from the productive workers and giving it out of compassion to this man in the form of welfare, he takes the one talent he buried and awarded it to the most productive member of his team.
Jesus' businessman had no intention of rewarding or subsidizing irresponsibility. The lazy servant had no right to anything he wasn't willing to work for.
So let's sum up. In this story, capital is in private hands. The owner of the capital is free to invest it as he chooses, and to entrust his private resources to anyone he chooses. Economic gain comes through investment, risk-taking and smart choices. The enterprise is based on ability and there is no quota system of any kind in place. Achievement rather than mere effort is rewarded. Accountability rests in the hands of private enterprise rather than in the hands of government. Laziness is punished rather than rewarded, and resources are not involuntarily transferred from the producers to the non-producers but the other way round.
Bottom line: Jesus, as much as Wallis will hate to admit it, had capitalism in his DNA.
You pay one way or another. If retail companies in large numbers keep a sizable full-time force then they have to raise prices...
Ombamacare is a poor business model that disincentives businesses from hiring full time employees. We need to fix this aspect of the new health care law. Too many of us are having our hours reduced to less than 30 per week, and that hurts the families who can least afford it :
"But in a nation with uniquely high health care costs, an issue that the Affordable Care Act fails to address, this is a regrettably unrealistic business model.
The private sector relies on minimizing costs and maximizing earnings. And those who compete within the economy must achieve those standards within the confines of rules established by the government. New rules from the ACA have been set, and Forever 21 has acted accordingly and eventually so too will its competitors and others in different sectors.
It is probable that in a perfect world, Forever 21’s management would love to continue employing full-time workers, provide them with substantial health care benefits, and maintain low prices for its customers. But in a nation with uniquely high health care costs, an issue that the Affordable Care Act fails to address, this is a regrettably unrealistic business model.
As long as health care costs remain as high as they are in the United States, many American companies will not be able to fund their employees' health insurance and provide their consumers with quality, cheap products. And as is inevitable in a capitalist economy, companies compelled to reduce costs will find a way to do so, even if their employees are disadvantaged in the process."
http://www.policymic.com/articles/59981/obamacare-strikes-and-forever-21-cuts-employees-hours
JR,
I never commented on your Forbes reference. Regardless, your pseudologic that "if one statement from a media source is true, everything it prints must therefore be true" is absurd.
But since you brought it up, I did look back at the Forbes article you posted about doctors quitting. The article is based on a survey by the Doctor Patient Medical Association, which was a group formed subsequent to the passage of ACA, in order to fight the ACA. Thats right... another lobbying group with a big dog in the fight cooking up a survey to support their argument.
The survey and the interpretation given in the Forbes article has been strongly criticized on media watchdog organizations such as Politifact and Media Matters. Read their analysis and decide for yourself.
gadfly... no, you USED FORBES AS A REFERENCE. My point is, conservatives use Forbes as a reference and it's "biased" but liberals use Forbes as a reference and it's "unbiased", apparently. Can't have your cake and eat it to.
mg- IDK how many people will be getting FREE healthcare, but every person who does not pay taxes that uses the OC system will be getting LITERALLY FREE healthcare.
interesting editorial on the causes of extortionately high medical costs in the USA:
Many people are worried that we are going to have socialized medicine in the U.S. Unfortunately, I don’t think most of these people understand that our current system is far from capitalist. There are still certain elements of the free market in medicine today, but overall, the system if far closer to fascism and socialism than it is to capitalism.
I want to point out just some of the reasons for the high cost of medical care today. They all have to do with government in some way. This could include state, local, or federal government. This is nothing close to an exhausted list. These are just a few of the major reasons for the high cost of medical care, which oftentimes coincide with an overall lower quality of medical care.
There are state laws that prevent buying health insurance across state lines, unlike car insurance or homeowners insurance.
Employers can deduct health insurance expenses. Individuals cannot deduct medical expenses in many cases on individual tax returns. There is a government incentive to have health insurance tied to your employer.
Medicare is socialized medicine for senior citizens.
Medicaid is socialized medicine for poor people.
Patent laws make pharmaceutical drugs vastly more expensive than they would otherwise be.
You must obtain a permission slip (a prescription) to get certain drugs from a pharmacy. You cannot be trusted as an adult to make decisions. A small percentage of the population might abuse this freedom, therefore we all have to suffer.
You must have a government license to be a doctor, even though many nurses and other people would be qualified enough to give certain medical advice.
Drug companies spend tens of millions of dollars, or more, getting drugs approved by the FDA. This keeps many drugs from ever being discovered. It keeps potentially life-saving medicine out of the market.
The government makes it illegal to use marijuana, even for medical purposes in most places. This is a potentially low-cost drug with a vast number of benefits.
State laws mandate insurance to cover certain things. You may have to pay for insurance against certain things like pregnancy or drug rehab, even if you don’t plan on getting pregnant or using drugs.
Companies that sell vitamins and supplements are not legally allowed to advertise the medical benefits of their products.
The government makes up a food pyramid that gives good ratings to high-carb foods, while criticizing foods high in saturated fats. People use margarine instead of butter (as just one example), at the government’s advice. Is this one of the reasons for the high epidemic in chronic illnesses in America?
There are thousands of regulations which doctors must follow, causing extremely high administrative costs.
The politicians are bought and paid for by the pharmaceutical industry, as well as the insurance industry. It is no surprise that the government tries to push expensive drugs, expensive tests, and expensive treatments.
Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) only exist because we have a federal income tax. At least with an HSA, you can carry over your money from year to year. FSAs are absolutely foolish (although I certainly don’t blame people for using them). It is a good example of unintended consequences encouraged by the government. If you have an FSA where you must use it or lose it in that calendar year, then it actually encourages you to incur more medical expenses before the year is over.
These are just a few of the ways that government makes our medical care expensive. If we had a free market system, medical care would be extremely cheap and I am guessing we would see a much smaller number of chronic illnesses. If you get into more detail and spend some time researching, you can find hundreds of examples where government makes medical care more expensive than it should be. We have nothing close to a capitalist system right now.
http://beforeitsnews.com/economy/2013/08/the-high-cost-of-medical-care-2545814.html
"but every person who does not pay taxes that uses the OC system will be getting LITERALLY FREE healthcare"
This does not make dollars and sense. I think you are using your special abacus again.
Here is the Kaiser Foundation calculator but to cut to the chase: for a family of 4 at 133% of poverty level, you still pony up 3% of your income. It is not exactly free or even literally free especially when you consider how little money they have. In other words: at this low income level you pay 10% of the insurance and receive a tax credit for 90% ---- tax credits just like Mitt Romny only way smaller! For a single person, they would pony up 15% and get an 85% tax credit, again at 3% of their income.
Of course you are on the hook for all co-pays as well for what one could assume is the minimal insurance plan.
Seems to hold true up to 400% of the poverty level and after that you are on your own.
http://kff.org/interactive/subsidy-calculator/
Below 133% of the poverty level is called Medicaid which, beyond the AHCA expansion, has not changed.
Man, I wish you would expand your search beyond right-wing fictional pieces.
interesting article on an actual reason medical bills are so high in the US -
http://opinionator.blogs.nytimes.com/2013/08/13/the-cure-for-the-1000-toothbrush/?_r=0 -
Here is a basic fact of health care in the United States: Doctors and hospitals know what they charge, but patients don’t know what they pay. As in any market, when one side has no information, that side loses: price secrecy is a major reason medical bills are so high. In my previous column, I wrote about the effect of this lack of transparency on the bills patients pay out of pocket.
We know about these bills, which hit us directly. What most people don’t know, because the costs are hidden, is that the same imbalance exists with insurance. The employers and employees who buy health coverage have delegated vigilance over health care costs to insurers — but insurers, for the most part, have gone AWOL.
Consider the story of Texas811, a company with about 200 employees based in Dallas. (They mark utility lines so people don’t damage them when they dig.)
In January 2010, the company was enrolled in a Blue Cross P.P.O., or preferred provider organization. That month, Blue Cross told Texas811 that it was planning to raise the company’s premiums by 75 percent. That was extreme. But health insurance premiums are rising three times as fast as wages, doubling since 2002. “We freaked out,” said Lee Marrs, the company’s president. They negotiated. Blue Cross agreed to lower the increase to 68 percent. “At that point it was go out of business, drop health coverage, or try something new,” Marrs said.
They tried something new.
What Texas811 did first was drop Blue Cross and its P.P.O. and become self-insured. That means that the company itself paid claims up to a certain amount, and bought an insurance policy that kicked in after that. This isn’t revolutionary – self-insurance is how it’s done for about a third of the insured work force. After one unsatisfactory year, Texas811 signed up with GPA, a Dallas-based company that administers claims for about 230 workplaces like municipalities, school districts, retail businesses.
The difference was astounding.
Under Blue Cross’s P.P.O., the company had been paying $10,000 per visit for dialysis patients. Now it was paying $975. Other costs dropped commensurately. After the first year, the company lowered premiums by 3 percent and increased coverage, providing free vision, dental and life insurance to all its employees, including part-timers. “We saved so much money we were able to hire a third-party contractor to establish a medical clinic in our office,” said Marrs. “We provide a free primary care physician in our office to all employees and their dependents.”
What Texas811 did was become part of a nascent movement away from the P.P.O. model, one that negotiates prices up from the hospital’s cost or the lower Medicare price rather than down from the hospital’s higher one.
Eighty percent of America’s insured — some 200 million people — are insured through P.P.O.’s. A P.PO. assembles a network of health facilities and providers who agree to deliver care at a negotiated discount rate. P.P.O.’s were not originally a force for price secrecy, but their role changed as hospital chains began to grow. Between 2007 and 2012, there were 551 acquisitions of hospitals. Chains have merged, and hospitals buy up their competitors and physician groups.
Because they are so large, hospitals now control negotiations with P.P.O.’s. Patients want their own doctors in the network — which means that hospital chains are must-haves for a P.P.O. A study of the health care market in 12 cities found that dominant hospital chains could get high prices, secrecy clauses and other contract advantages. Insurers don’t argue — they need the P.P.O., and they can simply pass the higher costs along to payers in the form of premium hikes. With some insurance contracts, the more the hospital is paid, the more the insurer makes.
“Even a giant company like General Electric in any given market doesn’t have that market power,” said Kathy Hempstead, senior program officer with the Robert Wood Johnson Foundation. “Provider consolidation is very, very hard to deal with. It gives providers the opportunity to play hardball with purchasers and their agents.”
P.P.O.’s, of course, negotiate discounts — the statement you get from your insurer always highlights how much was saved. Some of those discounts sound impressive: 50 percent off, sometimes more. “But nobody ever asks, ‘discount off what?’” said Mike Dendy, the chief executive of Advanced Medical Pricing Solutions, or AMPS, an Atlanta company that reviews and renegotiates hospital bills.
P.P.O.’s negotiate their discount off the hospital’s chargemaster price. The chargemaster is like a supersonic rack rate. It’s a fantasy figure, set by the hospital alone. These are the $77 gauze pads, the $1,000 toothbrushes, the components that add up to the $200,000 joint replacement.
Compare the chargemaster price with what hospitals pay Medicare — a figure that is around the break-even point. ( A recent study found that a third of community hospitals make a profit at Medicare rates.) Chargemaster prices are almost always at least 300 percent what Medicare pays a hospital, and some are 1,000 percent or 2,000 percent. Suddenly that 50 percent discount doesn’t seem like such a bargain. Fifty percent off a $1,000 toothbrush is a $500 toothbrush.
The lack of transparency with P.P.O.’s continues when the bill comes in. In general, insurance companies don’t ask for the details. They don’t challenge the prices. They just pay. Most corporations would never dream of paying invoices blindly. Yet they never look at the bills that make up their second largest cost category, after labor.
Hospital charges are by law supposed to be “reasonable and customary,” but some P.P.O. contracts have clauses that prohibit arguments about the price. “If the administrator decides to review a bill and finds a double charge for a service that is an error then they can correct that mistake,” Dendy said. (His company is hired by insurers to review some especially large PPO bills.) “But they can’t argue about what was charged for the service, regardless of how ridiculous the charge might be. Of course, they typically don’t look in the first place. Ninety-nine percent of hospital bills are paid without what any rational individual would consider reasonable documentation of the hospital’s charges.”
Hospital executives say the ban on challenging prices is justified. Joe Fifer, the chief executive of the Healthcare Financial Management Association, compared scrutinizing line items to looking at the price of a steering wheel of a car. “It’s the overall price of the procedure that’s important,” he said. “Line-item level review for ‘reasonable and customary’ forgets the forest for the trees.”
Auditing bills isn’t difficult. Medicare does it. (“Funny that the federal government got this right before private industry,” said Dendy.) It began to do automated audits in three states in 2005, and now audits are nationwide. It has recovered hundreds of millions of dollars by catching practices like double billing. And the fear of audits has no doubt reduced Medicare fraud in general.
Seven years ago, GPA, the company hired by Texas811, began offering clients the option of getting out of P.P.O.’s, working instead with ELAP Services, a Philadelphia-area company that, like AMPS, uses a very different method of evaluating the reimbursement for hospital bills. About 100 clients now have made the shift, said Kathy Enochs, GPA’s chief operating officer. ELAP advises plans to pay a hospital its cost, plus a profit. ELAP, like AMPS, also employs doctors who do a line-by-line audit of every single bill their clients receive.
Steve Kelly, ELAP’s president, said that this strategy was rarely used by the mainstream health insurance market. Enochs said that clients usually saw a 15 to 20 percent reduction in medical spending in their first year after switching from a P.P.O. — if they have a lot of hospital costs, the reduction can be much larger. After that, costs are close to flat.
Why don’t more employers choose this strategy? The most important reason is that a lack of transparency keeps businesses in the dark. Employers don’t realize that their insurance company isn’t doing audits. They know, of course, that prices are high, but they don’t realize that there’s no good reason for it. So they don’t look for other options.
There are other hurdles. Going cost-plus takes guts. Some hospitals won’t accept patients at these rates. It doesn’t happen very often — Marrs said it’s happened once to a Texas811 patient, who then went to a different hospital. But employees don’t like uncertainty.
The other retaliation that patients can face is the dreaded balance bill — a bill from the hospital for what the insurance company wouldn’t pay. Dendy calls this extortion: “if you don’t pay what we want, fair or not, we’ll harass the member.”
Enochs said that about 15 percent of patients get balance bills. But that doesn’t mean they have to pay them — lawyers for companies like AMPS and ELAP fight the bills. Hospitals depend on the fact that very few people request or challenge bills. Once they are challenged, the hospitals normally lose, since it’s hard to argue that the charges are reasonable. Kelly said that ELAP wins “98, 99 percent of the time.” Sometimes the health plan will negotiate and pay part of a balance bill, Enochs said, but she said that so far no patient with GPA has ever had to pay.
Related
More From Fixes
Read previous contributions to this series.
Some employers believe they can’t persuade their work force to accept the uncertainties of a cost-plus plan. But rising health care costs are changing the equation, especially since workers are now bearing much of the costs themselves. A little uncertainty might now seem preferable to large premium increases.
Another way transparency cuts cost is through reference pricing. CalPERS, the California Public Employees’ Retirement System — one of the nation’s largest buyers of health care — is a pioneer. It found that California hospitals charged between $15,000 and $110,000 for a hip or knee replacement — the usual ridiculous spread of costs. But 46 hospitals, including some of California’s most renowned, agreed to do these operations for $30,000. CalPERS told members it would reimburse them only up to that amount. They could go anywhere — but they’d have to pay the difference out of pocket.
This had two effects. One was that patients began shopping around. But far more important, 40 other hospitals lowered their price. A Berkeley study found that over all, CalPERS’ spending on joint replacement dropped by 19 percent with no reduction in quality. It also found that because some of the 40 competitor hospitals had charged very high prices, the drop down to $30,000 at those hospitals was responsible for 85 percent of those savings. The government’s recent public release of hospital charges is allowing WellPoint, which was CalPERS’ insurer, to expand reference pricing to other procedures and states.
A study (registration required) by Truven Health Analytics looked at another impact of more widespread price transparency. Truven looked at 300 procedures that are shoppable — patients plan for them and schedule them in advance. If purchasers got care at facilities charging the median price in their local market (not the lowest price; the median price after trimming the extremes on both sides), the United States would save $36 billion a year. And that does not take into account the downward pressure on prices that transparency would create — the factor that was so important to CalPERS’ savings.
Price secrecy costs corporations a lot of money. Yet one important reason that businesses don’t know what they’re paying is that they’re not looking very hard. “I was at a conference of C.F.O.’s on controlling health care cost,” said Kelly. “Not one C.F.O. at the table could identify what a day in the hospital cost. They couldn’t cost a CAT scan or an M.R.I. They had no idea of the unit cost of health care. They are under the impression that a detailed review of bills is being done, and if they leverage the largest carrier they’re going to get the best rate.
“We encourage employers to use their business instinct. Employers are very good at containing costs. Except in the area of health care, where they abdicate to insurers — we’d say with disastrous results.“
Gee BDog --- but when I said it's not a normal capitalistic system, everyone says it's just liberal hogwash........
Many of these financial work-arounds noted are there to try to mitigate the fact it is not a normal market model. For example, Bush Sr. started the HSA or HCRA accounts as his "health care plan," Boneheaded and confused as it was, it was the only thing he could come up with to help ------ a tax break !
What the author left out was the root cause why health care can never be a capitalistic market which I noted above: it's the buying model is not capitalistic to begin with. So even if you got rid of every piece of crud the author notes, health care would still not be a normal capitalistic model (nor necessarily one iota better).
While I don't agree with the tone, rhetoric, and some of the conclusions (like the socialist moniker), generally good stuff.
BD - you forgot to mention that now flu vaccination is required by state for kids to be allowed to attend school, preschool and licensed child care centers in New Jersey. Why I cannot decide what is better for my child or me? Flu is not polio. In addition even pharmaceutical and medical professionals admit that many times the flu vaccine doesn't match the current year flu virus strain. So why it's required? And it's not free.
correct Lena, and no one really knows what the government is putting in those vaccines, nor are we being told how it will affect children adversely, some vaccines and shots contain toxic levels of mercury, (as a delivery system, R U KIDDING ME?)
who knows what else the feds are experimenting on your children with? (the documented experiments of government agencies injecting veterans with syphilis to see what happened to them is appalling, there were also government experiments on unsuspecting victims with LSD) none of these human ginea pigs were told what was happening, it is criminal behavior on the part of the government and they have skated away mostly on all criminal charges,
who really knows what they are putting into our children?
not everybody said it's 'liberal hogwash'
not everything every liberal says or does is completely wrong
conversely, not every conservative and/or republican is a knuckle dragging neanderthal.
this medical debacle has been in the making for a hundred years, and both houses in the beltway have to own responsibility for the mess.
i would like see insurance be able to be purchased across state lines.
this is an easy no brainer.
i would like to see a postalized menu for services and charges from my doctor before service is rendered and then have the ability to comparison shop for second opinions. (other providers who might do the same work for less for example)
these two things are easy to implement, sadly the new health care law does neither.
and we need to stop all of the carve outs for unions, some big companies, and the public sector employees,
if we have to do it, so should all the rest of them. they made this bed, now they have lie in it and walk their own talk.
we'll see how that works out, i'm not holding my breath
I can't wait until 2016 when Obama care has been fully implemented and president Hillary Clinton is sitting in the Oval Office JR's head is going to explode
BD - they are putting a vaccine that can help not to get sick. There are vaccines for very serious illnesses but flu is not dangerous illness for in-general healthy person. But kids are forced to have flu shots and it definitely benefits pharmaceutical companies and increases medical costs.
When people are sick or fear a financial catastrophe, a society cannot be the best it can be. America is about being the best (or at least it used to be...).
The part two (like I mentioned before) is to hold people accountable to work unless they really can't. And I mean really. Where I work, a legally blind person works as a programmer using special hardware and he has been at my company for almost 2 decades.
The real problem is too many people do not want to work or feel that they should get disability when they really are not. My grandmother used to work at a senior home where she was old than almost everyone admitted.
Personal accountability is first. A just helping hand from the government is second...
oldred...
Matthew 10:8
Heal the sick, cleanse the lepers, raise the dead,[a] cast out demons. Freely you have received, freely give.
These were instructions to the apostles. I have yet to see a leper cleansed or the dead raised. And again we are talking about charity. Not forced charity, not redistribution of wealth, not forced redistribution of wealth.
The Mission of the Twelve.
1
* Then he summoned his twelve disciples* and gave them authority over unclean spirits to drive them out and to cure every disease and every illness.a
2
The names of the twelve apostles* are these: first, Simon called Peter, and his brother Andrew; James, the son of Zebedee, and his brother John;
3
Philip and Bartholomew, Thomas and Matthew the tax collector; James, the son of Alphaeus, and Thaddeus;
4
Simon the Cananean, and Judas Iscariot who betrayed him.
The Commissioning of the Twelve.
5
b Jesus sent out these twelve* after instructing them thus, “Do not go into pagan territory or enter a Samaritan town.
6
c Go rather to the lost sheep of the house of Israel.
7
As you go, make this proclamation: ‘The kingdom of heaven is at hand.’d
8
* Cure the sick, raise the dead, cleanse lepers, drive out demons. Without cost you have received; without cost you are to give.
9
e Do not take gold or silver or copper for your belts;
10
f no sack for the journey, or a second tunic, or sandals, or walking stick. The laborer deserves his keep.
11
g Whatever town or village you enter, look for a worthy person in it, and stay there until you leave.
12
As you enter a house, wish it peace.
13
If the house is worthy, let your peace come upon it; if not, let your peace return to you.*
14
* h Whoever will not receive you or listen to your words—go outside that house or town and shake the dust from your feet.
15
Amen, I say to you, it will be more tolerable for the land of Sodom and Gomorrah on the day of judgment than for that town.
So, by these "standards", everyone should only own 1 set of clothes, never be paid for anything, should proselytize the Word of God, and pagans should not receive free healthcare. ;)
Well, I mean really- either take the His word literally or don't; but you can't go halfway. It's either literal or it's not.
the codec's and other first century letters and historcial writings (some from Josephus) document and list out many of miracles performed by the apostles after receiving these instructions from Jesus and after he was crucified. the writings form the years of 50 ad to 150 ad document that these instructions from the book of Matthew were not just words. They really happened, and through the hands of the original 12 who given the power and authority to perform them from Jesus and the holy spirit.
the book of ACTS also lists out many healings and other remarkable events that the apostles performed after Jesus rose from the dead.
they were given these powers so that the young church would be able to grow, it worked then as the Church grew quickly and did so under the most brutal of circumstances. Many of the original 12 apostles went to their deaths before denying the truth. That alone is a powerful witness. Think about it, who among us today would be willing go our deaths if it was all just a story or a lie? They believed it was true because they witnessed the miracles with their own eyes, and they died for it.
that is compelling evidence that deserves a verdict . . . .. . .
and in this modern day and age you can see (if you take time to look around) that many around us have been given remarkable gifts by the spirit that shine through the cloudy muck of our daily lives in the most amazing and unexplainable ways.
the witnesses of these events walk away with a new understanding of their place in the world around them.
back to our topic: hospital costs are out of control, and we need to shine a very bright light on the details of their practices in order to bring them under control,
doctors should be required to tell before service is rendered ho much it will cost, and then each and every one of us should make a decision on whether to go ahead with that or shop around for a better price.
it is insane the way it works now.
BDog: " nor are we being told how it will affect children adversely," Yes, you are, just look.
"i would like to see a postalized menu for services and charges from my doctor before service is rendered and then have the ability to comparison shop for second opinions. (other providers who might do the same work for less for example)" You got to be kidding. No business should be forced to do this especially one that is service-based (beside manner). However a good idea. However, you will get that off the exchanges for insurance.
"stop all of the carve outs for unions, some big companies, and the public sector employees," What the heck are you actually talking about?
Personally I have no issue with AHCA improvements, a few of mine are noted above. Keep suggesting.
IJay, you are right. Not only do the lazy disabled not work like the rest of us, most of them work only part time so they can profit even more from ObamaCare. And like your Grandmom, most are old so what the heck is THEIR problem anyway: http://www.bls.gov/news.release/disabl.nr0.htm
And JR, thanks for pointing out that Jesus was a Euro-Socialist. If only the Church was.
University of Va drops health care for some employees spouses and directly attributes it to Obamacare:
UVa announced today that due to “rising health care costs,” some working spouses will become ineligible for University insurance coverage:
Starting Jan. 1, spouses who have access to coverage through their own employer will no longer be eligible for coverage under U.Va.’s plan. Spouses who do not have coverage elsewhere can remain on the employee’s plan, and coverage of children is not affected.
.“Rising costs” are cited as the culprit for the spousal (and several other) health coverage policy changes:
The University goes on to blame Obamacare for an anticipated $7 million cost increase next year:
Provisions of the federal Affordable Care Act are projected to add $7.3 million to the cost of the University health plan in 2014 alone. Federal health care reform will create new costs related to the “individual mandate” that requires all Americans to have health care coverage (or pay a penalty).
.And, that doesn’t cover the taxes that will punish UVa for its “generous” employee health care offerings:
In future years, U.Va. could face millions more in taxes through the act if the cost of its plans passes certain thresholds.
“Ironically, by providing generous benefits, the University becomes exposed to a federal excise tax known as the ‘Cadillac tax,’” [UVa Vice President and Human Resources Officer, Susan] Carkeek said.
Effective in 2018, the 40 percent tax would apply to the cost of an individual plan with average premiums per employee topping $10,200, or $27,500 for a family plan.
http://www.schillingshow.com/2013/08/21/obamascare-uva-drops-health-care-bomb-on-employees/
mg said "thanks for pointing out that Jesus was a Euro-Socialist. If only the Church was."
So you're finally coming out of the closet as a socialist? Took you long enough.
(and as I said above- I didn't write that piece.)
UPS to drop 15,000 spouses from insurance, cites Obamacare
The disaster that is Obamacare continues to devastate healthcare as it was designed to do. The more you delve into this atrocity the more it becomes clear that this legislation had nothing to do with providing accessible or affordable healthcare. It has already failed in both of those respects. As expected the lemmings and low information voters continue to march forward in blind compliance.
http://www.bizjournals.com/atlanta/morning_call/2013/08/ups-to-drop-15000-spouses-from.html?r=full
mark Folks: Once again I will say that the AHCA can not be perfect but ask yourself: is the answer to make it better or to repeal it and do nothing as we have for over the past 100 years since the first country offered Universal Health Care to it's citizens?
There are powerful forces at play here: political gambits, profiteers, cost cutters, PR plays, media careers, and plain old power plays. And if you are a cost cutter, of course you will blame the AHCA as your scapegoat for saving money.
Ask yourself: how does the AHCA CHANGE the law for spousal coverage? The answer ---- NOTHING. The AHCA does stipulate the need for dependent coverage but mentions nothing about spousal. That is no change in the legality of spousal coverage from the world before the AHCA.
Ask yourself: are these spouses being turned out to the cold? No, of course not. They are working spouses with coverage available at their own workplace. It's a pretty safe benefit cost cut for UPS for sure. No harm, no foul, and the AHCA to blame to boot. Win-win-win.
Ask yourself: does the AHCA add extra charges to business for health insurance? OK, on this one you need to parse the data between large and small companies, companies that can profit from part-time and those who can't, and between those companies currently offering coverage and those who don't.
If you are a large business that currently provides insurance as a benefit; the AHCA act does not change insurance cost much at all. However, you can still reduce costs by avoiding working spouse coverage. This is no different than what you can do today, no change to being able to cut spousal coverage except, like UPS, you can blame ObamaCare as the devil that done made me do it.
What did UPS say? They can't lie, they would get caught and that would be a PR disaster. So they just weasel-worded the talk points at let the press pick up the ball and run full tilt boogey for them. According to Kaiser Health Services, UPS explains the benefit cut as: "Rising medical costs, "combined with the costs associated with the Affordable Care Act, have made it increasingly difficult to continue providing the same level of health care benefits to our employees at an affordable cost," Rising medical costs and the AHCA costs.
The cost: "The Fortune 100 firm expects the move, which applies to non-union U.S. workers only, to save about $60 million a year, said company spokesman Andy McGowan." This is the total cost, not the AHCA increases.
Ask youself ---- do you think the AHCA costs UPS $60M to offer spousal coverage? Not even close.
According to UPS, the actual cost increase is: "While acknowledging that overall health spending continues to rise, the company also blamed cost increases on the Affordable Care Act's research fee (initially $1 per health plan member, then rising to $2) and a temporary fee of $63 per member to stabilize new online marketplaces for consumers buying directly from insurers."
Well, doing the math that means the AHCA spousal coverage costs UPS $975K for a temporary time dropping to $30K per year after the temporary fee is dropped. UPS made 807M in profit last year off 54.1B in revenue. They are doing this since the AHCA is costing them $30K a year in the out years. But where's the $60M?
UPS also said: "Other factors are the act's ban on annual and lifetime coverage limits and its requirement to cover dependent children up to age 26, UPS said. The law's mandate for individuals to obtain coverage will nudge employees who previously opted out to enroll, also raising costs, the company said. The health law is "one of the reasons that UPS is implementing the changes," McGowan said." OK, the AHCA, according to UPS is ONE of the things, part of that is because the law mandates extends child coverage and bans payout limits for sick people. And the really bad part, according to UPS, is that the AHCA is getting people to enroll in insurance. Hmmmm, bad thing. The damn AHCA is working.
OK, let's get to the real reason. My estimates is that medical cost inflation will cost UPS between $19M and $26M next year. That's about $11,000 in corporate coverage (Kaiser estimate) against a 4% inflation rate with between 45,000 to 60,000 employees (UPS estimate). Every employee they can cut from the plan will save them $400 in inflation increases. Sure some of this inflation increase would be passed to employees but you ain't getting to $63. That's a $400 savings versus the AHCA surcharge of between $2 and $65; you tell me what the real culprit for the cut is. The 800-gorilla is on the table but I am betting that $400 trumps $63 or $2.
But isn't it a win-win for UPS and convenient for UPS to cut the benefit now and blame the AHCA instead of just saying "given medical cost inflation, we're cutting costs but cutting those who are already covered elsewhere?"
Powerful forces at play. Sure, companies are going to look to cut costs wherever and whenever they can. Working spousal coverage has been declining for years as a provided-benefit and will continue to be cut with our without the AHCA in existence. But killing it now is uber convenient with the AHCA scapegoat ready to carry the blame. And certain media outlets are going to carry that story all the way to their goal line: AHCA repeal and subsequent return to our broken, busted, health care system without Universal Coverage.
Guess what company benefit would go next if the AHCA did not mandate corporate health care insurance coverage? Can you spell health insurance?
I just find it impossible to believe that even a novice journalist could not read between the weasel-words from the UPS PR flack. He basically set up a paint by numbers scenario, they only had to fill in the blanks.
Mark, That's a really insightful analysis. Its great to see someone doing so much of their own thinking, rather than just regurgitating platitudes and the party line.
Here's a couple of my own thoughts on your article:
1. The change in coverage at UPS affects only 4% of their U.S. workforce.
2. The affected people were limited to spouses that have health insurance available to them through their own insurance, so no body is losing the opportunity for an employer sponsored plan due to this decision.
3. This type of change in coverage has been the overwhelming trend in employer sponsored health care plans for many years prior to the ACA, and with much more drastic reductions than what UPS has done.
4. It seems like "Obamacare" is a very convenient excuse for any corporation that is currently reducing benefits, regardless of the actual reason for the reduction.
5. Its funny that you mention "blind compliance". Why would you blindly believe UPS's spokes person that this change is related to ACA, when its a relatively insignificant change that fits into a long-term trend that is unrelated to the ACA?
But please don't let any of this interfere with your story line. I suppose its good to have some chicken littles around to make the rest of us appear more rational.
If you are insured by two companies, won't you be paying full value to one company for a service you're only partially using? If so, wouldn't the other insurance company be indirectly providing a profit to the first by bearing the bulk of the outlays? They would be "funding the competition" so to speak? I don't know, but on the surface it makes a lot of sense to not insure someone who already has insurance.
" It seems like "Obamacare" is a very convenient excuse for any corporation that is currently reducing benefits, regardless of the actual reason for the reduction. "
Well, that's entirely an opinion based on emotion. As if it's inconceivable to you that a corporation might actually NOT be able to afford the greater costs OC is going to put on them? Please tell me you're not like most of the liberals/progressives who actually believe "corporation" means "made of money."
JIT: You only pay for what you use, you are either a subscriber (paid) or not (unpaid). And if you are dual covered sometimes you pay more, a penalty, for the secondary coverage. And, for the most part, you can only collect once per actual bill.
The insurance companies have pretty much closed any loopholes here.
JR: I just listed the dollars and let you decide whether the primary reason for UPS cutting spousal coverage was the $400 in increase health care insurance coverage costs due to inflation or the $2 to $63 AHCA increase. Obviously both but mostly.......well, you be the judge. And if the AHCA did not exist, do you think UPS would have saved the spousal coverage benefit and eaten the $400 cost increase?
And all emotion aside, UPS did state their reasons correctly but gave the illusion that the AHCA was 50% or more of their rationale. It was the press and you that only heard the lesser priority part of the story because you chose to. I call that convenient.
JIT,
These spouses do not have two policies. They have chosen to participate in the health care plan offered by their spouses' employer (UPS) instead of the plan offered by their own employer.
UPS's decision was essentially this: "For this category of worker, we are no longer going to provide health insurance to employee's spouses if those spouses have access to health care through their own employer."
Again, this decision affected about 4% of UPS's US workforce.
JR,
Now, that's the pot calling the kettle black....
Either you didn't understand my argument, or you're just not interested in having an intelligent discussion. I really don't care either way.
Ok family has 2 working parents that both can get insurance at thru their own employers. So one gets an employee only insurance plan thru their work and the other gets an employee and kids plan at their work. So what is the big deal? Does anyone have any proof that by having to do this it will cost the family more than getting 1 family coverage? It might actually be cheaper to do it. Say you have 1 parent that never gets sick and is in great shape, they get the single plan with a high deductable and low monthly cost. Then the other parent gets the lower deductable family plan.
And I remember the opposite use to/might still happen for employees in small companies. If one spouse wants to get coverage in their employer's plan they had to prove they COULDN"T be covered under the other spouse's employer. I remember my wife went thru that, her company finally offered insurance but she was not eligible because she could get coverage thru me. So most to the married people at the company were not eligible. The boss was a genius, finally offered insurance and only had to insure 5% of his employees
darwin Darwin - I bet, her boss "actually believes "corporation" means "made of money" and he was all about making money and he definitely wasn't "liberals/progressives" (quoted as per JR).
gadlfy,
Correct me if I'm wrong, but it sounds to me like you were saying corporations that needed to reduce benefits anyway (due to poor sales/smaller budget I would assume) were using OC as the "official excuse" to do so... as if it fit some kind of agenda?
well, regardless of what the real reason is, at least we know the economy STILL SUCKS... and OC ain't gonna' help... but to the contrary.
http://atwonline.com/finance-amp-data/ups-2q-net-profit-down-4
maybe not all corporations, but UPS's had a bad 2012 (compared to their 2011) and so far in 2013 is not looking that great. But i'm sure it was OC that caused them to make this move and not their shrinking profits. :)
Actually JR you are wrong again. OC will help the economy by providing 30M new insurance contracts, 30M new customers for preventative care, prescriptions, etc. You gots to do the math.
UPS like all companies is always looking how to increase it's competitive stance including cutting costs as well as offering competitive benefit packages to attract quality employees. It is just "convenient' to pull the trigger, take the cost cut, cut the benefit, blame the AHCA, at this time. They see it as an opportunity to excel !!!
Darwin: given the complexity of dealing with any insurance company in that lovely tar pit we like to call HELLth care billing, I can see a HUGE benefit to have my family covered by a single insurer. The amount of time I spend paying for anything to do with the medical industry is beyond belief. Every time I get a bill, I say this hell can not last forever, it just seems like an eternity. The confusion is epic. The learning curve the steepest. Etc. etc. etc.
But such is life and, based on our conversations on the AHCA alone, I can see why our legislators would avoid tackling anything like working spouse coverage that looks closer to a single-payer plan. Heck, the crap they are getting by NOT changing the system and NOT adding a working-spouse regulation is pain enough. Now the AHCA is getting blamed for NOT changing the health care insurance and benefit system on top of everything else!!!!
Point taken about the distinction of "eligible" for insurance versus "has" insurance.
But how would UPS know if a spouse was eligible for insurance through the spouse's employer? Something's missing here.
As Darwin alluded to above, it may just be that UPS is struggling a bit financially and needed to reduce costs. I'm not saying that blaming the ACA is part of "an agenda", I'm saying that in some cases it could be used to deflect the attention from the real cause of the cost-cutting. As in, "no, no, UPS is doing just fine financially, its just this damn "Obamacare" that's made us reduce employee benefits".
http://www.usatoday.com/story/money/business/2013/08/20/ups-spouses-health-insurance/2651713/?utm_source=dlvr.it&utm_medium=twitter&dlvrit=110940
"1. The change in coverage at UPS affects only 4% of their U.S. workforce. ""
The instigating story above states that about 1/4 of UPS employees will be affected.
"This type of change in coverage has been the overwhelming trend in employer sponsored health care plans for many years prior to the ACA, and with much more drastic reductions than what UPS has done."
Also per the above link:
"This year 4% of large employers surveyed by consultants Towers Watson excluded spouses if they had similar coverage where they work. Another 8% planned such a change for 2014, according to the survey."
So according to the USA Today article, the trend is becoming more prevalent but doesn't seem to have been a priority until now.
Funny how facts change depending upon the source.
"how would UPS know if a spouse was eligible for insurance through the spouse's employer"
You sign the form during annual "enrollment period", and provide a letter from spouse's employer, the same as providing letters from colleges to prove your child is full-time student.
"if you like the health care plan you have right now, you can keep it",
promise from President Obama to the American people as he pushed for passage of Obamacare
looks like that ship has sailed. another broken promise, oh well,
mg,
I did the math. Tons of companies going to part-time-only employees so they don't have to carry OC. If that continues to multiply, who's going to pay for the 30M new contracts? When you have companies like McD's getting exemptions, SOMEBODY... gee guess who... is going to have to pay. NOT helpful to an already-struggling middle class. Not to mention all the companies who will have to participate in OC will simply raise their prices to compensate. Again- NOT good for the economy.
Gadfly,
you are saying what I thought you said. Thanks.
JIT,
From your link, "The new plan at UPS, which earned $807 million last year on revenue of $54.1 billion, affects about a quarter of its U.S. workforce."
This refers to "the new plan". It does not specify that this decision which drops some spouses is affecting 1/4 of the workforce. The four percent number was my own calculation. I divided 15,000 by the total number of US employees that I found online. BTW, if your 1/4 figure was correct, that would mean UPS only had (15,000 x 4) 60,000, which would mean that they had 30% more delivery vehicles than employees!
Here's a counterpoint from the Atlanta Business Chronicle, the same sources that printed Mark's original article.
http://www.bizjournals.com/atlanta/blog/capitol_vision/2013/08/analyst-dont-blame-obamacare.html
Companies blaming Obamacare for their decisions to scale back their insurance coverage are unfairly making a boogeyman of federal health-care reform, an Atlanta-based health policy expert said Wednesday.
United Parcel Service Inc. (NYSE: UPS) cited the Patient Protection and Affordable Care Act in announcing late Tuesday that it’s dropping 15,000 employees’ working spouses from its health plan because they have access to coverage elsewhere.
“[Businesses] have been cutting spousal benefits for years or implementing surcharges,” said Tim Sweeney, director of health policy for the Georgia Budget and Policy Institute. “Blaming that sort of stuff on the ACA is a bit tricky.”
UPS, which expects to save about $60 million a year, is able to make the move because Obamacare will require companies with 50 or more full-time employees starting in 2015 to cover workers and their dependent children but not spouses.
But Sweeney said nothing in existing law requires businesses to offer spousal coverage, either, and employers began cutting back on extending health coverage to spouses long before President Barack Obama pushed the ACA through a then-Democratic Congress in 2010.
“The ACA doesn’t change what [businesses] are facing,” Sweeney said.
Dave Williams covers Government
Well the University of Va blames Obamacare for rising costs:
“Rising costs” are cited as the culprit for the spousal (and several other) health coverage policy changes:
The University goes on to blame Obamacare for an anticipated $7 million cost increase next year:
Provisions of the federal Affordable Care Act are projected to add $7.3 million to the cost of the University health plan in 2014 alone. Federal health care reform will create new costs related to the “individual mandate” that requires all Americans to have health care coverage (or pay a penalty).
JR, I just can't handle your new math. Tons = how many? You don't have a clue how many companies are shifting full time to part time just because of the AHCA. Stop being silly.
Folks, re the UPS story, when was the last time a major corporation put out a comprehensive press package when they dropped benefits much less got actual coverage for doing so? Makes you wonder about the timing and opportunity of UPS taking this cost cutting action.
I will did into the UofV $7.3M cost projection with ObamaCare being the culprit however the projected costs of the AHCA would mean UofV is insuring over 112,000 individuals when "There are over 12,500 employees at UVa." (wiki).
That's a lot of spouses and kids.
Or flip the $7.3M around and its an $600 increase per employee or at a 60% subscription rate it's close to $1,000 increase per employee. Trust me, if ObamaCare was raising corporate benefit costs by 10%, there would be a riot on Wall Street.
Got some weird assumptions here just like UPS and once we get the facts, I am sure it will look interesting.
Of course this is what the special advisor to the UofV Medical Center CEO said in
2010 "“I am writing on behalf of the University of Virginia Medical Center to indicate our support of the health reform package pending before the House because we believe providing affordable health coverage for more citizens of the Commonwealth is critical.”
And you thought you were having a bad day.
That said I would expect a landslide of working class spouse benefit drops. Why not, what's the downside? It's unfortunate in that it will make it more expensive for America (otherwise I am guessing folks would pick the cheaper plan) and certainly more complex to figure out how to process those medical bills.
But this is NO change in the law because of ObamaCare and the costs shown are more due to cutting the quantity of those getting healthcare not a reduction in a line-item cost factor. They are just insuring less people and passing those people on to another corporations benefit rolls, not offering less insurance.
Not sure how employers could figure out if their spouses had "similar" health plans. I guess it depends how you define similar. While my wife was working (retired 2 years ago) her company's plan was much better than mine, price wise, deductibles and max out of pocket costs. You had a choice of an individual or family plan. You paid the same price if you had two or 6 people on the family plan. I guess things are changing really fast as the unbelievable increases year over year are making companies to make tough decisions to reign in their costs. Its not getting better out there folks.
Delta Airlines estimates OC will cost the $100 million, and the extra cost will be paid by employees and customers.
http://www.humanevents.com/2013/08/22/is-delta-bracing-employees-for-an-obamacare-shock/
JR, Your source is a conservative blog posting about a rumor being spread by a conservative radio personality. I'd hardly call that a reliable source.
But even if it were true, the amount suggested in your link equates to an increased cost of $0.62 per ticket.
From the link:
"To politicians like Barack Obama, $100 million is pocket lint, but of course they’re spending other people’s money."
You're right gadfly, it's only money. Someone other than the person who uses medical services will pay for it. Ever hear the term "death by a thousand cuts"? Each one by itself is minor, but add them up...
Oh, but wait - we all use medical services you say? Right, which makes the entire ACA model one big obfuscated mess. I mean, if we *all* need medical care and we *all* have to pay for it, ultimately it comes down to finding a way to extract *more* from everyone without them really knowing why they are paying more. Outright taxing the rich is too obvious I guess, so now the cost of OC will be born in higher prices in the products and goods we all use. The sad thing is that economists will see this as a good thing because the value of GDP will be higher, which coincidentally (or not) is one of the primary numbers used to demonstrate the health of our economy. So we pay more, earn less, GDP goes up, debt to GDP ratio looks better, the high costs of healthcare will be obfuscated, etc. The average Joe? Lol.
Since that's the obvious reality, why not just ditch the entire damn system and socialize it. We'd at least reap the benefit of having a single middle man rather than the layer after layer that we're getting now. But socializing it is outright theft by the many of the few and doesn't look good - can't have that now, can we?
Or we could actually look at the root causes... ah, forget it. Never gonna happen in our modern world of hide and seek politics. It's the trend my friend, the trend that is our enemy.
JR. the numbers are right but Delta, and the other companies, are using relatively sound numbers with fuzzy logic and conclusions basically to lobby to reduce a $63 per covered employee charge.
The $63 charge is to fund to stabilize the insurance exchanges and Delta is right, it is a tax for something they do not use since they cover their employees (so don't need the exchanges) but furthermore can not access the exchanges themselves to use them to cover their people (in case the exchanges have a better deal).
It is a bad deal for them and they should lobby against it; I guess the entire American public should pay a tax to cover it OR have the insurance companies pay for it since they are the primary corporate benefactors.
However, as my math for UPS shows, the $63 charge adds up to nowhere close to the millions of cost they are bemoaning and the many of the other cost numbers lead to erroneous conclusions. They are claiming $100M increase and the $63 charge equals $10M. The other direct ObamaCare charges are $1 growing to $2 per employee (see UPS above for example). That's 90M they estimate coming from non-direct charges many of which don't affect Delta, the corporation, directly.
The $63 surcharge declines in the out-years, $63 in 2014, about $50 in 2015, $40 in 2016 and ending in 2017 unless extended ----- by Congress. So, it is temporary, declining, and disappears in three years.
I will go through the rest of the costs declared by Delta later but, for the most part, they are not direct charges to Delta.
Some interesting information and a perspective:
Unlike other industrialized nations, the United States health care system is centered-around for-profit insurance companies and a mixture of for-profit and limited non-profit health care options. Dependency upon for-profit insurers contributes to the U.S. having the most expensive health care system in the world, consuming nearly 20% of the nation's GDP. By comparison, the public health insurance systems of the world's other industrialized nations are more effective and less costly.
The dominance, large profits, and life-ending practices of America's for-profit insurers are at the core of current efforts to reform health care. While insurance rates rise dramatically and the CEO's of America's largest health insurance companies pocket billions of dollars, the companies routinely deny coverage and refuse to pay expensive policy claims in order to increase profits. The result is the deaths of about 40,000 Americans a year (those unable to afford insurance, as well as those victimized by health insurer's refusal to pay policy claims), over one-half of all personal bankruptcies in the county (some three-fourths of the bankruptcies from insured individuals and families), and roughly 35,000,000 uninsured Americans.
National health reform efforts are targeted at ending free market insurance company death panels, reversing spiraling profits that come at the expense of customers, providing more affordable policies for individuals and families, and insuring approximately 95% of Americans.
For example, in 1993, insurance companies typically spent 95% of customers' premiums on medical benefits (this is called the "Medical Loss Ratio"). By 2009, many insurance companies were routinely denying policy claims in order to ensure that no more than about 85% of premiums were put back into medical benefits, while plowing the excess profits into executive salaries.
During the same time frame, Medicare has reinvested 97% of premiums into medical benefits. Yet in 2009, health insurance corporations posted a 56% average increase in profits (one posted a 91% increase) while dropping coverage for nearly 3,000,000 Americans. The health care reforms under discussion in early 2010 would deny excessive profits for for-profit insurers, mandating that 90% of profits be utilized for medical benefits.
Finally, the inherent shortcomings and problems of for-profit health insurance have also played out in the history of Medicare Advantage, a for-profit operated (and federally subsidized) alternative to government-sponsored Medicare. The for-profit insurance companies operating Medicare Advantage have spent tens of billions of Medicare (tax payer) dollars on executive salaries and executive retreats in Cancún, as well as enormous sums on marketing designed to lure more customers away from Medicare to the privately administered Advantage plans. At the same time, studies have revealed that the supposed benefits offered by Advantage are window dressing designed to maximize profits for the for-profit insurance companies.
Major For-Profit Insurance Companies in the U.S.
•Blue Cross/Blue Shield
Founded in the 1920s, Blue Cross/Blue Shield (BCBS) is one of the oldest health insurance companies in the United States. It is also the largest health insurance company in the U.S., providing services to about 1/3 of insured Americans through approximately 40 insurance plans. In some states, BCBS effectively has a monopoly on health insurance. BCBS spends roughly 82% of premiums on medical benefits.
•United Health Group
United Health Group, founded in the 1970s, offers health insurance plans to businesses and employers. United Health Group spends roughly 82% of premiums on medical benefits.
•Aetna
Offering health insurance plans and services to individuals, families, and government employees, Aetna (founded in the 1860s) began offering group consumer plans in the 1930s. Aetna spends roughly 81% of premiums on medical benefits.
•Humana
Humana specializes in offering group health insurance plans to employers. Humana spends roughly 84% of premiums on medical benefits.
•TriCare
TriCare focuses on offering insurance to military servicepersons and their families.
OK, had some time to run the Delta numbers but whenever you see a quote like Delta saying: "A $100 million increase thanks in large part to Obamacare and ancillary cost increases derived therefrom." the word "ancillary" should make you suspect.
Delta is crying about the $63 charge equating to $10M, a whine that I frankly think is appropriate to make and a just complaint against ObamaCare. But the average healthplan inflation at 4% adds a minimum of $400 per employee which equates to $64M in Delta's case so to JIT's point, the root cause of extra cost is the increasing cost of medical price inflation which leads the overall inflation rate by a good amount.
Then the story says: "Between ObamaCare’s mandated coverage for “children” of advanced age, and the individual mandate that will compel people to seek insurance who might otherwise have chosen to decline coverage, you can pour another $28 million worth of red ink on Delta’s books" OK, anyone have a problem with people wanting to be covered, whatever the reason? I call that the price of doing business and 50% of it was risk that was always on the table even before ObamaCare. The 8,000 kids that Delta is now covering costs them $14M. From Forbes: "According to Delta, these added children have higher-than-average health costs." Really? Does not work that way in the rest of the world that healthier people pay more. The additional people signing up, who could have signed up before ObamaCare is also $14M.
"And the “Cadillac tax” is probably going to wipe out their pilots’ insurance plans in a couple of years." --- Conjecture and innuendo, code word is "probably." Delta is upset because "Delta doesn’t like Obamacare’s “Cadillac tax” on high value insurance plans. But that’s because the tax is doing exactly what it should do: motivating employers to pare down on costly plans that drive premiums upward." So let me get this straight: Delta does not like the Cadillac tax because it will cause people to downgrade forcing Delta to pay less cost and save money to cover them. Methinks they speak out of both sides of face when they hate spending money and hate saving money both at the same time.
According to Forbes: "It’s not clear exactly how much of that sum is due specifically to Obamacare, and how much is due to health inflation and the end of Obamacare’s Early Retiree Reinsurance Program, a $5 billion fund used to encourage employers to continue providing health benefits to early retirees in the near-term" Well, I think that says it all, "not clear."
When you add up what Delta did say, they said lots of things add up to a $100M cost increase and they noted $38M attributed to ObamaCare. We know that about $64M can be attributed to health care inflation with or without ObamaCare and that much of this money, as we HLers all painfully know will come out of the employees pockets as increased out-of-pocket coverage costs.
So, the bottom line is that 38% of Delta's increase is ObamaCare direct charges, of which 99% of those increases are short term and disappear in 2017. And 62% are undocumented, however, equate to the normal health care inflation rates that we have been seeing well before ObamaCare hit the scene and MANY of which will be passed on to employees as increased out-of-pocket expenses.
Undocumented and fuzzy logic for sure.
Then they bemoan the expected uptick in insurance prices due to ObamaCare coverage regulations like out-of-pocket caps, actually insuring the sick, and then actually not stopping payments over time just because you got sick. However, NO ONE really knows whether ObamaCare will force insurance prices up due to additional (and in my book reasonable) coverage or will force insurance prices down due to additional competition and price/offer transparency.
I do not fault Delta for lobbying against the $63 temporary and declining 3-year charge; I do fault their timing, they had years to kvetch about this, and the fact that they obscure the true ObamaCare effect with faulty logic and hidden data diminishes the good argument they have. But when you see code words like "ancillary," remember, if it walks like a duck but talks like a PR guy, it's probably something you don't want to step in.
gadfly,
there are MANY sources reporting the story. But nice try.
Further, they have an actual letter from Delta stating that OC will cost them money, for no benefit. But you go on ahead believing whatever helps you sleep at night.
Is the Atlanta Business Journal "unbiased" enough for ya?
http://www.bizjournals.com/atlanta/news/2013/08/22/delta-warns-obamacare-will-cost-it.html
According to Delta’s letter, the Affordable Care Act is “anything but business as usual.” Due to Obamacare regulations, Atlanta-based Delta (NYSE: DAL) said it faces $10 million in new reinsurance fees, $14 million to cover employees’ children until age 26, $14 million related to the individual mandate provisions and other costs.
“...make no mistake -- the costs imposed on Delta and our employees are very real and they are escalating,” the letter reads. “The costs mentioned above, when combined with normal medical inflation and the end of the ERRP program mean that the cost of providing health care to our employees will increase by nearly $100 million next year. Delta will have to absorb the vast majority of that increase in costs so that we continue providing a high value, quality health plan, but some of it will have to be shared with our employees as well.
Somehow I don't really feel all that bad for Delta...
Oct 24, 2012
ATLANTA, Oct. 24, 2012 /PRNewswire/ -- Delta Air Lines (NYSE:DAL) today reported financial results for the September 2012 quarter. Key points include:
Delta's net income, excluding special items1, for the September 2012 quarter was $768 million, or $0.90 per diluted share.
Delta's September 2012 quarter GAAP net income was $1.0 billion, or $1.23 per diluted share, including mark-to-market gains on open fuel hedges and other special items.
Delta's unit revenues were up 3 percent for the quarter and the company has produced a unit revenue premium to the industry for eighteen consecutive months.
JR I explained the numbers above, the larger proportion is due to "normal medical inflation" and would have happened with or without the AHCA unless, as oft you are prone to, you choose not to believe a few decades worth of data.
However, of the $100M, Delta has a quasi appropriate AHCA gripe against $38M of which $10M for the $63 surcharge is a totally appropriate complaint, $14M to cover folks who choose not to be covered today is a risk that Delta has had on the books forever and is a silly gripe and $14M to cover adult children as part of the family is one we can debate for the ages but is a quasi gripe at best.
The $10M appropriate gripe decline every year and disappears entirely in 2017 so it will be a profit center starting in 2015 :>)
Meanwhile $62M of their lament is undocumented and unsupported in the letter, probably, if you believe them, due to health care inflation, and is not due to ObamaCare at all. Also, this cost will be shared between Delta and it's employees so they will not even eat all of it at corporate anyway.
See above for tedious detail including the part where I agree that corporations really should not be accountable for the exchanges, even short term. A valid complaint IMHO.
"if you like the health care plan you have right now, you can keep it",
"you can keep seeing the doctor you have now+
President Obama's broken promises he made to the American people as he pushed for passage of Obamacare
and;
the University of Virginia has no problem throwing Obamacare under the bus:
“Rising costs” are cited as the culprit for the spousal (and several other) health coverage policy changes:
The University goes on to blame Obamacare for an anticipated $7 million cost increase next year:
Provisions of the federal Affordable Care Act are projected to add $7.3 million to the cost of the University health plan in 2014 alone. Federal health care reform will create new costs related to the “individual mandate” that requires all Americans to have health care coverage (or pay a penalty).
.And, that doesn’t cover the taxes that will punish UVa for its “generous” employee health care offerings:
In future years, U.Va. could face millions more in taxes through the act if the cost of its plans passes certain thresholds.
“Ironically, by providing generous benefits, the University becomes exposed to a federal excise tax known as the ‘Cadillac tax,’” [UVa Vice President and Human Resources Officer, Susan] Carkeek said.
Effective in 2018, the 40 percent tax would apply to the cost of an individual plan with average premiums per employee topping $10,200, or $27,500 for a family plan.
The "wheels are falling off" the train wreck that is Obamacare, said Sen. Ted Cruz, R-Texas.
Cruz, speaking with Fox News' Greta Van Susteren on Thursday, further explained the problems with President Obama's health care law and the effects that it would have on the economy.
"We all know President Obama promised the American people: 'If you like your health insurance you can keep it,'" Cruz said. "And yet, every day that's proving less and less true. And I think the American people are ready to stop this, to stop the biggest job killer we've got in our economy."
http://washingtonexaminer.com/ted-cruz-on-obamacare-the-wheels-are-falling-off/article/2534633
Jr. I was incorrect. The source of the $10M figure was indeed the actual Delta memo. I read the aticle too quickly and was mistaken.
However, even if you accept Delta's number, it's still only an increase of $0.62 per ticket if they pass the cost on directly to their customers.
In this economy I thought the goal was to reduce costs to the masses because we are already too poor given the 99%/1% divide? So why so non-nonchalant about being forced to pay a blatant subsidy to benefit someone else? Why not just make a donation on your tax forms and donate what you want to help those in need? Or better yet, as I mentioned early why not just eliminate the game and have the government simply impose a tax us in the first place?
Regardless, I have a further question: If we should think nothing about paying an additional $0.62 in ONE TRANSACTION to cover the costs of OC for the employees of that ONE business, should we question the additional cost that, by the justifications presented here, *will* be passed along to us by every single other business entity we transact with? Think about the number of times we make purchases, then consider that every single purchase will now be higher for the same reasons given above.
So instead of fixing the reasons for the higher cost of care, all OC does is find ways - indirect and very costly ways - to pay those higher costs. Very inefficient and extremely detrimental to our already fragile economic system IMO. This isn't a solution: it's legislated theft using the illusion of benefit. By that I mean most people will view OC as beneficial because they are now getting something they weren't before, but those same people will very likely not see the slight-of-hand that is required to make those benefits available. Is it too much to ask for the full picture? Or should I just forget that there is a mechanism behind all of this that is severely dysfunctional? Probably, since it feels like very few are even willing to acknowledge the reality of it...
Remember, the goal was to provide Universal Health Care to all hardworking Americans so that no American goes down the financial toilet just because they got sick. The rest is process. But to think we could do this for free or to save money is just plain dumb. Once done JIT, we might be able to better focus on costs since we will have actually simplified the system. I won't say streamlines because we only took a step, not a sea change.
To your latest points.
"Or better yet, as I mentioned early why not just eliminate the game and have the government simply impose a tax us in the first place?"
I agree. Unfortunately, the law would not have passed if they did the transparent thing and put yet another payroll tax on us. IMHO that was the way to go and it was one of the preliminary recommendations. So instead, to please a few Congressmen, the concept is to pass the cost to the business and then each business would raise the price of goods and services and instead of a payroll tax, we would be taxed every time we buy a good or service. JIT, you were one to point out correctly, nothing is free and to get more, you have to pay more.
"So instead of fixing the reasons for the higher cost of care, all OC does is find ways - indirect and very costly ways - to pay those higher costs"
You are only focusing on the cost side, I have listed a number of cost savings over time and can do so again. You don't know that this indirect manner is more costly than a payroll tax; you are assuming that and turning your assumption into a fact. And you are assuming that business, when faced with an indirect tax, will be very costly which is also saying that business is ineffective at handling cost. Can't be true if you believe in capitalism. Heck, if the government taxed us instead, you would be assuming it was indirect and more costly just because it's the government. So who is better at efficiently handling cost --- business or government?
Just noodling with you because while the cost root cause is very important so is Universal Coverage as a root cause of family financial pain in America and where America frankly woefully lags the world in defense of its citizens. And the AHCA is foremost about Universal Coverage. But as I said, no one really knows whether it saves or costs, I have listed many savings before, but all you and the press right now are focusing on are some costs (most of which have absolutely NOTHING to do with the AHCA but get tossed in the hate bag anyway to fill it up).'
You bet your roots, toots.
So your position is that increasing the cost of a plane ticket from, say $400 to $400.62 is going to sink the economy? And since your talking about subsidies for other people's insurance, the real number is $10M, which would equate to an increase from $400 to $400.06. And that's only if Delta passes the entire cost onto consumers rather than making their employees pay a portion of it, as their memo claims they will.
I would agree that there is a reasonable criticism to be made of the $65 per insured subsidy that MG detailed above, but I don't think it's reasonable to claim that a increase of six cents in airfare is going to sink the economy.
Gadfly, please re-read my post. I couldn't care less, personally, about 6 cents.
Have you ever seen the movie Superman III? Richard Pryor's role is telling in that it's not the *one* instance that's the problem, it's the *sum* of the instances. Death by a thousand cuts doesn't even describe it.
How many companies time how many people? And you think we're only talking about 6 cents? Think bigger...
Actually using our math skills there's another way to solve for X than just saying "think bigger" which is scary but not really accurate. We can back haul the charges at the employee level and solve on a systemic basis.
Of course, since the money will ultimately be paid by purchasing goods and services, it will ultimately be based on a consumption model meaning those who consume more will pay more, those consuming less will pay less.
But we will work it as an average.
If you remember the story, O-care direct charges to companies are a temporary declining fee starting in 2014 as 63, about 50 in 2015, $40 in 2016 and disappearing in 2017. Anything else requires Congress to act. And there's a $1 rising to $2 charge. And that's per employee, not subscriber.
So, using our math skills, the increase would be, wait, let me get my abacus ----- in 2014 --- $64 per family, 2015 about 52, 2016 - 42 and 2017 - 2.
Those would be the average price increases, per family, we would be charged given a perfect cost-plus pricing model where only the direct cost is added to the price. If you believe the corporation deserves profit on each cost, and I do, then add 2% to 20% profit margin depending on the industry for a worse case of 2014/$78, 2015/62.4, 2016/50.4 and 2017/2.4. Anything else would be like Poppa John who plans to profit wildly and blame Obamacare all the way to the bank for his bad math (or greed, you be the judge).
So ask yourself, is Universal HealthCare for all U.S. citizens as well as the rest of the benefits of ObamaCare worth less than $50 per year to cover the costs? To me, it is.
Again, you said it best --- there are no free lunches and the piper must be paid if you want to hear the song.
Yes, you have a great point. If the $65 exchange subsidy adds $0.06 to the cost of a plane ticket, it will probably also add $0.0006 to a cup of coffee. Are you really using the plot of Superman III to make your argument?
You can argue that the subsidy isn't fair, but I think it's difficult to claim that is very significant.
mg,
The problem with your "math" (and I use that term loosely) is that there is NO WAY to know if it's correct or completely wrong. The US Govt doesn't even have the real math on this issue, it's simply to big, too intertwined with many other things to be able to come up with an actual number. All anyone has are guesses. There are economists who are saying OC will sink the country financially, and other economists saying it won't. Both expert opinions. Who to believe?
All I know is, I am for LESS subsidies PERIOD. Smaller govt PERIOD. Anything that grows govt is BAD, at least at this point in American history. I read small businesses closing because they can't afford OC; I read larger companies going to all-part-time employees because they can't afford OC, I read companies saying they have to raise prices to pay for OC. I read doctors quitting the profession because of OC. ALL bad things for the economy.
I haven't read one article yet that is at all convincing that this behemoth will work, or will be affordable to the country, or will improve the quality or quantity of healthcare. The only thing I read is "but more people will get healthcare." Emotion. Pure emotion. Not fact. Not statistics. And the facts and statistics aren't REALLY known anyway, since everyone has their own version of them. Because they can be EASILY twisted and spun in any fashion to suit your personal agenda.
You DO NOT know what is going to happen. Neither do I. NO ONE does. Anyone who says they do is either a liar or a damned liar. Or so arrogant they believe it's correct simply because they believe it.
Maybe the republicans will be able to defund it. Maybe that'll be a good thing. Maybe they won't. Maybe it'll go into full operation and that'll be a good thing. Maybe it won't.
We are just going to have to wait and see. I see a healthcare system that may have 30M more people in it, but with lesser care and longer wait times. I see the bad outweighing the good.
Guess we'll find out.
Darn, when I first read the "loosely" part I thought, "Oh boy am I gonna have fun with JIT's mistake," but it was only JR so same old, same old
Well, loose canon, be careful when you throw the BS that you don't catch the ricochet. First, the 'loose' math is accurate. The dollars are ONLY the DIRECT COSTS TO CORPORATIONS as the LAW states. No, I think the government knows exactly what the law says here. And I only used the direct costs, the same ones that UPS, UofV, Delta and others used. It was you that expanded the discussion beyond wht UPS, Delta, UofV and others have been talking about in order to offer your famed "I don't have a clue" scenario and therefore, ObamaCare is bad.
You could have argued that averages don't paint a real picture. You could have argued about real extra ancillary government costs like the .9% tax on income, taxes on healthcare companies like for medical devices.
But no, instead you go with the fear and loathing approach of second order effects where indeed, as I have stated over and over, no one really knows and everyone has an opinion.
So sorry, but when you use Direct Costs like UPS, UofV, Delta and others have; the numbers are in the law, and my math is correct.
You are wrong, really sorry.
"if you like the health care plan you have right now, you can keep it",
president obama
Again Gadfly - death by a thousand cuts. I think the fact that we are where we are today is enough proof of that concept. None of the indirect taxation we pay is significant, but surely it surely adds up...
JR --- yeah, yeah, that's what you said about Social Security and Medicare and now you will be the first one at the trough.
JIT: I agree that the ObamaCare temporary direct tax on corporations which is a hidden indirect tax to us based on consumption are a sham and its a shame that our legislators felt that this was the only way to pass the bill.
However, I do like that payroll is used for Social Security and that you can see it teased out on your receipts. Also like that you "earn" based on work --- seems like a great quid pro quo. So while not a direct tax on income, it does seem appropriate.
And many indirect taxes, like the gas tax, are really just consumption-based taxes. If they are used appropriately, like the gas tax being used for highways, it makes sense. If they just go into the general coffers OR are used for something else (like the ObamaCare temporary tax), it's a sham.
Bottom line, I think government, in its continuing effort to be transparent, should put out a "menu" of taxes and their purposes (end use) so we can all easily see where our representation has put our taxation. Otherswise, I guess it's "taxation without representation."
And the ObamaCare temporary tax on corporations which will force them to increase prices so results in a consumption-based tax on consumers is most certainly unfair to corporations and not all that fair for us either. Should just be a straight up tax from income.
However, in a perfect world, this equates to a small inflation in prices which would be natural to cover ObamaCare which, if you believe in Universal Coverage for our citizens, needs to be paid for. That said, going back to your other question and desire for lower costs, makes you wonder if using the insurance mandate is better than either going to a single payer, two payer system as well as allowing the government to compete in the health insurance market with it's own offer (even in the insurance mandate model that we have). All of these were voted down in the preliminary debates. Obviously you can see where the lobby was in that we don't have a government insurance offer (to satisfy the capitalists and the insurance companies) and we do have an insurance mandate (to satisfy the capitalists and the insurance companies). Strange that it's the capitalists that are getting upset, however, it's clear that the insurance companies are the big winners here. Otherwise they would be really batching about the expanded coverage.
That said, it is still clear that UPS, Delta, UoV, etc. threw the kitchen sink of cost increases into their PR swill the majority of which had absolutely NOTHING to do with ObamaCare.
Let's get back to JIT's root cause issue of health care costs but focus on the AHCA. We wills still focus on insurance but we get to medical procedure costs in a later tome.
It is estimated that 60% of all bankruptcies are due to medical costs. IF you believe that America should provide Universal Healthcare and to it's citizens as a basic right like defense, education, roads, etc., then we had three choices of provisioning:
Number 1: From TrueCost.blog Insurance Mandate: " The government mandates that all citizens purchase insurance, whether from private, public, or non-profit insurers. In some cases the insurer list is quite restrictive, while in others a healthy private market for insurance is simply regulated and standardized by the government. In this kind of system insurers are barred from rejecting sick individuals, and individuals are required to purchase insurance, in order to prevent typical health care market failures from arising."
This is the one we've chosen, using private insurers or state-offered co-ops where available, focuses on use of private for-profit insurance companies. Obamacare does not regulate or ration healthcare, it does regulate private insurance rationing and ends, by law, payment caps. It creates on-line insurance exchanges to increase insurance company competition and price comparison. These exchanges can not be directly used by business or government. It offers credits to low income coverage and is paid for by 21 different taxes.
However, in the AHCA provisioning, since private insurers are used, there is additional cost added for profit, marketing, and administration. There is no public option. Thus with just the addition of the 18-26 crowd, insurance profits are at record levels.
Number 2: Singe Payer System: "Single Payer: The government provides insurance for all residents (or citizens) and pays all health care expenses except for copays and coinsurance. Providers may be public, private, or a combination of both."
Number 3. Two Tier Payer System: "Two-Tier: The government provides or mandates catrastrophic or minimum insurance coverage for all residents (or citizens), while allowing the purchase of additional voluntary insurance or fee-for service care when desired. In Singapore all residents receive a catastrophic policy from the government coupled with a health savings account that they use to pay for routine care. In other countries like Ireland and Israel, the government provides a core policy which the majority of the population supplement with private insurance."
Of the 33 countries offering Universal HealthCare: 8 use mandate, 16 use single payer, 9 use two tier.
One of the hallmarks of the single-payer system is government provisioning to lower costs, simplify billing, basically take the profit and the cost's of marketing to make that profit out of the system and replace them with government "efficiency." And thus the rub, since most Americans don't believe that and the insurance lobby has help make that perception a reality.
Here are the pro's and con's:
http://www.citizen.org/Page.aspx?pid=577
http://www.medcohlth.com/the-advantages-and-disadvantages-of-single-payer-health-care/
I tend to agree that turning it over to the government does not guarantee reduced cost, but then again turning it over to the insurance industry adds costs too and to cover the poor in this manner means spending our tax dollars to make insurance companies rich. So what to do to solve for root cause of high cost?
Right now, according to healthaffairs.org from Kaiser report, Medicare has a 2% admin cost, insurance 17%. Medicare costs rising by 4.3%, insurance by 6.5% per year. Let's face it, once you take the 8% profit margin that insurance companies average, that's a lot of "cost" right there if you go non-profit.
The answer was always before us if Congress had the balls to act; it was the public option. IF Medicare was opened up as an insurance alternative for those who can not afford it, insurance companies would have to compete with a non-profit just like other industries. We all know that Medicare is not an insurance replacement, it is a basic safety net. That's why all those Medicare supplemental plans are available. And other regulatory and service offering constraints could be put in place to retain the viability of the insurance industry while lowering costs, increasing competition, and putting a safety net up for citizens not able to purchase insurance, which, IMHO, is the prime focus IF you believe that America should provide Universal Healthcare and to it's citizens as a basic right like defense, education, roads, etc.
Root cause cost effect of adding the public option: 87B per year: http://www.cnn.com/2009/POLITICS/10/21/health.care.cbo/
Why I don't believe that number, I do believe it cuts costs and provides the basic safety net we want for those who can not afford health insurance rather than having the rest of us pay so they can have the same insurance we do.
Obamacare Nightmare: Fraud Reports Surfacing
Regardless of how you feel about the health insurance debate, some industry insiders have argued that one facet of it is indisputable: the Affordable Care Act, aka Obamacare, is a great opportunity… to scam people.
Fraud.org, a project of the National Consumers League (NCL), issued a warning about fraudsters looking to capitalize on the confusion surrounding Obamacare.
Here’s what happens: Con artists call consumers, peddling fake insurance plans. The scammers say they need to verify personal information, otherwise the person on the other end of the call won’t get their insurance benefits. Or they’ll face fines. Or legal action.
http://finance.yahoo.com/news/obamacare-nightmare-fraud-reports-surfacing-110011821.html;_ylt=A2KLOzLMPh9SDAsA48CTmYlQ
And according to the FTC, it will get worse. Be prepared.
It is a shame that where's there's a way, there's a will: http://usgovinfo.about.com/b/2013/08/26/obamacare-card-calls-are-scams.htm
The weird part is that when you look at the 15% who are vulnerable, it is not exactly the market a scammer would go for. So it's probably the insured, the ones who don't need the exchanges, where they make the bigger hits.
Be warned, tell your friends.
mg-
I'll be "the first one at the trough"??? Explain please.
I find it ironic, since, being self-employed, I pay TWICE into SS and MC what everyone else does. Yet I will not be eligible for twice the benefits. Doesn't seem "fair" to me. Not to mention I pay into UI and AM NOT EVEN ELIGIBLE to receive it, being self-employed. More of your so-called "fairness" I suppose?
First pig in line to chow down the SS and Medicare government swill; probably will edge me out :>)
On the flip side, if you didn't pay both the employer and employee side of SS and MC, then you would be paying only zero of what your business competitors pay giving you an unfair cost advantage :>) But look at the bright side. You now agree with those snot-nosed whining liberals at Huffington Post: http://www.huffingtonpost.com/nancy-k-humphreys/self-employed-social-secu_b_2712265.html
Meanwhile on UI, NJ does offer a program for the self-employed from the US Labor Department which MIGHT even be used during start-up: http://homebusiness.about.com/b/2009/02/22/7-states-have-unemployment-benefits-for-the-self-employed.htm
Been offered since 2009, hope you didn't miss your window.
Citing Obamacare, 40,000 Longshoremen Quit the AFL-CIO
In an August 29 letter to AFL-CIO President Richard Trumka, ILWU President Robert McEllrath cited quite a list of grievances as reasons for the dissolution of their affiliation, but prominent among them was the AFL-CIO's support of Obamare.
"We feel the Federation has done a great disservice to the labor movement and all working people by going along to get along," McEllrath wrote in the letter to Trumka.
Citing Obamacare, 40,000 Longshoremen Quit the AFL-CIO
The ILWU President made it clear they are for a single-payer, nationalized healthcare policy and are upset with the AFL-CIO for going along with Obama on the confiscatory tax on their "Cadillac" healthcare plan.
The Longshoreman leader said, "President Obama ran on a platform that he would not tax medical plans and at the 2009 AFL-CIO Convention, you stated that labor would not stand for a tax on our benefits." But, regardless of that promise, the President has pushed for just such a tax and Trumka and the AFL-CIO bowed to political pressure lining up behind Obama's tax on those plans.
http://www.breitbart.com/Big-Government/2013/09/01/Citing-Obamacare-40-000-Longshoremen-Quit-the-AFL-CIO
mg,
There you go with your "new math" again...
Hey- I got an idea... this OC thing is really getting some bad press these days... we need a diversion... I know!!! Let's bomb Syria!! I know we already bombed out detroit, so we have plenty of practice....
What, you know math? Go figure he said with a snicker.
If you are referring to the SS, MC, unemployment payroll deductions and availability, I provided links so you could better understand. Not sure how the math is new and there's not even multiplication or division to trip you up. Just adding and subtracting.
As far as Syria, we'll let Congress decide whether someone should be punished for using chemical weapons on civilians as a precursor to selling them to whoever once Congress gets over their nap, returns, has a big breakfast, has show n tell for "what did you do on your summer vacation" and then deadlocks over the budget for this.
NTW --- no diversion except the usual circus stunts; can't wait to Peter King steps into the ring.
Wonder whether Kerry will bust a gut over all of this?
Another misleading article from Breitbart... The the AHCA is mentioned in one sentence of a three page letter, that explains why one union is splitting its affiliation from another. Meanwhile, it spends a page describing disputes offer strikes and changes in the industry technology.
When will the extreme right wing start being honest in this debate? That's a comment on the source, not the poster, although it'd be nice it people stuck to more credible sources or at least vetted the articles they post.
"When will the extreme right wing start being honest in this debate?"
When the extreme left wing does? Lol, not gonna happen.
As far as credible sources: When you find a consistent one please let us know! Again, not gonna happen. We just have to continue to cross referenced and keep information in perspective. Key word - perspective.
There's a big difference between cedible news sources with a bias and trash "media" whose primary tactics are to distort and mislead.
I know Gadfly. I just happen to hate the standard R vs L line. Would love to see everyone get past it is all...
JIT, once again, has it right, and said it better than I can... when we have some credible CONSISTENT sources, maybe we'll actually know HALF of what we're all talking about on this issue. Everyone is just GUESSING at best, and simply believing what they're told at worst.
Like I siad, if the thing is actually enacted and functioning, get back to me in 10-20 years and we'll talk... if you're still alive by then.
gadfly,
yes- you are right again. And there is not one iota of evidence showing that CNN, or Fox, or Congress itself is "unbiased". That is the entire problem. You're "credible" is my "biased", and vica versa. Really don't get why that's so hard to understand...
Yes, JR, I know it must be confusing for you. You clearly cannot discern a credible news source.
JIT, I would have added "left wing" to my statement if I knew they did the same, but I really have no idea what theyre saying. No one regularly posts their articles here.
Gadfly,
There IS NO 100% credible news source.
The fact that you think the left is always credible and the right is always misleading shows your own bias and makes YOU not credible. And unworthy of debate. If we can't even get past the FACT that ALL media is biased at this point in history, than we cannot move forward.
JR. That last post was so ridiculous that I don't feel the need to respond. Sometimes I wonder whether you're just playing dumb.
At least I'm just PLAYING dumb...
Goodbye Gadfly, you have shown you're no longer worth the effort. Perhaps you and mistergoogle should form a think tank.
Including yourself JIT, including yourself.
Where you see "the standard R vs L line" that you "Would love to see everyone get past it," I see wondrous diversity that I would never to presume to be above. Some pick sides on issues, not always right, not always left, and others pretend to rise above a choice.
this just in - jr is only 'playing dumb', as opposed to... wait, that's not playing, bub. you are very consistent.
rc-
Your post proves my comment. But I don't think you're clever enough to understand.
local report blames Obamacare for 125% premium increase:
A local report from Green Bay, Wisconsin says that health care premiuns could increase up to 125 percent because of Obamacare:
"Half a million Wisconsinites will soon have to open up their pocket books for health care coverage," says a local anchor. "And new estimates show, it may be costly. ... The state's office of the commissioner of insurance released estimates of how premium rates for individuals will be changing under the Affordable Care Act."
The second anchor adds, "Yeah, for people who have no insurance or who may not have insurance those numbers show a wide range of increases- from 10-percent on the low end to as much as 125-percent. And with the requirement for individuals to have insurance set to start in less than a month, the law remains controversial."
Adds the reporter, "According to the state's office of the commissioner of insurance, there will be drastic premium increases as a result. The office compiled date from 8 cities for $2,000 deductible plans for three different age groups. The study did not include the numbers of actual estimated costs, only percentages. In Appleton a 21-year-old's cost would increase 54- percent, a 40-year-old's about 37-percent, and a 63- year-old's about 32-percent."
http://www.weeklystandard.com/blogs/report-health-care-premiums-increase-125-wisconsin-due-obamacare_752709.html?utm_source=twitterfeed&utm_medium=twitter
Yawn. Probably, maybe, could be. You never know and neither do they. They actually say they don't really know. Gee-whiz, a Walker commission highballs ObamaCare pricing, go figure. And we always liked his math :>(
From Wis. Public Radio:
"A written statement from the commissioner's office noted health insurance cost comparisons are difficult." but not so for the Standard who will take a "probably" as gospel.
"While officials predict premiums will increase for most consumers, the rates do not take into account federal subsidies. Those tax credits will reduce the bill for as many as half those who buy insurance online through the newly created exchange." Darn, there's those pesky facts painting the full picture and getting in the way of a good spin again.
And why do rates go up under ObamaCare BDog? Might it be because ObamaCare, by law, forces insurance companies insure all people, not just the healthy ones (no preexisting conditions) who are willing to pay for insurance from companies that won't pay out if the insured actually do get sick above a preset cap. Yeah, actually using insurance to cover all people for getting sick without cutting them off if they do. It's a terrible thing :>( According to WPR:
"In addition to subsidies, the Affordable Care Act also changes insurance rules to the benefit of consumers. “This is insurance rates for everyone getting coverage no matter what – not just healthy people that are considered a good risk for the insurance industry,” says Robert Kraig, the executive director for Citizen Action of Wisconsin."
"A recent study by Rand Corporation found many states will see little to no change."
So what's Wisconsin doing wrong? Probably listening to Ohio.
In a related story from The Unamerican Nonstandard: "A loco-report from Nowhere, Wisconsin states that pigs might possibly actually fly probably due to Obamacare."
"According to the state's office of the commissioner of insurance, there will be drastic premium increases as a result. The office compiled date from 8 cities for $2,000 deductible plans for three different age groups. The study did not include the numbers of actual estimated costs, only percentages. In Appleton a 21-year-old's cost would increase 54- percent, a 40-year-old's about 37-percent, and a 63- year-old's about 32-percent."
BDog: all I can say is read my previous post.
Nobody knows the insurance premium effect from the AHCA and to believe something coming out of Walker's administration is like drinking either the Huffington or Fox Kool-Aid.
On your plus side:
1. AHCA has many new laws that require insurance companies to actually cover the insured. That concept will raise premiums. That's what the price increase is about.
Personally I say this is a good thing, insurance should be available to all customers desiring it and insurers should not cap payments at their desire or stop covering people if they get sick or not insure people who have been or are sick. What do you think?
On the negative or price decrease side:
1. 30million new customers or a 15% volume increase might lead to lower premiums if you believe volume reduces price
2. The insurance exchanges might lower prices by heightening competition and providing price transparency and services transparency
3. Once everyone is insured, there will be no point in Hospitals and others having disparate pricing for the uninsured and the uninsured using expensive ER facilities for "free" service that impacts all of our insurance will drop dramatically.
That's a few of the pluses and minuses where some "experts" say higher premiums, others, like Rand, say that many will see no change. And to rely on a report from Walker's administration which has opposed ObamaCare vehemently and has even turned down the Medicare component may be drinking the Kool-Aid, especially if you attempt to extend their thinking to the rest of the country. Rand looked at the entire nation for example.
here is a list (that keeps growing) of employers who are cutting hours and not hiring full timers because of the Obamacare mandates. the list is 258 employers so far and it is increasing . . . . . . .
ObamaCare Employer Mandate: A List Of Cuts To Work Hours, Jobs
http://news.investors.com/politics-obamacare/090613-669013-obamacare-employer-mandate-a-list-of-cuts-to-work-hours-jobs.htm
The investors.com job hour cut list is getting lots of play so I picked a name out of the hat, "Southern Illinois Graduate Teaching Assistants limited to 20 hours a week" from the list to research.
Here's the description of the job from their week site
"These assistantships are offered as half-time (50%) or quarter-time (25%).
•Half-time (50%) assistantships require 20 hours of work per week.
•Quarter-time (25%) assistantships require 10 hours of work per week.
Fall and spring assistantship appointments receive a tuition scholarship (waiver) if the appointment is for 75% of the semester (13 out of 17 weeks). All assistants receive a full tuition scholarship. Tuition scholarships pay tuition only; students are required to pay all their fees for the number of credit hours they are registered for in the fall and spring semesters"
First, why would I work more? Do I get more than a FULL tuition if I do? Like being double pregnant.
Second, unlike investors.com that stated the job "cut" has a date of action or report as of 8.13.2013, I found the policy in place as early as 8.2012 and would bet I could find earlier citations if I looked. It is a long standing policy, not a recent event.
Third, I can not find any secondary independent news sources or press releases sourcing the SIU job hours cut. Only sources linking back to investors.com can be found, including FOX.
So, on the first reported "job cut" that investors.com listed that I picked out of the had, I would say BUSTED.
One down, 257 to go.
258...
Trader Joe's drops health care plan for part time workers - http://www.huffingtonpost.com/2013/09/11/trader-joes-obamacare_n_3902341.html?ir=Politics&ref=topbar
To be fair, just pulled SubwayMaine cut hours story and it's valid; 50 workers will get hours cut below 30 hours due to OC. So is Mexican American Opportunity Foundation a valid cut in hours.
And the Trader Joe's story is even worse, they are not necessarily cutting hours, they are killing insurance that exists today for all part-timers believing that a $500 check and the Insurance Exchange will actually benefit their employees over the current TJ insurance coverage. How could they know that? Given the Trader Joe customer, this is an PR nightmare that we will have to see how it pans out. I might have to get my 2-buck chuck somewhere's else.
Given the 258 report, and even in light of countervailing backwards looking statistics, I would say the White House is wrong to call this a tempest in a teapot especially if this part of the law does not even take effect until over a year from now in 2015.
But it is a loophole, a leak, it should not be the iceberg that sinks this legislation. I just hope some Obama rocket scientist has a workable solution and not some 400-page workaround. Certainly they have had time to think about it.
BLD -
"But with low-wage workers eligible for tax subsidies to buy health insurance next year, the company has apparently calculated that offering medical coverage to part-timers who work 18 hours or more is no longer worth the cost.
"Depending on income you may earn outside of Trader Joe's" -- i.e., another job -- "we believe that with the $500 from Trader Joe's and the tax credits available under the ACA, many of you should be able to obtain health care coverage at very little if any net cost to you," Bane wrote in the memo.
So it's actually will be cheaper for part-time workers to buy medical insurance from exchange than buy it from company. What's wrong with that? Low income people will be saving money.
"What's wrong with that?"
Nothing at all. Sounds great, in fact.
And maybe that answers the question that BD's been ranting about: Why does it appear that many businesses are trying to get workers off of their health plans?
If you ran a company, why *wouldn't* you save yourself some health care costs if you knew your employees will be covered, possibly with better coverage, the costs subsidized by we-the-people? Heck, that would be a very easy decision to make. Is there anyone that wouldn't make that decision?
Lena and JIT: The problem is that TJoe's does not know, they are guessing. It's a SWAG based on PFM estimates. There are no insurance prices out there since there are no exchanges so anything they have is an estimate on a program that has seen numerous tweaks so far. Or try this, let TJ's run the number based on insurance estimates for Ohio or Wisconsin.
And to surmise: "Depending on income you may earn outside of Trader Joe's," to that I say "blow it out your ear, Joe," since you don't have a clue of my total income nor should you since the deal is: I work here and insurance was part of my benefit package and now it ain't. I am probably not better off. Much less whether I will be better off with your $500, some government credits and a TBD exchange-based insurance price they don't have a clue much less factoring in whether I make money on the side or not.
Next TJoe's will lower the hours by 50% saying "depending on the income per hour you earn outside of Trader Joe's, lower TJ hours can actually give you the chance to make more money."
Oh yeah, methinks they are going to have some PR triage to do on this one. Boneheads.
lol BLD, I'm usually the one pointing that out. The carrot-on-a-stick approach is almost always the method employed to get the population to move in the direction the government wants - nothing surprising there. But as you said, who will pay for it? IMO that has been answered trillions of times by now ;-)
this whole sad trend just tears at the fabric we know as middle America,
as this continues we become weaker as a nation,
again, those who currently have good jobs and good incomes are having a very hard time identifying with those around them who are struggling with part time jobs that have reduced or non-existent benefits.
all around us, day after day we hear more and more stories about good , hard working and self motivated people who are having their hours reduced and their benefits cut.
JIT/BLD: Yeah, I wondered where JIT was on payment via govt. dole on this one too :>)
It's a thorny one. First, if we go to root cause: if we believe that all Americans, as a basic right of being a citizen, should have access to medical and not be subject to financial ruin just because of falling ill, a basic entitlement right like defense, education, police, roads, etc., then at some point we all chip in for the common cause and pay for it. And we help cover those who can not afford to cover themselves.
Today, in the world, there are three known methods of doing this, they are posted above somewhere, but all require some sort of common funding. And again, America is the only modern nation that does not offer this right. We stand alone as the only nation who does not have a healthcare coverage as a basic right and entitlement.
Our medical market is broken, it does not work.. Our Congress is dysfunctional, they do not produce. Our charity systems do not adequately cover those who can not cover themselves. Taxes, any taxes, are an anathema to around 50% of our citizens no matter what for or how they are used. And the AHCA, in an effort to cover sick people, kids, pre-existing conditions without reimbursement caps, has elements that put upwards pricing pressure on insurance that may or may not be balanced by savings.
So we ended up here, with the AHCA, an insurance mandate system which is used successfully in much of the world but with a US payment plan to avoid taxation on personal income that is complex, convoluted, and now even contradictory. Because culturally business offers healthcare as a benefit, we tax business not individuals,, but attempt to let small business off the hook with a part-time and number of employees loop holes for small business. Then we define big business franchises, and multi-location big businesses as small business. On top, we offer tax credits, hand-outs, to those who don't have the income to pay for insurance. And now we are surprised that business is leveraging the hours/size loopholes (as they should if they are savvy business people) and now even attempting to leverage the handouts.
Then there is, I think, over a 100 other taxes like those on Cadillac plans, that have yet to hit in terms of adverse effects, if any.
The payment plan process for the AHCA will not work as is. It will artificially bifurcate hours worked above and below 30 hours, size of business above and below 50, and now with businesses leveraging costs by lowering wages so employees can receive government tax credits. This is not conducive to growing the economy and will skew hiring and free market employment activities.
It will be a devil of a problem to fix since we probably can't go back and do the right thing, set it up like SS or Medicare pay plans, but instead will probably, if we do anything at all, will just add to the complexity and convoluted pay plan.
I still say we need a health care plan for America but agree with BDog that the AHCA will certainly change negatively how America works in its current form because of the payment plan. The payment plan needs to be fixed but since half the Congress does not want to work on health care (or anything for that matter), undoubtedly the best that can be done is to polish this turd of a payment plan for something that is desperately needed to help Americans with our completely dysfunctional health care system.
A new survey of chief financial officers finds that American companies expect to increase the number of full-time employees by 1.8 percent over the next 12 months as key parts of the Affordable Care Act go into effect, undermining conservative critics who’ve argued that the health care law would hamper business growth and expansion.
“The expected two percent growth in employment is solid, given the context of long-run shifts away from full-time employees largely because of concerns about health care reform and economic uncertainty,” John Graham, Duke Fuqua School of Business finance professor and director of the survey, said. The poll, conducted by Duke University/CFO Magazine, surveyed CFOs at 530 U.S. companies.
The results echo broader indicators showing that companies are hiring more workers.
Payroll figures released last month, for instance, found that job creation at small companies has almost doubled in the last six months, “reaching 82,000 jobs at firms with 49 or fewer employees in July, according to payroll processor ADP.” Small businesses are borrowing more, displaying greater confidence, and are seeing higher “sales of new franchises.”
Though some businesses are claiming that they are hiring more part-time workers to avoid the Affordable Care Act’s employer responsibility requirements, which apply to companies with more than 50 full-time employees, that incentive is limited and research from Moody’s economist Marisa DiNatale indicates that most industries “are actually using fewer part-timers than last year.” The growth in part-time employment, which has been taking place long before the health care law, is rooted in “industries such as restaurants and hospitality that use as much as twice as many part-timers as other companies,” DiNatale concluded.
Some employers in the Duke University survey did cite the health care law as a impediment to growth, though concerns about economic uncertainty, the belief that the stock market is overvalued and will “experience a downward correction,” and rising interest rates were also mentioned.
MisterG - You fail to address another big problem. People need to be accountable for their own healthy living habits. It amazes me how many people still smoke after all the research and documentation that has been done to show the adverse effects of smoking. Why should the taxpayer have to pay for someone else's stupidity? If you want to smoke go ahead but don't ask me to pay for your health problems. The same for obesity.
"The results echo broader indicators showing that companies are hiring more workers... Payroll figures released last month, for instance, found that job creation at small companies has almost doubled in the last six months, “reaching 82,000 jobs at firms with 49 or fewer employees in July".
"Affordable Care Act’s employer responsibility requirements, which apply to companies with MORE than 50 full-time employees..."
And there is the rub yankeefan. Employers of less than 50 will hire up until they reach 49. Also, Duke's study doesn't show how many companies with more than 50 employees are saying they are hiring but in reality they are hiring offshore or hiring contract employees who they don't have to provide benefits to.
Unions’ Misgivings on Health Law Burst Into View and cast doubt on the president’s assurances that those Americans who liked their health plans could keep them.
from yesterdy's NYT's: (link below)
“If the Affordable Care Act is not fixed and it destroys the health and welfare funds that we have fought for and stand for, then I believe it needs to be repealed,” said Terence M. O’Sullivan, president of the Laborers’ International Union of North America. “We don’t want it to be repealed. We want it to be fixed, fixed, fixed.
“We’ve had our asses kicked on retirement security and we know our health funds are under siege,” he added. “We ask the president and Congress to do the right thing for the men and women we represent.”
The resolution asserts that the law, by offering tax credits to workers seeking insurance from for-profit and other companies in the exchanges, will place some responsible employers at a competitive disadvantage and destabilize the employment-based health care system.
Any erosion of health care benefits poses a singular threat to labor leaders, whose arsenal of tools to attract workers into union membership has dwindled alongside the decline of their organizations and their concomitant loss of influence around the country. Many unions and retirees have lost some benefits since the recession began, especially in the public sector as governments froze pension plans.
Mr. Taylor cast doubt on the president’s assurances that those Americans who liked their health plans could keep them.
“Under the way the A.C.A. has been rolled out by the Treasury and I.R.S. regulations, it will make it completely impossible to live up to that,” he said. “We think this is an example of unintended consequences. And it’s completely disheartening that the biggest earlier supporter of the president hasn’t gotten the same listening and benefit of big business with the one-year delay in the $2,000 penalty.”
http://www.nytimes.com/2013/09/12/business/unions-misgivings-on-health-law-burst-into-view.html?_r=0
BLD and Yankee: Hiring could still go up or down but the AHCA seems to be clearly having an effect around the 30 hour mark and the 50-employee mark and if TJoe's stupidity catches on, the income limit for health care tax credits.
If your work uses part-time, you will naturally look at 30 hours to reduce cost
If you employee count is near 50, you will naturally look at staying under the line
And if you are stupid, like TJoe's, you will lower salaries to poverty limits and tell your employees making less is a benefit because now they are poor enough to get tax credit for the insurance benefit you are taking away. (this one really does not make employer sense, I bet that guy gets a new job)
Point is, if you normally have full time employees or are aways above 50 employees, you will probably not attempt this. That' s why we are hearing it from the trades who focus there, like the colleges TAs, fast food, retail, etc.
Frankly, unemployment could go down but part-time and under-50 employee companies could increase all at the same time.
Still does not take away from the point that the AHCA may, and I say may, be making artificial market conditions for an increased 30 hour week and 49-or-less employee companies.
And there are ways to mitigate this and still follow the original intent of giving small business an AHCA break.. For example, they could invent the definition of multi-owner-small-large companies and force all these big businesses with franchises to offer the health care insurance from corporate to all franchises and thus treat them as an over 50 employee business. Corporate could pass the bill onto each franchisee and the problem would be erased.
But no matter what, somebody is buying the insurance, either the company as a benefit (and then we pay for it when we buy the product), the individual through the exchange (hopefully cheaper than today) or partly by us taxpayers via tax credits to those individuals who don't meet the income metric. So every time TJoes, so and so college, or Subway cuts hours, fires employees, etc. well then just belly up to the bar because you will now pay for that insurance via tax credits coming from taxes you paid that could have been used for something else.
There is no free lunch. And not to mention the other 100 taxes like the Cadillac plan tax that could affect the market and economy as well, probably minimal, but who knows.
And BLD, when you get too deep into healthy living and potential insurance ramifications, uh oh ----- do I hear the death list chant? First the smokers, then the fatties, then those who don't jog...... it's a slippery slope fer sure.
Like I said, the payment plan is convoluted. JIT likes root cause. I also say try to keep it simple and make decisions as close to the source as possible. So the AHCA is an insurance mandate. But in America, insurance is mostly a company benefit. Why? Because somewhere in the dark ages, some schmuck decided he could get better talent offering this perk and next thing you know we were off to the races. Seemed good since healthy employees seem to be more productive too.
But now we want to offer healthcare to all citizens as an entitlement but we are stuck with this stupid company-sponsored system. So we mandate insurance which means we mandate the company to offer something that used to be a perk, a benefit. That's not a system where the decision (buying insurance) is close to the source (the guy using the insurance). So when the company who now sees what used to be a perk as a fixed cost tries to lower their fixed costs, that decision is out of the control of the guy who should be paying for it.
It's stupid, convoluted and they just should have made it like SS or Medicare as a payroll tax and be done with it. You work, you pay payroll taxes and you get entitlements. And if you don't work, or are a kid, we could handle that via the same system too. But the Tea Party would have done a scanner's mind melt on that one so instead we pay the same money for the same purpose in this convoluted payment process that's gonna get more crazy before it gets sane.
That's what you get when Congress is dysfunctional.
Here's the story with a statement, versus hidden memo, about Trader Joes, IBM and UPS. This is different than just cutting hours, these folks are cutting the benefit. TJs replaces it with a $500 hand out and an example where an employee is better off under the exchanges. Well, if that is good for most of the employees, then it's good but TJs does not have a clue.
And check the anecdotal evidence from the Kaiser guy; these guys are supposed to be above the fray and analytical so for him to say: "based on what I see......." is stupid on top of TJs stupid. http://www.bloomberg.com/news/2013-09-12/trader-joe-s-sends-part-timers-to-obama-health-exchanges.html
In a similar but different manner, IBM is moving retirees to a non-AHCA insurance exchange providing retirees with contributions towards insurance. Part of an 8-year trend, it is hoped to lower employee increases due to health care rising prices. This is not caused by the AHCA but certainly the ACHA timing makes it easier for IBM management to make the move. It all depends on the contribution amount as to whether this is a good deal. http://online.wsj.com/article/SB10001424127887323893004579059393251153348.html
Bottom line is it doesn't matter whether you are part-time, in a 50-person company, or retired from a blue chip HUGE corporation; they are changing the benefits due to ever rising costs.
Getting to JIT's root cause question: why are US medical costs the highest in the world? And what can be done to put us at parity with folks paying less in other places?
Obamacare will monitor your SEX LIFE ?!?!..... I don't like OC to begin with, but this is effing ridiculous. Just another reason why it's got to go.
http://www.humanevents.com/2013/09/16/obamacare-monitors-your-sex-life/
This story stinks of BALONEY. You might as well print stories from the National Enquirer about how aliens are behind Obamacare.
Franchise owners come to Washington to plead for ObamaCare relief
Franchise restaurant owners have come to Washington seeking a change to ObamaCare that they say could prevent them from having to cut their employees’ hours.
Franchise owners say the employer mandate threatens to erase their narrow profit margins and are telling lawmakers they need to overhaul the law before it’s too late.
“Employees won’t have the hours they need, and they won’t get employer-sponsored healthcare, either,” said Steve Caldeira, president and CEO of the International Franchise Association (IFA).
More than 300 members of the franchise association are making the rounds on Capitol Hill to lobby for the ObamaCare changes. Monday’s visitors included IFA members from Mr. Rooter, McDonald’s and Dunkin Donuts.
Their top priority is a trio of bills that would increase the law’s definition of full-time employee to 40 hours per week. Members of the IFA have been instructed to ask lawmakers whether they will co-sponsor legislation “to give employers and employees relief from burdensome employer regulations?”
Bills supported by the IFA include the Save American Workers Act, sponsored by Rep. Todd Young (R-Ind.), and the Forty Hours is Full Time Act, offered in the House by Rep. Daniel Lipinski (D-Ill.) and in the Senate by Sens. Susan Collins (R-Maine) and Joe Donnelly (D-Ind.).
The franchise trade group has also launched a website, 40hoursisfulltime.com, to encourage visitors to lobby their lawmakers on the full-time threshold.
Worries about the mandate extend broadly across the business world.
Trade groups say the 30-hour standard could cause havoc in several industries that depend on part-time workers, including retail and hospitality.
“This is about taking part-time workers who were at 32 hours, 34 hours per week and limiting their work,” said Scott DeFife, executive vice president for policy and government affairs at the National Restaurant Association.
“You still have to cover the shifts,” DeFife said, which means more workers and training. “There’s an additional cost for each worker you bring on.”
“You could have someone come as in an hourly worker. They can work 25 hours one week or 40 hours another week,” said Christine Pollack, RILA’s vice president of government affairs. “It’s requiring stores to fundamentally look at who is working and how much.”
“This 30-hour issue is beginning to resonate on both sides of the aisle. Since it has been pushed off now for more than a year, it could mature before the end of this year, and we could increase pressure on the issue,” said Neil Trautwein, vice president for the National Retail Federation.
http://thehill.com/business-a-lobbying/322583-franchise-owners-plead-for-relief-on-obamacare-#ixzz2fD0UtSqW
gadfly,
the article has a doctor being quoted. Just because you don't like the information you see, doesn't make it "baloney'.
I don't know why you'd find it so hard to believe, we've already been thru this before, with healthcare providers asking "are there any firearms in the house".... something else that is none of their damn business.
From one of your no doubt favorite "impartial" (rofl) sources: NPR:
http://www.npr.org/blogs/health/2013/07/17/203031144/doctors-questions-about-guns-spark-a-constitutional-fight
We've been through this before too, too many times. You or BD post some crap incendiary story from a conservative fake media site. These stories are always fabrications based upon some kernel of truth, spun and stretched into something that appears like a shocking story that supports a conservative agenda. So, I do a bunch of research to show how distorted and misleading the story is, and you just shrug it off as, "we'll I guess it just shows that all media is biased." No. I goes to show that show should get your news from crap fake news websites whose whole reason for existence is to make up stories to push an agenda.
so NPR and the NYT don't have an agenda? you're kidding right?
you only see one side of the discussion,
ALL news organizations have a political agenda of their own making, every single report and every individual reporter brings a pre-determined spin of the facts to the table.
What's amazing on the "sex" questions is the speed at which a story from the NY Enquirer becomes fact through massive repetition by the radical right. The story indeed has a grain of truth and much fabrication, error and innuendo, but not one of the radical right journalists did any fact checking on the NY Enquirer. Rather than spend 5 minutes searching, they ran with it instead.
And JR picks on the leftist media for bias. Where's the retractions on this one? Not even on page 10.
who only sees one side, bd? you keep switching back and forth between bias and lying. real journalists reasearch facts and report them, to the best of their ability, without bias. they also have editors who help scrape away any bias in the reporting. your sources overwhelmingly either flat out fabricate stories or inject them with so much bias as to lead you to the pre-concieved conclusion you wanted to hear in the first place. one example- could be any given show, any given day on your beloved fox - http://www.motherjones.com/kevin-drum/2013/08/fox-news-economy-healthcare
gadfly is exactly right to call you out for failing to read, or at least failing to link to, reputable news sources; instead you grab opinion pieces from fringe sources, then claim 'the media' failed when you are shown to not know what you are talking about. it's sad that you have nothing better to do but spread lies and disinformation.
So, NPR isn't a reputable news source? I'm glad realitycheck and gadfly FINALLY admit that.
;)
No, YOU are not a reliable news source, nor, apparently, literate since your above conclusion shows zero comprehension of my previous comment. F'n pathetic troll.
it's sad that you have no tolerance for conservatives, christians, republicans or red state residents.
my, oh my, you really DO have it bad for me don't you Miss Check? how about a cup of coffee sometime, i'm not as bad as you make me out to be
i have never lied to you. not even once. and i read, i read a lot, from lots of different places not just your personally approved list of liberal outlets. I just have differing opinions than yours for which you have Zero Tolerance, (oh, the humanity!)
you have posted many liberal think tanks opinion pieces as unbiased and properly sourced that are just loaded with progressive agenda items as 'fact checked' (they aren't really), never knowing, understanding or acknowledging where the content comes from. how about a little honesty from you on that one?
i have in this thread quoted the NYT's in several instances, and they are pointing out many issues with Obamacare, and the Obama Administration, the 30 hour work week, the hurting that the middle class is suffering , guess you missed those,
and i have admitted when i made a mistake in judgment, and you (and others) use that honest admission as a sign of weakness, and further hurl vitriolic personal attacks at the guy who just admitted he was wrong. i have gotten used to progressives behaving badly over the years and getting away with it scott free (can you say 'Alec Baldwin'?), but i was hoping that you and Gadfly and a couple of others, might come to realize how you behave towards those whom with you disagree.
come on now, coffee is on the table and it's getting cold . . . . . .
i have no tolerance for dishonest statements, which is why i regularly comment on your posts. far from having a thing for you. get over yourself. i have never posted a supposed list of approved sources - your making up stuff as per usual. got a nice hot cup of coffee here so i'll pass on your cold stuff.
so you don't want the coffee then?
who is the arbiter of what's true or not? you? and from what i've seen, you do have sources that you trust, (blindly it seems to me), and sources that you don't trust, and it's just one dog's opinion that you are intolerant of views that are different than yours, imo, you have little room for personal differences on these topics and as a result of this intolerance for those around you who are oriented differently than you are, sometimes (not all the time) you behave badly towards them. (jmho, this is just one dog's opinion)
still like and enjoy a full conversation, so the offer for a cup of (hot) coffee is legit and still stands. . .
from the WSJ, (are they a legitimate news source RC? or are they liars and truth twisters? please let us know):
Walgreen to Shift Health Plan for 160,000 Workers
Drugstore Chain's Move Underscores Shifting Burden on Insurance
Rising health-care costs and a climate of change brought about by the new federal health law are prompting American corporations to revisit the pact they've long had with employees over medical benefits.
Walgreen Co. is set to become one of the largest employers yet to make sweeping changes to company-backed health programs. On Wednesday, the drugstore giant disclosed a plan to provide payments to eligible employees for the subsidized purchase of insurance starting in 2014. The plan will affect roughly 160,000 employees, and will require them to shop for coverage on a private health-insurance marketplace. Aside from rising health-care costs, the company cited compliance-related expenses associated with the new law as a reason for the switch.
Walgreen is the latest in a growing list of companies making changes to their benefits. International Business Machines Corp. IBM and Time Warner Inc. TWX both said in recent weeks they will move thousands of retirees from their own company-administered plans to private exchanges. Sears Holdings Corp. SHLD and Darden Restaurants Inc. DRI said last year they would send employees to a private exchange.
Since the 1940s, health benefits have been a key part of many employees' compensation. A long trend of rising health spending and a wave of changes to the health-care system are prompting many employers to rethink their roles in financing care for employees and their dependents.
But as companies set their contributions at fixed amounts to limit benefits spending, workers could wind up shouldering a greater share of the burden if health costs increase.
As the health law was taking shape, President Barack Obama said people with employer-sponsored health plans would be able to keep them. While the health law metes out relatively few requirements for big employers, its impact on the industry has created a climate of change.
The insurance landscape is shifting in other ways. Earlier this month, Trader Joe's Co. said it would end coverage for part-time workers. The privately-held grocery chain said in a statement it would give those workers $500 to buy insurance elsewhere.
In August, United Parcel Service Inc. said it would end benefits for 15,000 spouses of its employees who are able to get coverage through their own employers. UPS said Tuesday no spouses would become uninsured as a result of the shift.
http://online.wsj.com/article/SB10001424127887323527004579081563998551366.html
The best independent source of US domestic news is a foreign press as nobody in other countries cares about the cost of medical services in US or our other internal issues. If someone has so much free time on hand they need to learn foreign languages and start reading unbiased articles.
The AHCA effect, IMHO not based on stats but on anecdotal trend data, is changing businesses that rely on part-time and those with employee counts around 50 and, IMHO, that's a problem that needs to be addressed since 30-hour work weeks and companies artificially capped at 50 employees are detrimental both to the economy and the recovery.
But as I noted before, IBM health care changes for retirees were not due to ObamaCare but instead part of a trend taking place for the last 8 years. I don't agree with the PR flack, they lie. The trend IBM capitalized on started well before the AHCA. Walgreen too is part of this trend and while they can blame ObamaCare, in actuality they are just seizing the opportunity to say "not my fault." Most of the other large companies making changes are doing the same scapegoating, it makes good press and keeps the employees off their backs.
They can blame ObamaCare but corporations have been steadily moving in this direction for close to a decade. Don't be fooled by the glossy PR scapegoating. But because of the AHCA timing, expect lots more moves to private exchanges while calling OC the cause. Lots more. So sure, we can blame ObamaCare for the trend increase but remember, it was going to happen any way within 5 years.
Well before the AHCA, for years, let's face it, the company health care benefit has been seriously eroding. Everybody knows it, everybody feels it. Company health care as a benefit started in the 1940's. When I started in corporate America in the 80's, it was a 100% corporate contribution; today we pay through the nose to retain our coverage. Over the past ten years, insurance has risen 97%. Employee contributions have increased 102%. So when I started, my contribution was zero, today it is 30% of the total insurance cost.
Now companies are saying, to reduce costs, theirs and yours, they will provide contribution subsidies and access to their private exchange. Walgreen is using Hewitt, previously best known as a finance house for 401K management.
According to Walgreen: " submitted bids for monthly premiums for the private exchanges were roughly equal to its current 2013 rates—meaning some savings could come from the fact the bids didn't factor in year-over-year increases." That's right, employees can save money with this move! Believe it or not.
Unless you're smoking something, that translates in mistergoogletalk to: "u b ok doky this year, but next year we pass the more and more of the insurance increase on to you ha ha ha ha." But then again, that's what's been happening for a couple of decades. And the company will drastically reduce it's cost by outsourcing any remaining company management of the insurance benefit to the private exchange just like they did with much of the IT departments.
Think of it as insurance benefit management outsourcing.
Walgreens said: "another reason behind the private-exchange decision was offering employees more health insurance options." which mistergoogletalk translates to: We were too incompetent to manage 25 different offers like Hewitt can on their exchange.
But if this had not been going on for a long while, like eight years, then private insurance companies like Hewitt, Towers Watson's, Wellpoint, Highmark, BlueCross, ADP wouldn't be firmly established.
And thank goodness for ObamaCare establishing standards for basic health insurance packages and offers. Otherwise these poor schmucks would be buying insurance like getting a used car from Fast Eddy.
So sure, give ObamaCare the credit for speeding up an ongoing trend that started with increased employee contributions and now hits full ramp into the inevitable next phase of outsourcing the management. But don't be fooled, it's the bottom line of what you get and what you pay that matters, not whose name is on the letterhead of the offer. So, year one of outsourcing will probably look OK so you don't revolt, but expect that future years will look bleaker as the company keeps it's cost fixed and let's you take the increases, right in the financial shorts.
The next step is to say, "screw it, give me my money and I will roll my own on the ObamaCare health exchanges" and then cut Hewitt and the other outsources out of the profit picture. Just let the public exchanges get some test time on them and it will be obvious where you want to be.
Again, this outsourcing has been going on for years and has nothing to do with the AHCA except for the scapegoating and the publicity.
We come back to JIT's root cause of the problem ---- why does health care in the US cost so much more than anywhere else on the planet for results that are average at best?
Even if the AHCA is a freakin financial poesy, it's ability to lower costs is minimal. Even it hits a home run, it will not be enough. And the risk of the AHCA raising costs is possible if you just look at the enhanced (and in my book proper) insurance coverage's (like pre-existing conditions and no payout caps) price hike risk alone.
So if we don't get our hands around the root cause, we will take it in the financial shorts, whether or not the company retains it's health care insurance plan in house or whether it outsources it to a private exchange.
Brother Dog wrote:
"so NPR and the NYT don't have an agenda? you're kidding right?
you only see one side of the discussion,
ALL news organizations have a political agenda of their own making, every single report and every individual reporter brings a pre-determined spin of the facts to the table."
No, I do not believe that NPR and NYT have an agenda, I believe they have a bias. I believe the same about major conservative outlets such as Forbes and The Wall Street Journal. That is a distinct difference from many of the fringe internet-based (mostly) pseudo-news outlets who don't just have a bias, but seem to exist simply to distort facts and push an agenda.
When JR posts a story like the above, and it appears on muck-raking sites like Breitbart, Newsbusters, and the like, but not respected media sources like those mentioned above, there is a reason for that. Its not because the Wall Street Journal missed the story. Its because they, and other serious news outlets, are above printing such distortions.
I hope that clarifies my position. If not, I'm happy to expound on the matter. But, I'm not willing to research and dispute every single story that is posted on this forum from a clearly unreliable website.
...as opposed to the "clearly reliable" mainstream media who ALL said the DC shooting was an AR-15. Riiiiiiiight.........
Brotherdog wrote: (portions I am not responding to deleted)
"i have in this thread quoted the NYT's in several instances, and they are pointing out many issues with Obamacare, and the Obama Administration, the 30 hour work week, the hurting that the middle class is suffering , guess you missed those,
and i have admitted when i made a mistake in judgment, and you (and others) use that honest admission as a sign of weakness, and further hurl vitriolic personal attacks at the guy who just admitted he was wrong. i have gotten used to progressives behaving badly over the years and getting away with it scott free (can you say 'Alec Baldwin'?), but i was hoping that you and Gadfly and a couple of others, might come to realize how you behave towards those whom with you disagree."
First and foremost, you did admit when you were wrong last week regarding the 911 tweet. I respect and appreciate your doing so. Many do not do so, even when they know they are wrong. If we all followed suit, perhaps we could all have a more civil and more intelligent discussion. Also, I apologize. I did "pile on" after you admitted you were wrong. I don't believe I made a personal attack, but I did continue to point out your error. Frankly, I didn't initially believe you were being serious. I was wrong, and was probably being too cynical.
Second, regarding your first paragraph above. Obviously, I am only speaking for myself. You are in the habit of posting a lot of articles. As you should, you post the text and the link in order to clearly present the source. I have not questioned most of these. I might draw different conclusions from the articles than you, but i don't dispute the articles or sources in the majority of cases. But that doesn't mean that I forfeit my right to dispute a source posted by you or others that is clearly not a serious news venue. In fact, I think it lends credibility to my objection.
JR, I'll address your weak arguments in the thread that is actually about the DC attack.
Brotherdog wrote: (portions I am not responding to deleted)
"i have in this thread quoted the NYT's in several instances, and they are pointing out many issues with Obamacare, and the Obama Administration, the 30 hour work week, the hurting that the middle class is suffering , guess you missed those,
and i have admitted when i made a mistake in judgment, and you (and others) use that honest admission as a sign of weakness, and further hurl vitriolic personal attacks at the guy who just admitted he was wrong. i have gotten used to progressives behaving badly over the years and getting away with it scott free (can you say 'Alec Baldwin'?), but i was hoping that you and Gadfly and a couple of others, might come to realize how you behave towards those whom with you disagree."
First and foremost, you did admit when you were wrong last week regarding the 911 tweet. I respect and appreciate your doing so. Many do not do so, even when they know they are wrong. If we all followed suit, perhaps we could all have a more civil and more intelligent discussion. Also, I apologize. I did "pile on" after you admitted you were wrong. Frankly, I didn't initially believe you were being serious. I was wrong, and was probably being too cynical.
Second, regarding your first paragraph above. Obviously, I am only speaking for myself. You are in the habit of posting a lot of articles. As you should, you post the text and the link in order to clearly present the source. I have not questioned most of these. I might draw different conclusions from the articles than you, but i don't dispute the articles or sources in the majority of cases. But that doesn't mean that I forfeit my right to dispute a source posted by you or others that is clearly not a serious news venue. In fact, I think it lends credibility to my objection.
But gadfly, your definition of a "serious" news source is not the only valid definition. In fact, I'd say that in this context, "serious" = "whatever gets the ratings we want as a news agency". IOW, your sources support your biases, just as alternative sources support the biases of others. The majority of news reports are true within whatever context the authors is presenting them, but change the perspective and the same story takes on an entirely different meaning.
My definition of "serious" new is any source that isn't afraid to delve deep into the topic at hand. Even if the conclusions drawn by the source are bogus, more often than not there are very valid, and very real, facts presented. It's our job, and this applies to any news source, as the reader to discern the difference between biased conclusions and the facts used to come to those conclusions.
First and foremost we should keep an open mind, separating out the biases (especially our own) from the facts at hand. IMO
JIT: while I agree with you on this one, I would add that any serious journalist would check the facts with multiple sources before "republishing and rebranding" any story.
The "sex" story is a great example of bad reporting by journalists breaking their own performance code. If you google it, you can see it's start with the NY Post (not the National Enquirer, my bad) not exactly a bastion of multiple sourcing but better than the Enquirer. And then you see a slew of folks rebranding the original story clearly without checking the sources. So many people ran with the sex story that it almost blocks out the sun (and the truth) from any google search. Almost none of them checked facts.
For example, the same simple google will point out that the "sex" law is not even ObamaCare but instead another law altogether, a pretty basic factual error. There are others too that take less than five minutes to research; actually ten minutes today because of all the sun blocks.
"There are federal EHR requirements. But those are part of the HITECH Act (which was part of ARRA), not Obamacare. What Obamacare introduces is that insurance must now reimburse physicians for preventive services. These include things like STI counseling (which is why more docs may ask about sex). They also include lots of other stuff, especially for women and children. I’m fine with this, because these things work. They have evidence behind them. That’s why they’re in there. For years, we’ve paid for tons of things that don’t work, while not paying for things that do. This tries to right that balance." http://theincidentaleconomist.com/wordpress/doctors-not-obamacare-will-ask-you-about-your-sex-life/
That's a pretty basic error in the story being printed by "serious" journalists including Fox and Drudge who I guess saw the word sex and dropped their journalistic pants.....again.
Others who are miffed at the rebranding: http://mediamatters.org/blog/2013/09/17/doctors-as-sex-police-baseless-obamacare-lie-ju/195913
So my point is, yes I agree delving is good. Believe it or not, that's why I like John Stewart because he dares to delve where angels fear to tread. He sees angles in the news that I can not even imagine, and often they are quite insightful (and funny too). But along with delving or even for basic coverage, checking the facts and multi-sourcing are at the heart of professional journalism.
And both were missing by vast majority of journalistic wannabees covering this story with the primary reason being it included the word SEX.
Please forgive me if this has been asked and answered. The thread is too long for me to go back and read all communications. The 2000+ page healthcare bill was passed without being read by all who voted for it. The senate leader, at the time, said “We have to pass the bill so that you can find out what is in it.” Why? Why would they pass a bill so huge without reading it and understanding it first? Can anyone please tell me why we shouldn’t be extremely concerned?
Concerned citizens are the heartbeat of our system. Stay concerned, but better yet, do something.
As far as Pelosi's famous sound bite: works for me! Wanna buy a bridge.
Not that it helps much, but here is the defense: http://www.washingtonpost.com/blogs/post-partisan/post/pelosi-defends-her-infamous-health-care-remark/2012/06/20/gJQAqch6qV_blog.html
I am not looking for clips, articles or anything from any media outlets. I would like to know if anyone on this thread can tell me…Why?...why was this 2000+ page healthcare bill passed and made law before it was read and understood by those who voted for it. Why is that?
lizat,
I know, sounds unfathomable, right? Mind-boggling. They did it because they COULD. Political favors were exchanged behind closed doors, money was going into people's pockets, and most of the elected officials don't give a damn about what the American people think, because we are too stupid to think, which is why we elected them in the first place.
Arrogant, corrupt, disgraceful.
The only opinions they care about are those who will continue voting them into office. And to accomplish that, they have created an entitlement class. Give stuff to the people, and they keep voting for you, so you can give them more stuff. These politicians don't actually care what happens to the country, they only care about their "careers", they money THEY get, the lifetime free medical they get, the ridiculous pensions they get, all the power that comes with the job, the superiority.
Almost the whole of government needs to be flushed down the toilet. I would recommend a different and inevitable course, but I don't want the FBI knocking on my door. ;)
lizat, a few observations:
Unfortunately, it is common for legislators to vote for bills they haven't read or fully understood, Happens all the time. It is similar to when you are given, at a real estate closing for example, a whole bunch of paperwork to sign, and someone tells you what you are signing. Many people don't read it. Sometimes there is no time.
The reason the bill is so massive is that there were so many interests to take care of, and perceived protections of one sort or another to include. Like sausage-making, the process included the good and the not-so-good. Even among those who voted for it, no liked it all.
jd2 And while I don't expect every politician to actually sit down and read every word of a bill they are going to vote on, all of this "discovery" that has been happening, all there changes, over the last year, ALL of this should have been DONE BEFORE VOTING ON THE BILL. Any bill that takes over 7% of the economy needs to be read, studied, vetted, and fully understood before being voted into law. Any other course is either corruption or madness.
JR is describing the way these things should work. Everyone would agree they should work that way. Kind of like we know all the ways we should be perfectly living our lives.
For some reason reality keeps intruding harshly.
uh, not one shred of proof has been offered that anyone who voted in favor of the bill didn't read it. also, it was available, in full, online, for everyone to read for weeks ahead of being passed.
"reality".... I don't think so. There's simply NO good reason or excuse for passing something into LAW before you know EVERYTHING it says.
It's just common sense. Which is what reality USED to be. I don't care if it's a healthcare bill, a gun control bill, an abortion bill, a freedom of speech bill, .... KNOW WHAT THE HELL IT SAYS BEFORE VOTING ON IT. Anything less than that is irresponsible at BEST, and corrupt ant WORST.
Very true jd2. But when reality does harshly intrude, do we choose to continue to work toward the ideal (hard way) or simply acquiesce for the sake of expediency (easy way)?
Different perspectives, different takes on the subject. Who'd have thought that? ;-)
BTW, I agree with JR on this one. There is NO excuse for our representative to be clueless on the bill they are voting on. ZERO excuses.
Also irresponsible is the obfuscation of many different goals into a single bill. One goal, one bill. If they don't like it they can get a different job. Just because that's the way it works today does NOT mean that's the way it should work. Let's change it by voting out those who justify the practice.
Not to be a stickler for the facts but:
What favors were exchange by who to who behind closed doors over ObamaCare?
Who put money in who's pockets over ObamaCare?
And since ObamaCare is a Republican invention, did they get the payola? (They probably have not read it to realize it was their idea)
And we all know the famous Pelosi gaff about reading the bill, but Jr, who did not read the bill (and remember, you can't count Congresspersons who had experts and specialists read it on their behalf just like the C-suite does).
I think there is a much greater chance that no Republicans, beyond Cruz, read the defunding bill before they voted. Otherwise, after 40 or so attempts, one would think they would get the wording right.
And if you didn't realize this sea-change bill would be tweaked as we learned more, then you didn't listen to your President when he told you that was the case and that we should always welcome change for the better.
Seriously though. Why is it that all the developed Nations in the world provide universal health care to their citizens and we have such problems getting started. Is there anyone who does not want to do this, in some way and in some manner. And why is it that so many countries have sucessfully implemented the insurance mandate and yet we believe we are not capable of making it work? And why is it that the ones leading this negative charge don't have a clue as to how to make it better, a better alternative, or better yet ----- any workable alternative whatsoever?
Empty bags of hot air.
Meanwhile, it's coming, get ready, here's what you HAVE to do: probably nothing!
http://www.huffingtonpost.com/2013/09/23/obamacare-change_n_3975425.html
And for the good news:
http://www.dailykos.com/story/2013/07/17/1224407/-Obamacare-Is-Working-Believe-Republican-Naysayers-At-Your-Peril
http://www.nytimes.com/2013/05/27/opinion/krugman-the-obamacare-shock.html?_r=0
gadfly,
I didn't see it until now- it wasn't in my feed. Happens here sometimes.
I can find no evidence that the HC bill was online for "weeks" before the vote; all I can find is evidence that is was NOT online, in it's entirety, even 72 hours before the vote:
http://mediamatters.org/research/2009/11/06/right-wing-media-falsely-claim-pelosi-broke-ple/156650
And besides that, all you need is Pelosi's quote "we have to pass the bill before we can read what's in it" to know how very corrupt these people are, how much they DON'T want the public to REALLY know what's in the bill, and how much the care (none) about our opinions on the matter.
And this isn't a right vs left thing for me; it's about representatives doing their JOB. REPRESENTING us, instead of telling us what we can and cannot do. Just to show my lack of bias in this matter, I feel the same way about Bush's Patriot Act.
Besides Pelosi's stupid comment especially when taken out of context, if either the House or Senate did not have a good idea what was in the bill, they are stupid and should be fired. JR still can not pinpoint anyone who did not read the bill and somehow uses Pelosi's comment as proof positive, like she is speaking for the Republicans too. There's a concept. She was actually targeting the Senate who did not have their own version of the bill working and passage in the House was the only way to get a working version in front of them.
Here's the history of the bill starting in 2/09 when Obama announces we are going to do something, followed by the first bill in July of 09, followed by the Houser version (the Pelosi quote) on 11/7/09 with the Senate using until 12/24/09. That's 4 months that the bill was kicking around the House and 7 weeks for the Senate. Like no one ever picked it up during that time. Right.
http://www.cnn.com/2012/06/28/politics/supreme-court-health-timeline/index.html
Read the entire text from Pelosi and see if she says, "no one has read the bill."
Sure, I agree that bills should be read. Absolutely.
And yet, I'm pretty sure that if I were in Congress, or JR, or JIT, each one of us would from time to time be voting on a bill without having read all of it. Sorry, guys. :-(
Many say this shows that the people involved are corrupt. I would say that the system has become corrupt over time and it is very hard for even good people to change it.
But they should keep trying, absolutely.
" I would say that the system has become corrupt over time and it is very hard for even good people to change it."
Well then, it's high time for TERM LIMITS. If it's good enough for the president, it's good enough for every member of congress.
I'm sick and tired of "that's just the way it goes" being used to make irresponsible and/or corrupt actions acceptable.
I haven't payed attention to news in a few days... it seems the house voted to defund Obamacare and instead to fund the government to keep it running. I realize alot of this is BS political crap, but I find it interesting it even passed. It'll never pass the senate of course, but I still find it interesting, that the body of government that represents the country by population, succeeded in a vote to defund Obamacare.
mg, thanks for the link to the timeline.... I still don't see where the PEOPLE had access to the bill except for about 72 hours before the vote? The governing bodies having access is one thing, but there's still the nit that we have to trust what they are telling US is the truth... that's a pretty big nit, especially when you have 2 sides screaming the other side is lying.
As for Pelosi, this sums it up- one sentence. There is no "context." She said it, she regretted saying it as soon as the words came out of her mouth, no doubt. The contempt they have for the people is appalling. The level of stupidity they think we occupy.... well, I guess some of us do- otherwise how could "Jersey Shore" ever be on television....
http://www.youtube.com/watch?v=hV-05TLiiLU
JR wrote:
"I haven't payed attention to news in a few days... it seems the house voted to defund Obamacare and instead to fund the government to keep it running. I realize alot of this is BS political crap, but I find it interesting it even passed. It'll never pass the senate of course, but I still find it interesting, that the body of government that represents the country by population, succeeded in a vote to defund Obamacare."
Apparently it's been more than a few days. The republican congress has accomplished less then the infamous "do nothing" congress of the late 1940s, but they have managed to find time to vote to repeal the AHCA. In fact they have found time to pass it 41 times. Fourty-two, if you count this latest attempt to hold the country hostage over an issue that they do not have the votes to win legitimately.
Voting to repeal is not the same as voting to defund. You are incorrect. I said voted to DEFUND.
So, you know that they voted to repeal the ACHA over forty times, but your surprised that they would vote to defund it?
I know you keep trying to "get me", gadfly- which is why it's no use discussing anything with you- rather than stick to the ISSUE and debate it, every post you make is attempting to slight ME, thereby (supposedly) slighting my message. Classic Rules for Radicals. When you can't debate the point, attempt to destroy the messenger.
Move along.
Sorry if you feel that way, JR, but the entire point of your post was that the Republican Congress's vote to defund the ACHA was remarkable. I was just trying to demonstrate that it was business as usual for this Congress.
The remarkable part is that they are willing to hold the nation and the economy hostage over the issue, or at least they seem willing to do so. The same ploy didn't work so well for Newt Gingrich and company back in the mid-nineties. How far do you think they'll take it? They're in a tough spot. Lose support from the far right if they cave, but lose support from everyone else if they shut down the government.
"willing to hold the nation and the economy hostage over the issue"
Those are the administrations words Gadfly. We've certainly heard them repeated ad nausium...
http://research.stlouisfed.org/fred2/graph/?s[1][id]=GFDEBTN
http://research.stlouisfed.org/fred2/graph/?id=TREAST,
http://research.stlouisfed.org/fred2/graph/?id=M2V,M1V,MZMV,
research.stlouisfed.org/fred2/series/GFDEGDQ188S?cid=5
research.stlouisfed.org/fred2/series/TRP6001A027NBEA?cid=33026
research.stlouisfed.org/fred2/series/A063RC1A027NBEA?cid=33026
and on and on and on...
(please add the prefix http:// where missing - can't post with them)
Tell me again who's putting us in a tough spot gadfly? I suppose we could all follow blindly without any consideration for our current situation, but healthcare put in context as a single part of the whole the story is a bit different, wouldn't you think?
Oh, but JIT, I'm not blindly following the administration. I'm listening to Republican Party leaders like John McCain, Mitch McConnell, and John Cornyn. Also, the GOPs most recent presidential candidate, Mitt Romney, and Mr. Gingrich, the last guy to try this stunt.
I've said it before an I'll say it again... over government was DESIGNED to either be able to come to a consensus or in the event they can't, do NOTHING. Which is the point- if enough of the country can't agree on an issue, then NOTHING should be done until a consensus can be reached.
Besides, we all now this stunt (along with many others pulled by both parties over the last 224 years) is nothing more than the "blame game." We're sick of it. BOTH sides are sick of it. Anyone with half a brain is sick of BOTH parties at this point.
Besides, a govt shutdown isn't that big a deal....
Congress keeps getting paid.
Unemployment benefits keep getting paid.
Welfare keeps getting paid.
Food stamps keep getting paid.
Medicare and Medicaid keep getting paid.
So, you see- the people in power- and the people who put them there- all keep getting paid. That's all that matters. At least until the bus drives over the cliff...
gadfly, yes, I think Obama has said those exact words. But that wasn't the point. Both parties were instrumental in those graphs - *that* is the point.
The fiscal perspective is quite valid. Restraint is not evil.
I find it amazing that in this morass of "do nothing" that America is the one developed nation on the planet that does not offer universal health care to its citizens. Are we right or are we wrong?
Universal Health Care has been offered for over a century in some places. The insurance mandate is used successfully in a number of countries as the process to do this. Yet America can not make it work. Aren't we the country that gets things done?
And the opposing parties, Tea and Republican are willing to shut down the government, which as JR says, keeps us running, but what he misses, again, is that stopping payments, like on the debt, will risk our world credit rating, which --- if it falls again ----- like it did the last time the Tea and Republicans did this ---- our debt crisis will be a tempest in the teaparty pot compared to falling off that fiscal cliff.
That's the problem when you're a world economic super power. People actually take you seriously and, believe me, they take their own investments in you seriously. If you screw with the economy, even just to make a meaningless point, people take your frivolous actions seriously and dump their investments.
Imagine buying a stock, and the company decides to defund major projects. Will the stock rise or fall? Will it come back after the company says, "hey, we were just sending a message, we probably won't do it again...." Not bloody likely.
And if that doesn't hack you off, then think about all these JR types who cling to their notion that the Supreme court has blessed the individuals right to bear popular arms as sacrosanct but refuse the same Supreme courts blessing of ObamaCare as being Constitutional. Freaking hypocrites willing to ruin our good world credit over some misconstrued belief instead of pitching in and providing universal health care, like every other single developed nation in the world, and making the Constitutional process, ObamaCare work.
We used to be the best nation as making things, and making things work. Now we are the world's joke in how we behave.
Now we are best at doing nothing and making things worse.
And there is a whole tea party that only works at finding ways to do nothing. It's like a Seinfeld episode for the world to laugh at, and then cry.
.
not rubber stamping everything the president wants is part of our system of checks and balances. correct?
BD,
no- it's obstructionist. If you are against anything Obama wants you are a racist. Where have you been???
Against Bush's war? Against the Patriot Act? You're a concerned citizen.
Against Obama's war? Against Obamacare? You are a heartless, unsympathetic, obstructionist racist.
thanks JR, at least now i finally know who i am, :)
btw, too many falsehoods are being presented as 'fact checked' when they are not
Just run productivity stats against this Congress to measure how poor they are at doing anything except nothing. And you are paying them for working hard to do nothing.
If you believe doing nothing is progress, well, then you're my Huckleberry for sure.
We're already paying for MILLIONS to do nothing- it's called welfare- what's several hundred congressmen in the grand scheme? WHAT DIFFERENCE DOES IT MAKE?
I think you are wrong to say Welfare does nothing. I think Welfare helps some people in a time of need.
I think you're wrong to say Congress can not make a difference. I believe government has done some good things too.
I just called Sen. Menendez’s office to tell him if he won’t defund the ACA then he and his staff need to join the healthcare exchanges with the American people WITHOUT THE TAXPAYER SUBSIDY they’ve been given by President Obama. I spoke to Mrs. Gwen Smith who answered the district phone: 973 645 3030
Um... Lizat. I'm sure the Senator already knows that....and there isn't a subsidy, unless that's what you call all employer contributions to healthcare plans.
I didn't say welfare does nothing. I said we're giving to people who do nothing.
And I didn't say congress can't make a difference. I said if the government shuts down, everybody will still be getting their money, including congress, so what difference does it make? (only HALF tongue-in-cheek)
Congress has nothing to lose. Because they are CAREER politicians (which was NEVER intended for this form of government), they have no skin in the game. Even if they never get re-elected again, ONE term in Congress give you a pension to live on for the rest of your life, as well as free healthcare for the rest of your life. They simply don't have anything to lose, except power, ego, and well some money. THAT is the problem. They're just playing a chess game- and the American people are the pawns.
Boy, I bet they loved that call. Look a right-wing blog reader, or was it Forbes.
First, it's not a subsidy, at least no more subsidy that the subsidy we get called insurance benefit if we work They have taken the benefit dollars they were paying to the govt. insurance plan as a benefit and putting them to the insurance exchange plan basically as a benefit. There is just no way for the government, or business for that matter, to make a direct payment to the insurance exchanges as they do today to private insurers.
And President Obama had nothing to do with it, it was the Office of Personnel Management that made the decision and cuts the checks.
This is just like the benefit we get from our employers, which soon we may, like Congress, be forced to use either in a PRIVATE exchange or the public exchange. It seems to be an up and coming trend, even before ObamaCare to start using private exchanges (read above)
So get ready and enjoy lizat
"And President Obama had nothing to do with it, it was the Office of Personnel Management that made the decision and cuts the checks."
you're dreaming again or dizzy with your own spin, (you just gots to slow dwon mr g, i fear for your health) or you are possibly in complete denial.
obama brokered this deal just like he did with the major corporations out there, the only ones who have to pay full boat are the middle class, (again)
or are you going to maintain at all costs to your personal credibility that whatever happens in Washington has absolutely nothing to do with President Obama?
which way is it?
"and there isn't a subsidy"
Umm, why would Congress be voting to defund a program if it wasn't being paid for with taxpayer funds?
JIT, I think if you look again, you'll see your conflating two issues. Lizat stated that there were subsidies given to congress, staff and federal employees, and I was correcting that error. You're referring to subsidies for low income people. Yes those subsidies will exist as part of the AHCA.
jr said - "It'll never pass the senate of course, but I still find it interesting, that the body of government that represents the country by population, succeeded in a vote to defund Obamacare.". false. democrats won the popular vote in the house by 1.4 million votes, but due to gerrymandering the republicans kept their majority.
"House Democrats won a plurality nation-wide by over 1.4 million more votes (1.4%),[6] but the Republicans were able to retain a 17-seat majority due in part to their advantage in the congressional redistricting process following the 2010 United States Census,[7][8][9] and because many Democratic votes were concentrated into urban and minority districts.[10] Both parties had opportunities to redraw congressional districts in their favor, but since the Republican Party won an overwhelming amount of state legislature seats around the country in the 2010 midterm elections,[11] it provided them with an overall advantage.[12]"
source - https://en.wikipedia.org/wiki/United_States_House_of_Representatives_elections,_2012
Well BDog, maybe he made a call or had one of his henchmen make a call, but you'll never pin it on him :>)
Fact is this was a technical problem in that the FED, nor any business, can directly fund insurance through the exchanges. So the EXISTING benefit dollars could only be transferred by the OPM to employees to be used to buy the EXISTING health care benefit, but now provided via the exchange.
Now Vitter wanted to cut the benefit so Congress can be like the rest of America is another story, and a funny one at that (you just have to read that link I posted on it in the other thread, it's hilarious). But that's Vitter cutting the benefit, whether directly paid to insurers as it is today or to employees from the OPM to use the insurance exchanges.
Here's the really funny part. If Vitter gets his way, that better paves the way for business to cut our benefits since if Congress does not get heathcare benefits when working full time, why should citizens? I mean what are we working people gonna do about losing benefits, get a government job? Great guy, really thinking for the people.
Interesting read.
http://xfinity.comcast.net/articles/news-general/20130925/US--Health.Overhaul-Premiums/?cid=hero_media
Christine: good stuff and like I said, the proof will be in the price/service pudding and with so many plans and options, it will take a bit before the "experts" tell us what it means and before the "marketers" help us with the comparisons. So, I think you have to the end of March 2014 to sign up so you might want to wait till some of the dust settles and the reviews are in before jumping in.
Also, the insurance companies are targeting lower income consumers so many of the plans will be basic with reduced lists of servers and services. However, since one of the goals of ObamaCare is to raise the minimum bar (preventative procedure coverage, pre-existing conditions accepted, no caps on payouts, etc.), hopefully even the basic might be better than if left to the previous carpetbagger approach where the fine print could literally kill you.
And like I said, one way or the other much of the current fun will be over starting on 10.1.13. I mean the naysayers, like on this site, started with "I hate everything about obamacare." Now it's "I hate obamacare except for the good parts." and if the exchange prices are better than current, due to competition, transparency, and the rush to get new customers, they will be forced to say "I hate obamacare except for the good parts and the lower insurance prices ---- but I still hate it." Air might be starting to get a little thin up there.
It's days like today that confirm in my mind that I made the right decision 2 years ago to register myself as an Independent after being a Republican for 30 years.
Denis An interesting perspective...From an article by Thomas Edsall...
Ultimately, a conservative — in the classical sense — wishes to preserve a stable society. Of course, this includes stable institutions and observing the rule of law. For these reasons (and several more), a conservative prefers evolutionary, more incremental change to revolutionary change: revolutionary change threatens the stability conservatives seek to conserve. Hence, conservatives reluctantly accept change — so long as it isn’t revolutionary. They do so for the sake of stability and order. Moreover, for the sake of order and stability, real conservatives are amenable to political compromise with their opponents.
Conversely, according to Parker, reactionary conservatives are
backwards looking, generally fearful of losing their way of life in a wave of social change. To preserve their group’s social status, they’re willing to undermine long-established norms and institutions — including the law. They see political differences as a war of good versus evil in which their opponents are their enemies. For them, compromise is commensurate with defeat — not political expediency. They believe social change is subversive to the America with which they’ve become familiar, i.e., white, mainly male, Protestant, native born, straight. “Real Americans,” in other words.
Obama lied, my health plan died
Last week, our family received notice from Anthem BlueCross BlueShield of Colorado that we can no longer keep the plan we like because of “changes from health care reform (also called the Affordable Care Act or ACA).” The letter informed us that “(t)o meet the requirements of the new laws, your current plan can no longer be continued beyond your 2014 renewal date.”
In short: Obama lied. My health plan died.
Remember? Our president looked America straight in the eye and promised: “If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.”
Across the country, insurers are sending out Obamacare-induced health plan death notices to untold tens of thousands of other customers in the individual market. Twitter users are posting their Obamacare cancellation notices and accompanying rate increases:
Linda Deright posted her letter from Regency of Washington state: “63 percent jump, old policy of 15 yrs. cancelled.” Karen J. Dugan wrote: “Received same notice from Blue Shield CA for our small business. Driving into exchange and no info since online site is down.” Chris Birk wrote: “Got notice from BCBS that my current health plan is not ACA compliant. New plan 2x as costly for worse coverage.” Small-business owner Villi Wilson posted his letter from HMSA Blue Cross Blue Shield canceling his individual plan and added: “I thought Obama said if I like my health care plan I can keep my health care plan.”
Few among Washington’s protected political class are paying attention, because they enjoy their lucrative government benefits and are exempted from Obamacare’s destructive consequences. But one of my state’s congressional representatives, GOP Rep. Cory Gardner, also lost his individual market plan. Unlike most politicians on Capitol Hill, Gardner chose not to enroll in the federal health insurance program. He told me that he opted to participate in the private market “because I wanted to be in the same boat as my constituents. And now that boat is sinking!”
Gardner points to recent analysis showing individual market rate increases of 23 percent to 25 percent in Colorado. “After my current plan is discontinued,” he wrote last week, “the closest comparable plan through our current provider will cost over 100 percent more, going from roughly $650 a month to $1,480 per month.” He now carries his Obamacare cancellation notice with him as hardcore proof of the Democrats’ ultimate deception.
Maryland announced that its post-Obamacare individual market rates could also rise by a whopping 25 percent. The National Association for the Self-Employed is recommending that its small-business owners and freelancers plan for at least a 15 percent increase nationwide. One of the reasons for those rate hikes, of course, is that Obamacare’s mandated benefits provisions force insurers to carry coverage for items that individual market consumers had deliberately chosen to forgo.
Americans who had opted for affordable catastrophic coverage-style plans now have fewer and fewer choices. This includes a whole class of musicians, photographers, artists, writers, actors and other creative people who purchased health plans through the individual market or through small professional organizations. As St. Vincent College arts professor Ben Schachter reports in the Weekly Standard, groups like the College Art Association, Modern Language Association and the Entertainment Industry Group Insurance Trust are dropping their plans. Young, healthy members of these groups “are far more likely to see their rates go up — or to face the individual mandate penalties.”
Thanks to Obama, access is down. Premiums and health care spending are up. Research and development on lifesaving drugs and medical devices are down. Hours and benefits have been cut because of Obamacare costs and regulatory burdens by at least 300 American companies, according to Investor’s Business Daily. And the Obamacare layoff bomb continues to claim victims.
Obamacare is destroying the private individual market for health insurance by design, not accident. For hundreds of thousands, if not millions, of self-employed job creators, three fundamental Obamacare truths are becoming as clear as Obama’s growing nose: 1) You can’t keep it. 2) We’re screwed. 3) The do-gooders don’t care.
http://michellemalkin.com/2013/09/25/obama-lied-my-health-plan-died/
TOTAL BS
Michelle Malkin has worked as a Fox News Channel contributor since 2001, where she appears frequently on "The Sean Hannity Show," "Fox & Friends" and other programs.
Michelle Malkin has written four best-selling books: "Invasion: How America Still Welcomes Terrorists, Criminals, and other Foreign Menaces to Our Shares (Regnery 2002), "In Defense of Internment: The Case for 'Racial Profiling' in World War II and the War on Terror" (Regnery 2004), "Unhinged: Exposing Liberals Gone Wild" (Regnery 2005), "Culture of Corruption" (Regnery 2009).
Costs will vary widely from state to state and for different types of consumers. Government subsidies will cut costs for some lower-income consumers.
Across the country, the average premium for a 27-year-old nonsmoker, regardless of gender, will start at $163 a month for the lowest-cost "bronze" plan; $203 for the "silver" plan, which provides more benefits than bronze; and $240 for the more-comprehensive "gold" plan.
But for some buyers, prices will rise from today's less-comprehensive policies. In Nashville, Tenn., a 27-year-old male nonsmoker could pay as little as $41 a month now for a bare-bones policy, but would pay $114 a month for the lowest-cost bronze option in the new federal health exchanges.
Likewise, the least-expensive bronze policy would rise to $195 a month in Philadelphia for that same 27-year-old, from $73 today. In Cheyenne, Wyo., the lowest-cost option would be $271 a month, up from $82 today.
The Affordable Care Act marks a fundamental shift in the way insurers price their products. Carriers won't be allowed to charge higher premiums for consumers who have medical histories suggesting they might be more expensive to cover because they need more care. They will have to treat customers equally, with limited variation in premiums based on buyers' ages or whether they smoke.
Insurers also will have to offer a more generous benefits package that includes hospital care, preventive services, prescription drugs and maternity coverage.
For consumers used to skimpier plans—or young, healthy people who previously enjoyed attractive rates—that could mean significantly higher premiums.
The benefits are greater for people who previously were rejected for coverage because they were ill, or who were charged higher premiums. They are expected to find better coverage through the exchanges for the first time.
The concern for supporters of the law, and the administration, is whether enough healthy people sign up to balance the likely higher costs incurred by the sick and newly covered
oh, well, that's from michelle malkin's website, and she's a right-wing extremist liar who can't be trusted.
Michelle should learn how to read; you're giving us data we surmised in April this year or earlier. Don't these people even bother to reseach.
ObamaCare raises the bar for basic levels of insurance adding preventative services, essential services, pre-existing conditions, and limiting spending caps. If your plan did not hit the mark, and 50% of our plans do not comply, your vendor can update or cancel. Guaranteed they will have another plan to replace it. But most current plans do not comply: http://money.cnn.com/2013/04/03/news/economy/health-insurance-exchanges/index.html So Michelle's vendor opted to cancel and do-over. Probably because the fixes would end up looking like a new plan since Michelle's plan fell so far below the ObamaCare standard. Good shopping Michelle.
Of course raising the bar puts upwards price pressure on insurers. But the transparency of the exchanges combined with increased competition for new markets with subsidized consumers (free fast money for insurance companies) puts downward price pressure. Plus prices will now be transparent NATIONWIDE. It's a new dawn for consumer awareness.
Michelle also bought a really bogus plan where profits are high and patient spending is low, just look at these guys putting profits over people: http://www.sickofbluecross.com/profits_over_people/ Guess what --- the insurance exchanges will highlight these outages like picking out JR at a Biden gun control rally. Guess she missed that report from around 2008 but then again, she's an expert.
Forbes just ran a story quoting a 24% increase in price across 13 states. But in CO, sorry Michelle, there's a 30% decrease projected. And guess what, for the OMG-its a 40-80% price increase state of Ohio, Forbes quotes a 20 -40% decrease depending on age and gender. New York, of course 30% decrease. And Forbes hates ObamaCare; don't think they knew the interactive map updates itself.....
In Maryland, where again Michelle must be pulling info from like July when the 25% increase was touted and she reports on, State officials just said they expect to have some of the lowest prices IN THE COUNTRY. Good sleuthing Michelle --- way to stay on top of it. MD knows they are coming in under CBO estimates. It's $93 a month for a 21-yr old non smoker. For a 50-year old non smoker, the mid range plan starts at $267 a month. Mid range. 50-years old. Michelle is calling that a 25% increase? Get some current data.
I just hate lazy journalists.
Fact is that many of the prices are coming in looking pretty darned good. Not all but many. And, guess what? TRANSPARENCY means we can see them....anywhere. So in NJ, where Chis Christy admitted to being incompetent to run the exchange business for NJians so he let Obama do it for him, we will be able to see how much more we pay than say.....Maryland. And then we can quickly determine why and hopefully fix it. Chances are if we pay more in a weird way it will be some legislative idiocy like what happened in NY (which is why their prices came so far down). Of course, they have a state level exchange since their governor can handle the job.
from the white house's own report on the negative effects of ObamaCare:
Tennessee: Obamacare will triple men's premiums, double women's
The White House on Wednesday released a report on the costs of Obamacare for most Americans, heralding its interpretation that 95 percent of the nation will be able to buy health insurance premiums below “earlier projections.”
But note the words “earlier projections.” That doesn’t mean that the insurance Americans will have to buy, or be fined, under Obamacare will be cheaper than what they pay today, before Obamacare kicks in.
We know this because at the same time the White House was releasing its broad study, Tennessee Sen. Lamar Alexander released his analysis of the report's portion on his state. He found that Obamacare will cost far more than what many of his constituents are paying today, some by as much as 190 percent.
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From his release:
— Today, a 27-year-old man in Memphis can buy a plan for as low as $41 a month. On the exchange, the lowest state average is $119 a month — a 190 percent increase.
— Today, a 27-year-old woman in Nashville can also buy a plan for as low as $58 a month. On the exchange, the lowest-priced plan in Nashville is $114 a month — a 97 percent increase. Even with a tax subsidy, that plan is $104 a month, almost twice what she could pay today.
— Today, women in Nashville can choose from 30 insurance plans that cost less than the administration says insurance plans on the exchange will cost, even with the new tax subsidy.
— In Nashville, 105 insurance plans offered today will not be available in the exchange.
http://washingtonexaminer.com/white-house-report-tennesee-men-face-290-women-197-obamacare-hike/article/2536363
Do you think that's how they couched it, "the negative report...." Very funny.
Yes, there will be higher and lower prices per state but the good news is you already know more about health insurance pricing on a national level than you ever did. And I expect it will even out over time once we know the difference and why.
Now I don't know much about Tenn, but from your story the fact "In Nashville, 105 insurance plans offered today will not be available in the exchange." tells me that those plans fell below the basic standard set by ObamaCare or another way of looking at is, those old dogs didn't hunt and probably was not good to get sick in Tenn. even if you had insurance. Just a guess based on that whopping number of failures.
Amazingly that $119 plan (God, would we die to have that price in NJ even at a 190% increase) costs $286 in Wyoming. Now that's without subsidies. With subsidies a family of four pays...wait for it...$0 in Arkansas and $57 in Texas. Since many of the 20% of the US that will be using the exchanges will get subsidies, well $57 a month for a family of four in TX makes one want to filibuster.
The government's statement that prices are coming in lower than CBO estimates is a who-cares, I mean the CBO should have been conservative and they were. And saying it's "apples to rotten apples" to compare post ACA with pre ACA is stupid, Mr. Carney, of course we are all going to compare.
So some places lower, some places higher, transparency already, higher competition (matter of fact the weak plans are leaving the market in droves), but yet we know more, as consumers, than we ever have before. And mark me, prices will balance if the market works as competitive markets do.
OK, the good news is that for the first time in our history we can compare insurance prices locally, regionally, and nationally. Right now what we know is like the first hour of new after a mass shooting -- basically nothing. And we will be able to pitch new highs (BDog) and new lows (MG) till we puke. But after 10.1 or a little before it will come together and then, as consumers, we will make choices and there will be winners and losers. Massive differences between state prices will be erased, explained as regulatory (like NY) and hopefully re-regulated, or rationalized by regional differences.
And like I said, overall higher prices will kill it, lower prices will be great for all Americans in the long run.
Can we get back to the root cause soon?
obama promised the nation :
“If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.”
but the reality is health care for many Americans is being canceled:
"Last week, our family received notice from Anthem BlueCross BlueShield of Colorado that we can no longer keep the plan we like because of “changes from health care reform (also called the Affordable Care Act or ACA).” The letter informed us that “(t)o meet the requirements of the new laws, your current plan can no longer be continued beyond your 2014 renewal date.”
so isn't it true that Obama lied, spin-meisters?
root cause is good to get to, and i am getting sea-sick with all these numbers churning around last few days for sure,
any one got a pill or plan for that?
Contemporaneous to your quote, the President clarified his statement several times. Here are a couple of quotes:
“When I say ‘If you have your plan and you like it,… or you have a doctor and you like your doctor, that you don't have to change plans, what I'm saying is the government is not going to make you change plans under health reform.”
and
“I can't pass a law that says, 'I'm sorry, employers, you can never make changes to the health care plans that you provide your employees.' What I can say is that the government is not going to force you to, your employer or you to join a government plan, for example. If you're happy with it, and your employer's happy with it, keep it."
The government obviously cannot guarantee what decisions your employer will make in the future about what plan it offers. Additionally, since one of the main points of the law was to increase minimum standards, it was certainly no secret that plans that did not meet the new standards would have to change.
While I believe the President's statement could have been more clearly stated. I think its a stretch to say this was a lie.
Yes, he lied. More so if you had private insurance, less so if you have insurance as a company benefit; but in either case --- he lied.
But if you can get past the lie, you still get coverage probably from the same carrier and you can still get coverage to keep your DR. Michelle's insurance company is open for business and will provide quotes and take applications for open enrollment starting 10.1 for 2014.
https://shop.anthem.com/sales/eox/cp/demographics/home?state=CO
It's kinda like the US measure to metric measure trick, it's still a bottle of wine, just smaller and for the same price as the old bottle. And since it's Obamablend, it is better for you!
They have a very nice high level summary of ObamaCare specs to show you how the 2014 plans are improved. Of course, BDog would probably rather pay less and not have these things. You know Michelle does, she's so smart.
https://www.anthem.com/health-insurance/resources/timeline
Just attended my 2014 Benefits Seminar at work today. Only 2 plans being offered by Aetna and United Healthcare. Both are 80/20 plans with different deductibles depending on which option you choose to go along with it, a HCSA (Health Care Savings Account) and a
HRA (Health Reimbursemt Account). You can put up to $6,550 in the HCSA for payment of health care expenses after you have paid your $3,200 family deductible. Under this choice you if you do not use it you can roll it over from year to year and invest it in mutual funds or some other investments if you so choose. Under this choice the money is always yours and goes with you even if you change jobs or retire. Any non-preventive drugs are subject to the deductible with preventive drugs covered with a co-pay. Also, under this choice you will have to pay your deductible ($3,200) before the 80/20 plan kicks in and the out of pocket max under this choice is $12,700 for a family or you plus 1. In the HRA you can put up to $2,500 a year in an account which can be rolled over from year to year and can keep it if you remain with the company until you are at least 55 years of age. If you leave the company before 55 and have money still in the account it goes to the government. The prescription plan under this plan is the typical Tier Plan with co-pays. The deductibles under this plan are $2,000 per person before the 80/20 plan kick in. I do not recall what the oup of pocket maximuns on this choice was but I believe it was in the $9,000 to $10,000 range. There were 5 plan choices last year and the one I was in is no longer available because the government deems it as a Cadillac Plans. The employee prices for each choice will not be available until October 28th with elections need to be completed by November 15th. We were advised that the HCSA plan price will be cheaper due to the higher deductiblemy company has over 50,000 employees. A lot to chew on in the coming weeks but the plan I have had is now no longer available.
KB, ouch, I think my grey matter is starting to leak out. Cadillac taxes are steep and on the employer. This is a stupid tax/way to try to fund the program. But they don't take effect for a few years, but companies are jumping ship ahead of the clock.
I have not reviewed but my plan structure has not changed, still have not pushed the button to see the numbers.
Would be interested in how you compare both prices and services, i.e. is the new plan a Yugo?
Those are awful high deductibles. My family would never be able to pay that. wonder what your premiums will be?
Wow, the system pushes responsibility, but how do you do it if a large mass of people are clueless and lacking responsibility?
mg wrote
"once you get past the lie"
...so is THAT how we are judging our representatives now? If so, it's over.
If you judge a politician on what they say versus their actions, you are naïve.
First, things change by time making anyone a "liar." Other times you can just misstate things. I don't think there is a politician up there you can't catch in a lie if you pull everything they every said.
But he lied, he is caught and if you measure a man on every word and in your black and white principled world discard anyone ever caught in one, then I would say in this case:
"Mission Accomplished."
Probably would have been enough to cost him the election actually, but I do not think you will get impeachment, sorry.
"If you judge a politician on what they say versus their actions, you are naïve. "
I've been saying this for years.
OK, I am watching FOX and am proud to say that HLifers can probably do a better job at reporting the facts on healthcare.
They started by stating there are 14 state run exchanges and 36 federally run exchanges. There are 18 state run, 6 fed/state partnerships, and 26 federally run exchanges.
Then they showed the Forbes map and said this is the nation's average of a 24% increase. It's actually the average of 13 states plus DC and clearly talks about some state actually lowering prices. It is not the national average.
Then they talked about the fact that if AETNA, UNITED and other companies quit that the states would not be able to run the exchanges and the fed would take over insurance and it would be socialism. What? If companies quit, then they will either go to private exchanges (as noted above) or to state exchanges (fed and state controlled) with or without subsidy. No way does that lead to a federal takeover. And even if the fed does control the exchanges, they are free posting boards for any capitalistic insurance company to offer their capitalistic wares.
Wow, these are some bad journalists and HLife is much better informed. Good job guys.
OK, I may have to eat some crow. Here is the WSJ article which is a pretty good read and starts to explain the price differences, but indicates a 24/36 state/fed exchange control, the FOX number. I used the .gov website number and here is yet another one, from May, at 17 State-based Marketplace; 7 Partnership Marketplace; 27 Federally-facilitated Marketplace. I think the WSJ is wrong but, frankly, not sure.
Good read though: http://online.wsj.com/article/SB10001424052702303983904579095731139251304.html
OK, I am in. Our healthcare will go up $20 for the family. While that's about a 3% increase, that's against life insurance, FSA, dental, etc. Against just medical, it's more like 6%.
Not too bad, good management.
mg,
This illustrates my main point: everybody seems to have a different number, everybody seems to have different ideas of how all this will implement, in other words NOBODY KNOWS ANYTHING.
Call me crazy, but I don't like the idea of the govt taking over 1/7th (I thought it was 7%, I was mistaken...it's 18% of GDP, which is a little more than 1/7) of our economy with the "spaghetti experiment": let's throw it against the wall and see what sticks. It's madness. And irresponsible.
"spaghetti experiment": let's throw it against the wall and see what sticks ?????
That's just wrong. You make it seem like this is an experiment. But the reality is it is similar to the Massachusetts system that Romney put in place and contains the kind of provisions that Republicans used to want and supported some years ago. Massachusetts didn't get destroyed - at least the sate seems to be there and in reasonably good shape. But, there seems to be a fairly widespread ignorance of the genesis of health care reform activity and there is a faction of the Republican party rabidly opposed to what used to be supported by the party. You can check the history of legislative proposals to reform health care - it's all available.
This last minute death march by Republicans is only because there is no going back when the exchanges start operating in a week. The final outcome is we will certainly learn of the problems and unintended consequences, but overall Americans will be better off and much better protected.
I agree RAD and it will all be over once we do the math on the prices post 10.1.
I think we will question:
- price differences per state (I think some of the answer will be state regulations)
- why so many plans are being pulled (I think the answer is between the fact a company only needs 5 plans or less for the exchanges plus some of these plans stunk to attract low-needs customers, like kids, and offered low caps/payouts if you actually got sick)
- overall price versus what we are paying today (explanation because Ocare is average pricing not targeted against age, health, etc. plus a new higher bar for basic coverage (like no caps)
I look forward to the analysis and am still hopeful, especially since my insurance, family, went up $20 per month, 3% of total, but 6% of medical only. Pretty good in my book given ObamaCare but think our plan was already above the ObamaCare bar.
Now, on to the Debt Ceiling fight, wonder what Obama will give up to save the hostages this time and how it will come back and bite the Republicans right in the Tea Bag. Oh boy, more fun!
"May you be born in interesting times' Old curse
RAD,
It's not wrong. Too much conflicting information, too many waivers given out, nobody has the DEFINITIVE information how well, or IF, this is going to work, or how much it's ACTUALLY going to cost. It's too big, too complicated.
NOBODY KNOWS. So it's very much an experiment. Many supporters have already admitted that- "we need to try SOMETHING, anything is better than what we have, we'll make changes as we go along."
" but overall Americans will be better off and much better protected."
Opinion. The truth remains to be seen.
It doesn't matter anymore whether "He Lied". If you want the truth as to how good an idea this entire Affordable Care Act is, just look at who is not covered and who wants to opt out; the government and their employees, the AFL-CIO, many large employers and other unions. Everybody who backed this and wanted it put in place will not be, or does not want to be, subjected to it. What does that tell you about how great an idea it is.
JBJSKJ 18% is a little less than one-fifth... a little more than one-sixth.
I think a much bigger problem than government regulation ("taking over" is stretching it more than a little bit) is the fact that Healthcare costs take up so much of the GDP pie in the first place.
A couple of weeks ago, my wife and I sat down with a doctor for 15 minutes and discussed family histories related to spina bifida and other conditions. Silly me, I though it was part of a standard office visit... turns out I had just had the pleasure of receiving "genetic counseling" that wasn't covered by my insurance plan and that it cost me $422 for that 15-minute consult. The money would have been better spent on a $1,500 per hour prostitute... at least I would have had a smile on my face when I was done getting f!@#$ed...
IA,
Boy, that sucks. I had a similar problem with simply having my blood drawn AT MY DOC'S OFFICE. Apparently, my insurance covers office visits at my doctor's office, but I can't get blood drawn there- I have to go to an in-network lab for that specific task.
Iman: Talk to Vitter, he's in the Madam's black book!
I agree, Iman, it is the problem, the root cause.
We spend 18%, the next country --- the next 15 countries are between 10 and 12%.
Need I say more that we consume more than 33% more of our GDP than the next 15 countries, any of which you would be pretty much OK with living in.
Not that it is correlated but they all have universal health care. Of course, everyone else does :>) It's only been working for a century.
OK, only kidding, but really, like I said, Obamacare has upside price pressure via expanded coverage and downward pricing pressure due to price competition, transparency, and larger markets. At best the downward pressures will dull the sword, at worst we will see healthcare inflation continuing to outpace inflation.
"Opinion. The truth remains to be seen."
Well, how about opinion backed by the fact that many tens of millions of Americans that couldn't even get any health insurance before will have access at reasonably affordable prices. They can't be denied for pre-existing conditions. You can't be dropped because you get sick and exceed the limits. I agree with people who say there is a lot wrong with this legislation. But we have to face that it is just a start and there will have to be changes. Something is wrong with an supposedly advanced society where over 50% of bankruptcies occur because a family member became sick or injured and they either didn't have, couldn't afford, or ran into the limits of their health insurance.
But if you want opinion, then my opinion is that it's not a terrible situation to have your medical insurance tied to your job and essentially be blocked from getting individual insurance either because of pre-existing condition(s) or because the price is exorbitant.
Another opinion is that even if some of this is an "experiment" it still needs to be done. You do the best that you can, you learn, you correct, and move forward. The current situation just sucks.
RAD... at least you admit it is all OPINION, rather than people passing opinion off as some kind of fact.
In my opinion, you will see doctors leave the healthcare system, fewer doctors going into it (which mean the govt will have to start a program where the taxpayers fund med school for thousands), you will have longer wait times for care, and less quality of care based on more demand + fewer doctors... it's simple supply and demand. I've read enough stories of socialized medicine in other countries, and the ridiculous wait times, to make me extremely wary to believe the US government is competent enough to make such a system work, work well, and work for everybody.
I've seen EVIDENCE from other countries socialized medicine is not all it's cracked up to be, but have seen zero EVIDENCE, only opinion, that for some magical reason it will work just fine here.
Nothing would please me more than to see healthcare go down the path of infrastructure- roads and bridges and such- they are simply "taken care of" without any of us having to even think about it. Unfortunately, the cost required to make such a system work... the money doesn't exists without taxation high enough to to move people DOWN an income bracket or two... and when THAT happens, you will hear people screaming "this isn't what I was told was going to happen."
JR, I'm not sure I understand exactly where you're going with that last post. It's not "socialized medicine" if you're buying health insurance from the existing insurance companies - unless you think they are owned and run by the government. And the government is NOT selling health insurance. It's not "socialized medicine" if you are still seeing your chosen physician or the physicians approved by your chosen insurance provider. What the AHCA does is 1) say you must purchase health insurance, 2) sets certain minimum standards that must be met, and 3) subsidize low income people to help them purchase said insurance (yes, your tax dollars at work!). And that is not opinion, it's fact.
Now, I'm not sure why you feel doctors will leave the healthcare system. Do you think they will stop practicing medicine? What "system" you mean? If you are saying that they will not accept the insurance payments then I don't know why that would happen beyond what happens pre-AHCA. Now long before the AHCA my former physician stopped accepting the particular insurance that I had at the time (Aetna) but was accepting others - apparently he had some disagreements with them. But that already happens and is not related to the AHCA. That's an issue between providers and insurers that has been going on for a very long time.
Honestly, some of these things people are saying seem more like fear of change than rational problems with the AHCA. When you start throwing around terms like "socialized medicine" it makes me wonder if you really understand what this is all about. It's only "socialized" if the government owns and runs it.
doctors leaving the HC system:
http://dcclothesline.com/2013/07/23/6-of-10-doctors-say-many-will-leave-profession-because-of-obamacare/
http://www.washingtontimes.com/news/2013/feb/7/doctors-feel-ill-winds-blowing-as-they-look-closel/?page=all
Now, no one knows how accurate these claims are, BUT.... if they are even SOMEWHAT accurate, it should REALLY concern you pro-OC folks.... less doctors + more people going to doctors (more people previously uninsured now insured under OC), = less doctors for more patients = quality or quantity of care must go down. Period. Simple math.
If you really read that stuff you will see that the results are rather bogus and meaningless. Let me cite just one example for the first reference that jumps right out:
"4 in 10 physicians had reductions in their take-home pay from 2011 to 2012. Of those, 4 in 10 believe their reduced pay was a result of Obamacare."
Now that is pretty ridiculous thing for doctors to say. They think their reduced pay from 2011 to 2012 is the result of the AHCA which wasn't in effect at all during that period. In the personal example I gave before, my physician wouldn't take Aetna because he felt reimbursements were not high enough - that's not the result of the ACHA and it was two years ago. Maybe today he could blame it on the AHCA and everyone would believe him.
All this says to me is that doctor's are just as scared and ignorant of what the AHCA is as pretty much everyone else. I wouldn't expect anything else given the absolutely obscene amounts of money being spent by the members of a certain political persuasion to kill it and spread fear, uncertainty , and doubt.
@Ian..your experience with the "genetics counseling" is criminal, especially when you didn't know it wasn't part of a regular doctors visit.
Bessie "All this says to me is that doctor's are just as scared and ignorant of what the AHCA is as pretty much EVERYONE ELSE. " [emphasis mine]
Yes, including everyone trying to PUSH it, and everyone on this forum. Thanks. That's been my point all along.
JR - So you don't understand it but you're against it in principle? And there are some here who understand it well enough.
"And there are some here who understand it well enough."
Show me one. There isn't one. Only people who THINK they know because they BELIEVE what they've been told.... problem is, the 2 sides (pro and con) have been told different things. Now, realistically, what do you think the chances are that one side or the other is doing ALL of the lying? Because somebody's lying... otherwise, all the facts and statistics would match.
And my comment about hating it in principle above was a half-joke. Hence the smiley face. I think things like not being able to be dropped do to illness and not being able to be denied due to existing illness are great things.
Oh bull JR, I do understand this law at a pretty good level of detail and, more important, I know where to look to find out more detail. What I don't understand and where the pundits play to fog the picture, is the ramifications, where I agree that in many cases, no one does. But I have a good estimate.
Meanwhile, remember when I said: "What really amazes me is why Chris Christie feels he can not efficiently and effectively provide such a service (state-run insurance exchanges) with over two years of free federal funding because he does not trust their cost estimates. Can't he find his own estimates? Can't he figure out how to cost effectively run a web site that would benefit any NJ citizen who buys health insurance? Is he that bad a businessman? It's a website. Does he really not care about NJians looking to score some health insurance? Something else is more important?
I would like to see NJ stronger than this storm and feel that defaulting to the Federal ACA exchange is a real dis-service to New Jersey by Mr. Christie."
Of course you do :>) Earlier I even suggested that folks write, call whatever Christie and other reps and tell them to get to work on this. Well guess what they didn't and now here's what the FED brought us thanks to Chris not able to tackle the job:
http://newyork.cbslocal.com/2013/09/25/costs-of-health-care-plans-on-n-j-health-insurance-exchange-among-most-expensive-in-nation/
Recognize that even Ohio where Republican officials scared the heck out of us claiming a 40% increase through running their own exchange are showing up to a 40% decrease.
On top of all that, when NJ peels away the onion, you can bet your bottom dollar much of the price issue will be state regulations which NYhelped to countermand by setting up and managing their on state-run insurance exchanges and the new ObamaCare regulations granting them up to a 30% decrease (for individuals, fyi 50% decrease had been projected).
Nice job Chris, very productive and business-like.
Here are all the NJ prices they found; you have to scroll down a few pages in the pdf to get to the chart. Good luck! http://aspe.hhs.gov/health/reports/2013/MarketplacePremiums/ib_premiumslandscape.pdf
You don't understand it, mg. As I said- you only understand what you have been told by people you choose to trust.
And those in opposition only understand what they have been told by people they choose to trust.
Somebody's lying, or everybody is. My money is on "everybody is." I'll even give them the benefit of the doubt- everyone's isn't lying, they just don't know what the F they're talking about.
Maybe some of you OC-lovers could fact check this for me.... (I didn't write it)
So the penalty for not getting health care is $95 or 1% of your income.
Say you net $60k a year. The penalty would be $600
Obamacare however would cost you $2,982 a year.
Emergency treatment can be done in the ER and you can do a pay-as-you-go for regular doctor visits and be ahead of the game if you keep your costs under $2300.00
In a big time emergency, sign up for Obamacare, you cannot be turned down. Let the government shoulder your bypass surgery.
You're talking about opinion and beliefs JR, not facts. And then you quote in your next passage of bunch of facts. Must they be untrue by default of your own definition?
Of course not. Just some of them, mostly through omission and what appears to be stupidity (I am sorry, but you didn't show your work and you forgot to do part of the assignment). One of the most important thing you left out was subsidies for families. Here is a link for folks to ESTIMATE subsidies. It is an estimate, I guarantee it is not right, but at least you can see the direction of the subsidy. Notes explain the estimation rules.
http://kff.org/interactive/subsidy-calculator/
Meanwhile, JRs facts and his omissions (now you know the rest of the story)
"$95 or 1%," no $95 or 1% of household income.
You use $50,00 as an example which I take it to be a single adult. But median income in H-town is about $62K, age 37, and 2.48 persons per family.
"Obamacare however would cost you $2,982 a year," no that number can only be true as a meaningless national average or for a particular plan for a particular age for a particular gender in a very specific state in the Union which you did not source. I got $2,568 for a bronze plan, age 35, 50K, non smoker, Hackettstown zip code using CBO 2016 estimates for example. You gotta source your work.
And you left out a little tidbit for the families who choose to do this. That is, you are liable for any dependents listed on your tax return. Fine-wise, you can be liable for up to two more people. So now your math could be at $1,800. Ooops.
So now take your "facts" and add a little income, multiply by 2.48 to come up with the real fine, on average, and then multiply the risk factor by 2.48 as well.
And if you choose to do this, remember it's a sliding scale over time so next year, 2015, it's $325 or 2% and 2016 695/2.5
So, using JR's example, how's a $50K married family of 4 work out for subsidies. Well same stats as above, add in 2 non smoking kids and its a $9,416 premium, possible subsidy of 4503 so a total cash outlay of 4913.
Average ER visit price: Average was $2,168 however 75% of the folks pay between $200 and $4,100. http://www.theatlantic.com/health/archive/2013/02/how-much-does-it-cost-to-go-to-the-er/273599/
Work those numbers carefully before you roll the dice. Or just don't file taxes. And sure, our lawmakers did not want to whack you on day one if you don't want to play.
Back on root cause: From the NY Times, http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html more price comparisons showing how we get skewered in the US on medical and it ain't the insurance companies, it isn't the general practitioners, our doctors, it's the drugs, the devices, the tests, the procedures and especially the specialists. Each of these cogs in the same wheel, our health, are trying to maximize profits while benefitting from hidden pricing, no up-front pricing provided, line-item pricing (and profits) and many more things that none of us would put up with when buying a house, a car or other items in our lives.
The story links to two other installments but the price craziness includes:
= inflated insurance company costs for the time they spend (and we pay for) to haggle prices, but that's actually saving us money even though the only reason they do it is to compete with other insurers. But it shouldn't have to be done in the first place.
= in the US, it costs more to have a colonoscopy than to be born in many countries. In what used to be an office procedure, we now have a MINIMUM of a DR, a nurse and an anesthesiologists; in my case two nurses turned up (but I have a sweet a...). There are other non-invasive tests but the specialists (gastro) have lobbied for the expensive one --- a typical problem in the US is we, because they told us to, opt for the expensive, profitable procedure with a multitude of personnel, tests and drugs
= we get our tests more often than the rest of the world because some one told us to.
= price variance is extreme, try the colonoscopy game in the NYTimes to watch the price move from $2K to $9K as we crisscross the nation. One of the worse prices --- Bayonne --- go figure.
= Hidden prices. Often neither the DR or we know or even ask about the price. But that does not matter, if you call the hospital, chances are they will not know the price either. If we want to do price research, there are very few sources beyond ad hoc web sites. Nobody posts their prices. It is a 100% sellers market, the consumer has almost zero price power
= We are "covered" for the most part and the "covered" don't usually push on the price like when we are buying a car which helps the seller own the market.
= There is no market price curve. Colonoscopies grew by 50% in volume between 2003 and 2009 and the price went up unlike any capitalistic market anywhere.
= It's a hard market for new companies to enter. For drugs and devices, the entrance cost to play in the US is extreme to get through our regulations and testing, and then you still have to figure out how to distribute your product
= Device and drug makers constantly tweak their products, get a new patent, and lock out the competition
= Many providers have non-disclosures with hospitals, etc. so prices can not be disclosed so that even the DRs and hospitals can not know what others are paying (or charging for that matter).
= We "line item" all bills now which means more billing cost and more profits centers ---- you never get the "triple play" when you get a procedure, no bundling allowed
We know the healthcare market is broken. The facts are evident. Wild profits, hidden pricing, lack of true competition, just so many things are broken. There are too may barriers to competition to ever have this market heal itself. This is the worse solution but, IMHO, the only answer is legislation. We need to open the market, make it transparent, communicate prices, quality metrics, and have a viable source to determine what procedures, drugs and tests are necessary and which ones are not. I just don't know how to do it rationally.
Any ideas on legislation or alternative solutions?
FYI --- given the season, tax info for ObamaCare: http://obamacarefacts.com/obamacare-taxes.php
For folks buying insurance, there's a section on tax credits based on income.. Obviously, the larger your family and the less gross income, the higher the credit which can be applied to insurance premiums if you choose. Good luck!
harry reid is a bum for calling Americans who wrote about their personal situation with canceled plans and high monthly costs liars.
the majority leader of the United States senate calling everybody who complained about Obamacare 'Liars'?
he should be censured and removed from office
The root causes, IMHO: out-of-control greed and complete lack of common sense and compassion on the part of insurance company executives. A doctor who works for an insurance company and gets bonuses for denying patients reimbursement for care should ask himself the question - how does this job jibe with "first do no harm?"
The whole system is sickening to me, and DH is a doc, so I get plenty of feedback on how it works.
Well, Harry Reid is not my favorite guy, and he did start with the word "all stories" and then backpedaled to say the vast majority of Kock brother ad versions are lies and that one could easily be true. On the first statement, he's wrong, on the second, we'll wait on the fact checkers to assess.
But when it comes to mad-dog partisan fact-changing, I have a long list that Reid is only in the middle and the Koch Bro's and everyone who feeds off them are wayyyyyy at the top.
Meanwhile, in other breaking ObamaCare news: http://money.cnn.com/2014/02/27/news/economy/obamacare-restaurants/
This one cracks me up. Like why in God's good graces weren't these schmucks providing insurance earlier. They clearly have shown it couldn't be the money. And, more important, what about the fixed and variable costs of providing rest rooms. Where's the toilet surcharge? You know, the one I can't use unless I eat there so it must be covered by the bill, right? I mean if you're gonna itemize things you provide that I don't use, then be complete as least :>)
Meanwhile, as far as I can tell, the sky has not fallen yet.
MG - if you're a patient who can't get care or who has insane medical bills that you cannot pay, the sky has indeed fallen.
Yes that's true Rebecka, before, during, but less so after ObamaCare. But still true then too.
glad it's working for you mr g, there are lots of others who it's not working, their sky is falling.
canceled plans, loss of doctors, doubling and tripling of insurance premiums, thousands of dollars of extra 'out of pocket' surcharges, and now to top it off the leader of the United States senate (Harry Reid) is calling them all liars.
and one wonders why we don't have much faith or trust in our representatives.
but it's ok for you i guess, so that's that then.
For every horror story in ObamaCare I can match it three folds with pre-ObamaCare stories. Not to say that there are not issues. But just screaming and saying repeal, repeal, repeal, does not fix it. Not that you are saying repeal, this time, but I say find the problems and fix em.
And yes, the sky has not fallen.
Oh really MG? Where are these fabulous Obamacare stories?I'm sure if there were as many as you say they would be all over the news and as of today I haven't heard about them. Maybe the sky hasn't fallen for you but it has for me. My premiums have increased as well as my deductible. But the good news is I am now covered for pediatric dentistry. Too bad my kids are 33 and 35 and married. But I guess I'm just one of the "liars" Harry Reid is talking about.
simo Simo,
Note the word pre-Obama.....
Really, Harry Reid was including you as one of the advertised Koch Bro horror stories? Was it that bad. Did you world really collapse?
We were talking "horror" stories.
But OK, come up with some fabulous stories. (t's pretty tough though.......Let's see, let me think....One report totals 7.6M young adults under 26 now covered by insurance that were just rolling the dice before. I would say that's fabulous.
Want some more?
3.9M folks additionally covered via ObamaCare medicaid expansion. Wow. That's fabulous.
2.1M enrollees from the state exchanges. 1.1M from the Fed exchange.
Look out, that's nearly 14M people with insurance that did not have it before (unless they were all canceled......) That's just fabulous.
But if you want, I can get personal too.
Again, not perfect and in the best world some folks will pay more, they have, the bar for coverage was raised for example. But show me a better plan, especially one that can pass Congress.
I can tell one thing - if I finally will decide to quit my job where I am bullied and be-littled every day, I will be able to get a medical insurance under Obamacare and not to pay huge premium for Cobra. The plan my employer has is the most expensive possible, out-of-pocket $5K per person, deductible $2500, monthly premium company pays is about $1200, don't ask me why they chose this plan, probably only because they can deduct it from their taxes 100%. With my DH history of cancer we would never be able to buy medical insurance on our own before.
My husbands premium just went up 25% a paycheck! Now I cannot even afford to pay some bills. Add that the extra copays and I don't eat for the month.
yeah I am also a liar.
_I wonder exactly how many of you have gone on the government website and compared plans and prices. My sister had the same attitude as some of you people do. She went on the healthcare website to compared plan's . She ended up giving up her old plan in which she paid for it out of her pocket and went with a plan on the government website. She saved over $700 a year in health insurance and got a better plan. and Christine it's hard to believe that they are taking 25% more per paycheck
I am sorry that your insurance went up. Ours did not, at least less than usual. Here are the national stats from the Kaiser foundation:
Year/Annual family health insurance premium/Percentage increase
2004 $9,950 --
2005 $10,880 9.34
2006 $11,480 5.51
2007 $12,106 5.45
2008 $12,680 4.74
2009 $13,375 5.48
2010 $13,770 2.95
2011 $15,073 9.46
2012 $15,745 4.46
2013 $16,351 3.85
And no, I am not calling you anything and recognize that many people have had increases. At 25%, I would hope that something changed for the better and you can take advantage of that change at least.
I'm happy for your sister Dan but I think she's in the minority. I too paid for my own plan as my husband and I own our own business. I was told by the president if I liked my plan I could keep it. Guess Harry Reid should add the president to his liar list. I guess I'm really angry that my tax dollars are paying for their insurance and got lied to.I can only hope come November Harry Reid will be in the minority.
Yes the President lied and the insurance companies withheld info too. Stinks. He got scrod and he passed it on to you. Not everyone could keep his plan and with changing plans, doctor choices might change too.
I just love how you people grab on to a liberal lie and can't let go to you wrestle it to the ground, pin it, stomp it, chew it up and turn it in to compost. On the Reid one, you go to his first stupid statement, forget the correction he made moments later, and hold on to that first stupid and retracted statement like a junk-yard dog on a ham bone. Crikey, give it a rest.
And I am glad, in Simo's case that you "think she's in the minority" when the flippiin stats say the average price increase has been less than the last 6 out of 7 years. You may think it but I am thinking that you can't prove it. But what the hey, it must be true.
dantheman so now you call me a liar? We have a group plan with his company and on a company letter head it reads, "due to the increase in our Healthplan premium from Horizon BC/BS we have to carry it through our employees. We know what a burden is this to some of our employees so we will be looking for alternative plans."
I when the Obamacare came out looked into it and it would have cost my husband more in copays and deductibles. So at the time we stayed with his employment healthcare. We pay $275 (about) a paycheck that's 26 paychecks a year. PLUS we pay copays and deductibles.
Suddenly from January 1st my employer decided dramatically increase insurance premium paid by employees. I know that monthly premium paid by company to insurance company didn't change (the renewal was back in October). He just simply decided to get save some money by forcing employees to pay more. I did research of state laws and discovered that in NJ employer can change employees premium payments as freely as he/she wants. They even don't need to inform employees prior to change. So in general if paid by employees premium went up it doesn't mean that actual cost of health insurance for company went up.
Well we are a small business and pre obamcare our insurance was 1300/month. After obamacare our small group plan went up to 2000/month. We went thru the exchanges our rate is under 200/month. We are definitely a success story.
Sarasmommy what plan is that? Are you doctor's still in it? I'd like to check it out.MRG, it's not Harry Reid's first stupid statement. And yes he did try and walk it back after he said it. Too bad he said it in the first place. And I don't just pick up on any liberal talking point. You don't know me at all so don't assume you do. I'm an individual that got lied to big time and yes it does stink!!!!
Simo, Only some of our doctors are. I went thru the exchanges and filled out an application. Rates are now dependent on age,family size and income so are deductible and coinsurances etc. So the rates you see listed on website are not necessarily what you would pay. I had quite a few of plans to pick from. Ended up with a Silver plan HMO. The rates were anywhere from about 80/month to about 1300/month depending on plan I picked thru the exchanges and subsidy.
iJay Simo, I didn't say any, I said a. Sorry if you're offended but my goodness, Harry Reid retracted it in minutes and his second statement may or many not be true. Have to wait on the fact checkers but you can be sure the Koch Bro's have lied before. Won't be a first.
As far as it not being Harry's Reid's first stupid statement, you're right on in my book. Like I said, Harry Reid is not my favorite guy and as leader of the Senate, while he has to defend against partisan Republican and Tea Party attacks, he should be better. He should have quit years ago. So should Mad Dog Mitch, Boner, Cruz (leave now, go early), Pelosi, and a big bunch of them. In this polarized era, they all lie, reposition, and re-cast at will.
Heck, now the Republicans are against immigration reform just because Obama wants to pursue it. He could be for tax reductions and they would rise up and stop it in it's tracks quoting Reagan as support for higher taxes. They will stop everything at least to the 2014 mid-terms. The only bills the House will come up with will be still born at conception with zero chance of debate much less passage. 47 repeals of ObamaCare, most after the Supreme Court blessing. By the time 2014 midterm comes up, we will be at over 5 years of the Do-Less-Than-Nothing Congress and unless there is a sweep we will reach over 7 years of inaction by the 2016 elections. We probably have more than 2 more years of this crap at least.
And so I did not even have to come up with personal stories of the "fabulous" for ObamaCare, they are out there. Wow.
Christine, I have been paying that amount for years adding the inflation % shown in the chart. Sounds like I just got there before you although probably talking apples and bananas. And yes, employers can do what they want re employee contributions. It's not a law, it's not an entitlement, it's a benefit that they use to attract talent. Yeah, right....... It's also a huge tax break for your employer that we all end up funding anyway. It's a stupid outdated system at this point but given the Congress, the only system that could be used to gain universal coverage for all Americans (remember, the main goal of ObamaCare that most applaud --- the goal that is). And at the core of it, ObamaCare is a Republican invention. It is their brainfard. Cool.
Yeah that makes more sense iJay. I did not find that plan when I looked. Good for small business. Not so good for our family.
Christine I did not apply as a small business cause under the new laws a husband and wife group is NOT considered a group so they fall under the individual plans and mandate. So my rates are on the income, famiy size , age etc thru the individual marketplace
My health care premiums at work have gone DOWN over 30% as a result of the ACA. In previous years it's gone up about 20% every three years or so.
Simo,
You complained that you are now covered for pediatric dentistry even though your kids are in their thirties. Your implication was that you are paying for that coverage. But isn't it true that only people with kids are really covered for that, and only they pay for it? If that's not the case at your workplace, your HR department had made a mistake. We went over this thoroughly at my office and only people with kids are paying for pediatric dentistry. Makes sense, no?
time to censure and remove the serial lair Harry Reid, he needs to retire to his illegally obtained properties in Nevada
also mcconnel and mccain, they both need to go home for good
also the almost billionaire Pelosi needs to go home and stay there, she is bad for americas future.
and boehner, he's really gotta go. he wears white pants when he shouldn;t and he cries stupidly when he ought to be manning up. big embarssament to our whole system of government
also time for anne feinstein to retire. just go home and don't come back.
we need new blood in the senate and the house,
that's right! I said it!
and it's past time to impeach Barrack Hussein Obama, at least start challenging some of his lawless actions in the courts.
the executive branch has sized too much unconstitutional power, and our inert congress has not got the strength or fortitude to stand up to it.
time to use the courts to redress this un-constitutional grab for more power by this president (and our past president).
i believe that this country is headed for a constitutional crisis over both the nsa spying and the health care mess.
THAT'S RIGHT! I said it! (again)
Well Christine maybe Obama care isn't that bad if you follow directions and no what you're looking
Gadfly, is your company participating in the ACA or is your 30% less in premiums from your former insurance company that was used? Also, what are your deductibles compared to your prior coverage. I was able to get cheaper premiums but my deductibles were sky high.
dantheman I have done extended research and have applied thru Obamacare and did not get those kind of numbers. It could be that we make more money then you or have more medical problems then you but I would bet my last dollar its not even close to the truth.
KB. I'm not sure what you mean by participate in ACA. All insurance policies have to comply with ACA, no matter how you buy them. This is a group policy, purchased the same way my company has always done, not through an ACA exchange. I believe it's a so called silver plan. Deductibles went up a bit, but not much compared to the premium savings. In the past we've usually had increased deductibles AND increased premiums, so this was a nice change.
Dantheman: that was uncalled for. Even if Christine did miss a step and could get comparable coverage for less money (and I am not even remotely saying she did), I would blame the complexity of the website before I made the assertion you did.
BDog -- that was actually funny and I tend to agree. But "the executive branch has sized too much unconstitutional power, and our inert congress has not got the strength or fortitude to stand up to it." The real problem forcing the President's hand in Executive actions is the inert Congress, not the other way around. After over 4 years of Tea Party run House inaction, I applaud him stepping up. And of course you can't actually give us examples on his illegal seizures of authority that could actually be won in court. Just a bunch of whinning.
And you might as well give up impeachment. Sans a HUGE smoking gun, you ain't got the time to do anything but figure out how to get things done. And Constitutional crisis over heath care. Not bloody likely.
yeah, you're right, i should have posted that rant in the venting thread.
the executive branch has been seizing more and more power over the course of the past few presidents terms. Not sure where it began, with JFK, Johnson, Nixon, Carter, or Reagan, but ever since there has been significant 'bracket creep' assumed by the executive branch at the expense of the congress and the court system, our three legged stool of co-equal branches of government is tipping over, and before it falls i think we need to take action.
the unconstitutional patriot act is anything but patriotic, the nsa spying, committing the USA to wars that are/were never declared by congress, the over-use of executive signing statements by both republican and democratic office holders is scary to me.
i don't get why it isn't scary to the rest of us, it sure ought to be.
i do think we as a nation are headed towards a constitutional crisis over it
in the subject of this thread "high cost of medical care", i do believe that Obama has stretched the limits of executive power even further, and i think it's wrong.
He (obama) has by executive fiat changed the health care law at a whim, like 23 times now i think. this is wrong. the president cannot arbitrarily change the law by executive action. that is un-constitutional, and i think it needs to be addressed. why the press gives him a free pass on this is just stunning.
i suggest we start using the court system more often to address the un-constitutional over reach by this sitting president. (and others before him, it should have been done)
"At a whim"? Making reasonable changes to ease the transition to the requirements of the new law, ESPECIALLY in light of the roll out problems is hardly at a whim. The Executive branch has a lot of latitude in implementing new legislation, including the timing of implementation. It's not uncommon at all. Conservatives complain when the administration is rigid and unresponsive, and then complain when compromises are made.
If it was illegal then the Tea Party would be on him like cold on New Jersey...:>(
But again, I agree with much of what you said. When the Pat Act went in, I said "how long will it be until the pendulum swings to abuse." Amazingly, Bush and Cheney hit it in record time, much faster than I ever would have believed.
But I still would have passed the law; it is war since I am for winning more than protecting my communications as a part of liberty. At the same time I am glad for Snowden too. It's complex but we live in interesting times.
I am doing some genealogy lately and am amazed at 1) how my ancestors made conscientious moves to stay off the grid (before there was a grid) and 2) how, given that we are microfilming historical documents and then digitizing what's in them, I can trace them back to 1800 on a newly created grid.
Think anyone who creates anything electronically is a fool not to believe it's accessible by friend or foe.
i complained about both if you read my whole rant, and it's just your opinion that it's 'reasonable changes' , (and you will find many that agree with your opinion i'm quite sure), but if you re-read what you wrote it looks like you are ok with the president making changes to written laws. that's not constitutional, you know that right?
it's my opinion and many others opinion that it is capricious and at his whim. from where i stand it's un-constitutional for the executive branch to change written law.
you and i will just have to agree to disagree on this.
i am hoping and advocating for the court system to weigh in on this, there are many suits/decisions pending right now and it will it interesting to see how it all plays out.
Actually, there is Supreme Court case law on what constitutes reasonable vs unreasonable delay of implementation of new legislation. Delay of implementation is not in and of itself unconstitutional.
11 State AGs (all GOP go figure), say Obama broke law when he allowed discontinued plans to continue (but they like that he did, honest), and delayed the employer mandate. In January, they wrote a letter (oh no). As far as suing the President or impeaching, one's probably gonna have to prove either harm or that the government had plenty of resources to NOT delay the law's requirements. Good luck. Here's the degree of difficulty: http://www.forbes.com/sites/danielfisher/2014/01/06/is-there-a-limit-to-what-president-obama-can-cut-out-of-obamacare/
From WND "Supreme Court to admit Obama broke law?" Ah yes, the question mark headline. This one is about appointing 3 to the National Labor Relations Board during recess which the DC appeals court found unappealing but is being appealed to higher courts (not sure its a Supreme issue yet) thus the question mark in the headline making it stupid. Obama has done this 32 times since Congress is useless and actually more effective when they are on recess and since they only vote no on anything-Obama so why bother asking. Sure, sure, it's the law but then again, the Executive branch has done this over and over and over. Not Obama but the other guys. Of course as much as this is tantamount to impeachment, Bush silly did it 78 times, Clinton 138, Bush serious 171 times and our hero of the Constitution, Ron Reagan did it 232 times. Good luck on stopping it much less impeaching anyone over it.
I find it funny people still calling for impeachment since they must just not grasp the basic concept of time of which they don't have enough to impeach any President unless an egregious smoking gun is found. And this gun has rubber bullets at best. So any impeachment action would be all for show and PR and nothing would ever be decided at this point.
Can you just imagine if this energy could be used to make something better (like Obama's energy in changing the ACA on the fly) rather than to stop anything from changing whatsoever?
Again, good luck since you have barely a leg to stand on to begin with.
Another Obamacare waiver. Gee....if this is such a great bill I wonder why all the waivers? Oh, that's right the 2014 election.
ObamaCare is flawed, that's for sure. And the website started as a disaster, that's for sure. I, for one, feel that relying 100% on commercial insurance providers is a flawed system to begin with and that the public option would have been far cheaper for the American public to fund versus subsidizing lower income Americans in the commercial insurance market. The public option system exists today also, Congress just chose not to use it bending to the insurance industry lobbyists waging the fear of government death squads. Silly since the public option is the one that covers Congress, but hey....what do I know.
However, the goal to provide coverage for all American citizens can be achieved with the ACA and thus far no opponent has offered an alternative. Flawed, yes. Failure, no yet and there's no better alternative advanced so do we give up because there are issues? Are the flaws that severe that we are ready to scrap it with nothing better in sight to return to a system that was universally broken and continue to be the ONLY developed nation not to have universal coverage where a large number of our citizens risk financial tsunami's just because they get sick?
As far as Presidential changes to the law not only proving it's failure but also exhibiting Constitutional illegalities, like I said, good luck. Either pass a law (yeah, like Congress can pass any laws), or take him to court. You might win but odds are that you will lose: http://www.theatlantic.com/national/archive/2013/07/delaying-parts-of-obamacare-blatantly-illegal-or-routine-adjustment/277873/
And at the root of this the question of whether the changes are the right decision to begin with gets forgotten. They were mostly great decisions in my book but like the article focuses on, opponents of the law desiring repeal believe these decisions equal total failure and the law should be scrapped: http://www.nationalreview.com/article/364080/twenty-seven-obamacare-changes-grace-marie-turner-tyler-hartsfield
Sounds like Social Security all over again kinda. Except with Social Security, Congress crafted a better law and then actually worked together and amended the living hell out of it to fix problems and make it better.
Fix problems and make things better. Interesting concept but against many conservative dreams of winning in 2014.
then why not delay the individual mandate? (because that would be admiting complete failure at enacting this flawed law)
everyone gets a pass except for the little guy
presidential executive fiat has been exaggerated and stretched to new and even higher unconstitutional levels, i hope the courts will intervene as these cases move along
Uh, he did delay the individual mandate.
Like I said, good luck. When it comes to executive orders, Obama is way down the food chain. http://en.wikipedia.org/wiki/List_of_United_States_federal_executive_orders
Perhaps, but not likely, the courts might slam him but if you want to end this, you should want to do it by law and that takes Congress. This Congress, blocked by the Tea Party, can't and won't do that. After all, they expect the Presidency.
yes, yes, thank you for the correction, but wasn't that just for a month or so?
business got a one year delay and individuals got little more than a month?
Obama sticks it to the middle class yet again, when will he stop?
we are going to have to agree to disagree again, the reach of this presidents signing statements are changing written law. this needs to be vetted out in court and shown for what it is.
it's not the raw number of executive actions, that's a comparison that really doesn't say much.
Obama has taken this executive fiat behavior to new and unheard of heights, it's not the number of them as much as it's their influence and scope and the fact that he is changing the written law at his whim.
imo, this is UN-constituional, and we don;t agree with each other on this (go figure) so we are just gonna have to stay in our 'mutual respect' corners on this, you have lots of people who agree with you, it's true, and there are lot's more who agree with me on this one. a few more every day.
imo the tea party has this one right, and many more things as well, it's hard for the progressives to come to grips with it for sure, switch the situation around to a liberal majority in the house stopping laws that don't fit their agenda and the spin-meisters (like you mr.g) would be calling them 'Heroes', and another thing; it takes two to tango; how come the president is not reaching across the aisle? (answer: he doesn't have the skill set to work on projects collaboratively, Obama's tent isn't big enough to include those who have differing opinions, it's another sign of his weak leadership skills), continually blaming one side for not cooperating is missing half the puzzle
The delay of the individual delay didn't mean squat. Once my plan was cancelled and he said he would tell insurance companies to let people keep them it was too late.Obama lied my healthcare plan died.
Hey, delay is delay. What can I say. The right amount of time depending on needs and situation. But then you said: "it's not the raw number of executive actions, that's a comparison that really doesn't say much.
Obama has taken this executive fiat behavior to new and unheard of heights, it's not the number of them as much as it's their influence and scope and the fact that he is changing the written law at his whim."
Uh, it's a comparison that says everyone does it and the vast majority do it more than Obama. He is in the minority and no matter how much he uses it going forward, will remain in the minority. And as far as "unheard of heights," you don't have a clue. You just made that up after listening to your spin masters as you like to call them. You didn't do the work, once again you are fact-less.
So how about some egregious executive orders since you are all about quality, not quantity:
Were the WWII internment camps worse than Obama's orders, or just for our Japanese and German citizens so that's OK?
Here's a pretty good one: AUTHORIZING THE SECRETARY OF WAR TO TAKE POSSESSION OF AND OPERATE THE PROPERTIES OF THE CLEVELAND ELECTRIC ILLUMINATING COMPANY, LOCATED IN AND AROUND CLEVELAND, OHIO
All sorts of corporate socialism, land grabs, and human displacement for the War. Was happening left and right. But Obama is worse than that?
George Bush Jr. signed one restricting access to his Presidential papers; wow, foia be darned. Sure slowed down looking at Dad's VP Iran-Contra papers. Sound a little constitutionalfishy to you?
Bush also signed one to stop property use on any property held by anyone "suspected" as threatening Iraq's stabilization. Puts some teeth in anti protest, eh. Kiss all of your ass-ets goodbye but Obama is still worse?
I can list humdreds of these. HUNDREDS. All legal and no overturns in court.
Point is and has been; you think it's illegal, take him to court.
However, only two Executive Orders have ever been overturned. That's right --- TWO. One was for socializing steel mills by Truman and the other stopped federal contracts with companies that hired scabs by Clinton (that seems like a good one to me, but oh well.). That's it. Everything else passed muster.
That's what you find out when you do a little bit of work and actually research the topic.
So again, good luck. You're tilting at windmills.
But the better answer since Obama certainly does not and will not hold the numerical record and I would say will not hold the "potential" egregiousness award either, is pass a law and stop what you don't like once and for all (until amended at least). And given your "tea party has this one right"'s ability to get anything done beyond vacations, really good luck on that one.
Actually I have called out a number of my party for replacement and, correction to your point. The Tea Party rejects ANYTHING Obama but also can't write any laws that will pass either. And they are on record as saying this is how they will operate UNTIL the people give them power. This is far, far worse than anything the Democrats or non-Tea Party Republicans have ever done.
Have a nice day and best wishes in court. It will either be a wasted of time or a landmark so tilt away, tilt away.
George Bush Jr? Who is that? lol. We're standing on one leg, wer'e tilting our windmills. Any other clichés?
i already told you that you wouldn't agree with me, that's your opinion, mine and many others is different from yours, so like i said to you earlier, we will just have to agree to disagree on this, as we have on most other things.
i think you're wrong, and there are many others who agree with me, and as i told you before, you have plenty of company on your side.you just have much less than you had before.
you don't see a difference with Obama's behavior, that's purley your opinion and you bring up all kinds of unrelated actions by prior presidents as if that makes your guy aok and good to go, but imo, Obama is changing written law with his pen strokes, this is unconstitutional (as more and more regular americans are saying as well) and you don't want to get it, well you know what? i get that. i think it's because he is is your guy on the left and you are grading him on a curve because you cannot hold him to the same standard as you do republican presidents. (or republican candidates) i get that too.
that's why we to need to agree to disagree on this subject from our corners of mutual respect.
see if you can find a way to do that, ok?
You miss the facts.
First, if it is illegal, either take him to court or better yet, create law. You want to take him to court, a vengeful but inadequate response.
As far as court, first, EO's have been done since George Washington. In great numbers. That's the fact, jack. Many have much more egregious Constitutional offenses than Obama. That too, is a fact jack. Only two have been successfully litigated in court. That's a fact also, jack. These facts should lead you to the logical conclusion that probably Obama will NOT be found guilty because what he did has not been found illegal in the past. You know, precedent.
Even if found guilty, you have your revenge but you have not fixed your root problem without writing law that makes such EO actions easily identified as illegal which history has shown that they are not currently.
This is really not an argument on your opinion that what Obama has done as being illegal. It is just the facts of what has transpired in the past and an extrapolation of said facts into the "qualified opinion" that you are pretty much pissing in the wind if you think he will be found guilty. At least based on past experience.
It is an exercise in windmill tilting and a waste of the taxpayer dollar.
your opinions are not facts. using historical facts is one thing, applying them to your own progressive political view is subjective on your part (as it is on my part)
i do not agree with your contentions, while i appreciate the truth of the historical record.
you seem to think that anyone who disagrees with you has not done their homework, this is incorrect, and you will not be convinced by anything that i post,
illogically applying historical facts to your partisan views and then presenting them as unassailable facts is a cherry picked extrapolation on your part that supports your rather narrow view of what is happening, (in my personal view.)
again you and i will just have to agree to disagree on this as we have on so many other issues. time to break into our corners of 'mutual respect'
is that possible for you ? (yes/no)
what do you say? is your tent big enough to tolerate differing views?
Obama's tent sure isn't. The president does not know how to play well with others. and we all suffer as a result of his personal intransigence,
again that's imo. your personal opinion may differ.
lately there are more and more regular every day americans agreeing with me than with you.
Just got the numbers that HRMC has submitted to my insurance company:
$35,419 for mom and 11,319 for lad. Total of $46,738.
And this doesn't even count the bills from the separate physicians that will be coming shortly, I'm sure.
People talk about the high price of college. It cost more than a year at Harvard just to get him out of the womb, lol.
Wow!! iPhone-imal....These figures are shocking! I had no idea having a baby today cost this much... What happens to families that do not have good insurance coverage???
joyful Oh Iman, that's nothing. Wait until you get the final bill from your first Disney trip!
Better start saving now :>)
PS --- they are not "cheaper by the dozen" either.
And Bdog: I pretty much listed the facts and opinions in my last entry. Earlier, I was also pretty clear on where you missed your due diligence in offering supporting facts. I do agree that we have different opinions
here's another cynical, Machiavellian use of executive power from Obama:
New O-Care delay to help midterm Dems
The Obama administration is set to announce another major delay in implementing the Affordable Care Act, easing election pressure on Democrats.
Prolonging the “keep your plan” fix will avoid another wave of health policy cancellations otherwise expected this fall.
The cancellations would have created a firestorm for Democratic candidates in the last, crucial weeks before Election Day.
The White House is intent on protecting its allies in the Senate, where Democrats face a battle to keep control of the chamber.
“I don’t see how they could have a bunch of these announcements going out in September,” one consultant in the health insurance industry said. “Not when they’re trying to defend the Senate and keep their losses at a minimum in the House. This is not something to have out there right before the election.”
http://thehill.com/blogs/healthwatch/health-reform-implementation/199784-new-obamacare-delay-to-help-midterm-dems#ixzz2v6qOmr00
MG, I've been to Disney three times in the last 10 years. Any increase in cost due to the boy will be more than offset by my reduced booze bill, lol.
just for you Ianimal - did you guys consider the 'do it yourself' option? :
Home births still rising, driven by white moms
ATLANTA (AP) — Home births have risen to their highest level in about four decades but are still only a fraction of all births, according to a new government report released Tuesday.
A little more than 1 percent of U.S. births occur at home, the Centers for Disease Control and Prevention reported. Experts say they remain largely a phenomenon of white women and those who live in remote areas.
In the 20th century, births shifted from homes to hospitals. Out-of-hospital deliveries were down to 1 percent by 1969.
But around 2004, they began inching up again and reached about 1.36 percent in 2012. That translates to about 35,000 births in homes and another 16,000 in freestanding, birthing centers
http://news.yahoo.com/home-births-still-rising-driven-white-moms-185735378.html;_ylt=AwrBEiTxIxZT6xgA177QtDMD
While more birthing centers have opened, perhaps the main driver was an increase in out-of-hospital births involving white mothers, said T.J. Mathews, one of the authors of the new report.
The proportion of white moms delivering outside hospitals rose to 1 in 49. For Hispanic, black and Asian mothers, it is around 1 in 200.
Experts believe there's been a culture shift among many white women, who question high rates of cesarean sections in hospitals and have come to think of home births with midwives as a preferable alternative.
"They are having conversations about it and influencing each other," said Mathews, a CDC demographer.
"I pretty much listed the facts and opinions in my last entry."
thanks for agreeing with me that you are mixing them up liberally from your own progressive perspective.
that's good movement right there, our beer summit grows a little closer every day.
I actually specified the facts and opinions so you could easily recognize them and not get mixed up. Sorry if you still are confused. Perhaps if you re-read and look for the words: "that's a fact, jack" it will provide a clue.
"The White House said Tuesday that President Obama would veto a House GOP bill to delay a contentious part of Obamacare for one year." Washington Times, March 4
"The Obama administration is set to announce another major delay in implementing the Affordable Care Act, easing election pressure on Democrats." The Hill, March 3
So which is it: good or bad to delay for the mid-terms?
simo, you are correct, it's a cynical, machiavellian move by ombama. pretty transparent if you ask me, and once again it's an unconstitutional over reach for the president to rewrite the law whenever he feels like it.
Looks like the top Obamacare architect is going to resign on 3/31. Looks like the rats are beginning to jump ship. I wonder why since this is suppose to be the greatest thing since sliced bread. ( couldn't help myself I just had to throw a cliché in).
this isn't just Obama's signature accomplishment, it's his only accomplishment, and by him delaying the enactment of his own (Obamacare) signature (and only) accomplishment he is sending a clear message that he doesn't really support his own program, that he the president doesn't honestly believe it can work as designed.
this latest delay is the 31st adjustment he has made to his own program. and clearly it is self-serving because this latest move by him is only being done to protect the Democratic majority in the senate
in my humble opinion this is a cold hearted, cynical machiavellian use of executive power. and it reveals to me Obama's lack of true character, again. He is just not a nice guy. He doesn't play well with others, and he holds grudges and takes revenge. Not good qualities for the leader of the free world. imo.
"this isn't just Obama's signature accomplishment, it's his only accomplishment,"
MG -- not true, there are others or did you forget Bin Laden for example?
" and by him delaying the enactment of his own (Obamacare) signature (and only) accomplishment he is sending a clear message that he doesn't really support his own program,"
MG not true either since the program is still active.
"that he the president doesn't honestly believe it can work as designed."
MG -- Yes, I would say that's true and a given since he has changed some design elements. For delays it is half true since he is really saying "it can work as designed, just not at the present time."
this latest delay is the 31st adjustment he has made to his own program. and clearly it is self-serving because this latest move by him is only being done to protect the Democratic majority in the senate
MG -- half true. Of the 37 changes (totall will always be different and is not included in the "truth" scale), 20 are admnistrative (obama), 15 are by Congress, and 2 are by the Supremes. So somewhat true but mostly not.
in my humble opinion this is a cold hearted, cynical machiavellian use of executive power. and it reveals to me Obama's lack of true character, again. He is just not a nice guy. He doesn't play well with others, and he holds grudges and takes revenge. Not good qualities for the leader of the free world. imo.
MG --- well it's an opinion but I think most would disagree on whether he is a nice guy or not and whether being a nice guy is an important characteristic for leader of the free world. So, this one is unrated.
Busted.
Yes we heard.....Alqaeda is on the run and Bin Laden is dead. Another election line of bull. Bin Laden is dead but terrorism is not on the run.
"The number of serious international terrorist incidents more than tripled last year, according to U.S. government figures, a sharp upswing in deadly attacks that the State Department has decided not to make public in its annual report on terrorism due to Congress this week.
Overall, the number of what the U.S. government considers "significant" attacks grew to about 655 last year, up from the record of around 175 in 2003, according to congressional aides who were briefed on statistics covering incidents including the bloody school seizure in Russia and violence related to the disputed Indian territory of Kashmir.
Terrorist incidents in Iraq also dramatically increased, from 22 attacks to 198, or nine times the previous year's total -- a sensitive subset of the tally, given the Bush administration's assertion that the situation there had stabilized significantly after the U.S. handover of political authority to an interim Iraqi government last summer."
Oh wait, that's a 2005 Washington Post story..... Sorry, that was the Republican response to terrorism. Here's Obama from the Star Ledger at the end of 2011: "If Barack Obama were a gunfighter, he’d have more notches on his shootin’ iron than Wyatt Earp.
In Obama’s 21⁄2 years as commander in chief, his administration, through adroit use of unmanned drones and shared intelligence, has orchestrated the killing or capture of more than 20 terrorist leaders and field commanders of al Qaeda, the Haqqani network and the Taliban.
Indeed, one of the most perilous occupations on the planet these days is as boss of an Islamic terrorist band. No sooner does al Qaeda or its franchises give some bloke a promotion than he swallows a drone missile. It’s a hard world."
No, you are right terrorism is not on the run; they would be killed if they did that.
From the Political Research database in 2012: "The numbers have dropped dramatically. Since 2007, the number of global deaths from terrorism has dropped by 45%, almost cutting the terrorist death toll in half over five years. The biggest success story on this front is Iraq, where the number of annual terrorism deaths has dropped to less than a quarter of what it once was. The Bush administration gets some credit here: 69% of the reduction in global terrorism deaths and 82% of the reduction in Iraq terrorism deaths occurred during his final year in office.
Although the number of terrorism deaths both worldwide and in Iraq have continued declining under Obama, the number of deaths in Afghanistan has risen steadily. The number of deaths in Pakistan began increasing under Bush, peaked in 2009 and has since slowly declined.
The data are a reminder of just how ghastly the Iraq war got and of the dramatic decrease in violence there during Bush’s last years and Obama’s first."
I think Bush killed 4,600. Oh wait, that's US soldiers killed in Iraq to chasing invisible WMDs and furthering terrorism in that country that Bush later could claim he cured spinning away from the WMD angle.
Spot on Simo, spot on.
only busted in the dark dank alleyways of your own muse, that's all.
hah! , you actually made me made literally laugh right out loud, thank you i needed that today, (it's been another brutal week for this sad lonely dog)
are we having fun yet?
Uh oh ---- over 8 million signed up.
Still can't find comprehensive, and current, pricing study. Latest news includes AHCA pricing for NJ is lower than what it used to be. And CBO forecast for future pricing got lowered ---- but that's a forecast. Still waiting for comprehensive pricing results.
So we are better covered. Now what?
Anyone who believes we are better covered has to be nuts.
We're paying almost double what we did last year with a whopping deductible we didn't have before.
jrsemom Paying more and a higher deductible. But good news, we have pediatric dentistry. Too bad our kids are 33 and 35. This is what we get for owning our own business and paying for insurance ourselves. It's them and my grandchildren I worry about.
Simo, how is it that you're paying for pediatric dentistry? At my office only people wiith qualifying children pay for that. Or are you just exaggerating?
Family of 5 paying over a thousand less a month in premiums than I was last year. Better coverage. Lower deductible and lower co insurance .Doctor copays stayed the same $30 gp or $60 specialist. Could not be happier
dismom Dismom, so you are saving over $12,000 a year. How much were you paying last year and what plan did you move from to? If you don't mind me asking. I assume you are self employed.
30%+ increase in my contributions this year without a substantial pay raise.
Something has to give.
JIT: I am sorry for the price change, unfair, but hard to say way. Is it you company, the insurance wanks, or obamacare? Is it NJ or the US? I know knowing this would not help, but price increases and increased contributions are a way of life in the private sector. And the advent of Obamacare offers great timing to stick it to you again independent of real reason.
The price/cost jury on Obamacare is still out, there's no compelling evidence for up or down. Although I expect a mixed bag where, for example, NJ might go up, but NY goes down. http://www.politifact.com/punditfact/statements/2014/mar/28/ed-schultz/ed-schultz-obamacare-driving-costs-down/
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