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July 2, 2012 at 11:42 pm #762394
dobroParticipantPersonal responsibility is the cornerstone of the ACA law. Having health ins=personal responsibility. It is required by the ACA or you pay a penalty to be administered by the IRS. Those funds will help defray the costs of those who choose to remain uninsured (those who eschew personal responsibility).
The idea behind ACA, a Republican idea from the conservative Heritage Foundation, is that rates will be more moderate because insurance co’s. will get a huge influx of young healthy new customers from which they will make $ on premiums right away but to whom they won’t have to pay much in claims until many years later. There are also preventive care incentives, etc. designed to keep costs and rates down.
The ACA doesn’t establish actual rate caps. Health insurance co’s. aren’t even subect to federal antitrust laws. That’s why many Americans supported a public option, a competing government-run non-profit insurance program, to provide competition to the insurance companies. But this is what we have to start with.
July 3, 2012 at 12:10 am #762395
DBPMemberBostonman you said your boss was thinking about dropping insurance and paying employees 2k to 3k more a year. Would they be able to buy insurance on their own for that much? I’m guessing not.
If I worked for your company, I would be pissed-off about that.
In any case, you’ve raised an interesting problem. I can see where a business of just over 50 employees (like yours) would be motivated to shed a few of them in order to maintain a competitive edge. If the ACA penalizes larger companies relative to smaller ones, then that is clearly a weakness of the program and it should be addressed so that we’re not incentivizing employers to shed workers or drop their existing health care coverage.
Likewise, we should not be incentivizing doctors to opt out of providing coverage. Rather, we should be disincentivizing them, and I’ll talk about that in a separate post.
July 3, 2012 at 2:37 am #762396
miwsParticipantJuly 3, 2012 at 4:16 am #762397
redblackParticipantJV:
Their objective is to “give” us all of these nice things then say, “good luck trying to walk that back” because they know that once people get an entitlement, it can never be taken back. See any gov’t program as an example.
you’re referring to less than 1% of the population at large. outside of large businesses that refuse to provide employees with access to group rate health insurance – like wal*mart – that’s who the ACA affects.
if it’s a tax, or a penalty, or a tithe, it only affects those who don’t have health insurance.
it doesn’t affect you, me, or bostonman.
btw, bostonman, how are you going to feel when your employer drops his health plan? how about your wife and kids? are you willing to go seek health care insurance in the open market, with no group rate discount? if so, are you happy about it?
no? well, welcome to the bottom 1%.
July 3, 2012 at 11:07 am #762398
kootchmanMemberDepends redblack… warehouse workers, service workers will take the brunt.
Dobro… again look to Mass. Your “cornerstone” is wet sand not granite. The fines are indexed to income. It’s still cheaper to pay the fine then enroll when you get sick. Mass health care costs are rising faster than any other state.
“The country is currently engaged in a pitched battle over the size of government and the fierce struggle over the debt ceiling is a skirmish in this much larger war. Health spending is central to this debate. But many Americans may not realize the degree to which healthcare has dominated the growth of government over time. Between 1966 and 2007, the entire increase in the size of government relative to the economy resulted from growth in tax-financed health spending.”
To the chagrin of Obamacare proponents.. there are data points to compare talking points to.
Before ya tangent off into “incentivizing” docs… to lower their incomes or… perversely, improving production efficiency in Kaiser style plans…
http://www.american.com/archive/2011/july/health-is-the-health-of-the-state
July 3, 2012 at 12:16 pm #762399
redblackParticipantthat’s great, kootch. but here’s another data point to counter your talking points.
massachusetts has something that the country as a whole doesn’t have: nearly-universal coverage at 98 – 99%.
the u.s. as a whole? around 85%.
July 3, 2012 at 1:47 pm #762400
DBPMemberReally? 85% of Americans are covered? Frankly, that number surprises me. But then . . . so does the official employment rate.
Hm. I wonder if that coverage figure includes Wal-Mart employees. Wal-Mart has an optional insurance program that’s so stingy it’s practically worthless.
Low coverage + high premiums + high deductibles ≠ real insurance, IMHO. Anyone covered under a miser plan like Wal-Mart’s should not even be considered as being insured. Those folks are probably going without other necessities, just so they can stay insured. It’s not sustainable.
I do hope that ACA was written so that Wal-Mart and companies like it won’t be able to wriggle off the hook. That would suck.
July 3, 2012 at 4:08 pm #762401
BostonmanMemberWell I wouldn’t be happy if he decided to do it and if it happened I don’t think I would need to find some employees to trim because the attrition would probably happen naturally.
That being said I am a pretty healthy 40 year old and my wife and kids are healthy also so I am fortunate. In fact I pay for a plan outside of my company to cover my family because my work policy changed to not cover any portion of family members and we had a rate increase. Amazingly I pay about $400 less a month with a plan we found but again, we are all pretty healthy.
July 3, 2012 at 4:12 pm #762402
BostonmanMemberI can’t believe 85% of people in the US have insurance. On top of that I am to believe that on one hand its those people driving up everyones rates but on the other hand you are saying those are the healthy people who will not use the insurance???? Which is it?
Wikipedia says 16.7% don’t have insurance but that are mainly poor or unemployed so they would get insurance for nothing meaning insurance costs go up without anymore money coming into the system.
July 3, 2012 at 9:32 pm #762403
kootchmanMemberShoot the don’t what songbook they are singing from, let alone the key.
Obamacare is like this. Ya go on a first date, .. the next morning, you buy a house, get married, get two car loans, decide to have 4 children, invite your in-laws to move in. Now, you may have hit pay dirt. But I doubt it. Let’s take out health care reform for a little road testing eh? In fact, let 50 states do it. Then we can see some consumer reports on how it all works and who rates their care the best. Replace and repeal … no. Repeal and reform.
For he chirping birds that think OMB has credible projections… square this?
Obamacare was going to punish states who didn’t participate. It was necessary for each state to pay 10% of the increased costs of coverage. ALL of them. That was the OMB assumption. Obamacare in the Supreme Court decision was told they cannot use retribution and lower the state reimbursement rates. Unconstitutional.
Ta da..
Florida Gov. Rick Scott tells Newsmax he will refuse to implement provisions of Obamacare despite the Supreme Court’s ruling because the healthcare overhaul will be “devastating” to Florida families and taxpayers.
and
On Fox News on Thursday night Jindal declared, “Absolutely, we’re not implementing the exchanges. We’re not implementing ObamaCare” following the Supreme Court’s ruling that Obamacare is constitutional
and
Ohio Gov. John Kasich released a statement saying, “We are very concerned that a sudden, dramatic increase in Medicaid spending could threaten Ohio’s ability to pursue needed reforms in other areas, such as education.” While the federal government would pay at least 90 percent of the cost of expansion, some states say the remainder is still too much. As Margot Sanger-Katz writes in National Journal, if states refuse to expand Medicaid, there’s no other provision in the Affordable Care Act to cover the very poor. “The decision puts these poorest residents in a difficult position. They’ll be required to buy insurance but ineligible for Medicaid,” she writes. Daniel Hawkins at the National Association of Community Health Centers tells her, “you are effectively consigning them to health insurance hell.”
And while they won’t admit it .. and are scrambling like hell to keep their liberal creds… California CANNOT, fiscally is incapable of picking up the additional cost. Illinois is in the same sceanrio.
Texas has already sent money back to the feds and says they have no intention of implementing any section of Obamacare.
AZ has now announced, they will use no state resources, including state Medicaid records, to assist the federal government until such time as the federal government assists in enforcing immigration law, AND they will not implement Obamacare.
Now .. tell me that your OMB score is accurate Dobro!!! Hell it’s not going to come even close.
July 3, 2012 at 9:36 pm #762404
kootchmanMemberOne more time redblack….
As Margot Sanger-Katz writes in National Journal, if states refuse to expand Medicaid, there’s no other provision in the Affordable Care Act to cover the very poor. “The decision puts these poorest residents in a difficult position. They’ll be required to buy insurance but ineligible for Medicaid,
See the 95% who are covered,.. they vote too. As it now stands, the needle hasn’t moved..the public isn’t buying the story. 54% of Americans still want Obamacare repealed.
July 3, 2012 at 9:47 pm #762405
waynsterParticipantKootch don’t forget the death squads that Sara P. says will happen http://politicalticker.blogs.cnn.com/2012/06/25/palins-death-panel-lives-on/……..From what I just read its 50% in favor of healthcare and 49% against so…. http://politicalticker.blogs.cnn.com/2012/07/02/cnn-poll-health-care-ruling-changes-views-of-supreme-court/……kinda makes you wonder who’s pole is right and I’m sure someone else could find different ones from ours…..and to think conservative judges do and have in the past sided with the liberals when they read the laws like they were written…. so its time just to move on and watch to see how it works and tweak it to work better everyone is so worried about a law that everyone has the knowledge on that has never been in place and won’t be for 2yrs… we could argue untill the cows come home and then some kind of like they did during the medicare/civil rights acts of the 60’s…….
July 4, 2012 at 7:58 am #762406
kootchmanMemberIt’s not time to move on. We don’t play that way. The majority of Americans supported civil rights. When that happened, the collective consensus made it possible. You can’t tweak a monster. Medicare is probably the worst example. It is so entrenched it sucks the budget in ever greater gulps. You want to build a national consensus on a program, 54% per cent of American want repealed. By the polls I read. One point, even if your polls are correct is not consensus. Here’s the trouble for the left. The tweaking options to nullify the act are vast and myriad. I see the IRS is hiring 800 employess.. that’s where this is going… HHS?.. double, triple their current size?
“Peace is that brief glorious moment in history when everybody stands around reloading”.
–Thomas Jefferson
July 4, 2012 at 8:05 am #762407
kootchmanMemberIt’s preventative care.. the Wal Mart plan. Health screenings. “stingy”? That’s what the left said they wanted “basic healthcare”… so, you are saying basic healthcare is too stingy? Tis the doublespeak … at least redblack stands up and says nothing to too expensive, no costs too great… to give equal care to everybody. It’s a tad “pollyannish” but on point and clear. No one on the left will ever say what “basic healthcare” is.
July 4, 2012 at 4:01 pm #762408
DBPMemberWal-Mart’s plan cannot be considered “basic healthcare” by any stretch. You don’t seem to have a very good grasp of the concept.
Here’s the deal:
Basic healthcare =
¶ Low/no premium
¶ Low/no deductible
¶ Check-ups covered at 100%
¶ Basic outpatient procedures covered at 100%
Wal-Mart insurance =
¶ High premium (relative to pay)
¶ High deductible (relative to pay)
¶ Check-ups apply toward deductible
¶ Basic outpatient procedures apply toward deductible
Wal-Mart has made some progress in the last 10 years, but recently they’ve started to slide back again. You know something’s not right when the company you work for tells you to apply for Medicaid!
Here’s some info from a Wal-Mart employees Web site:
Even for employees who are eligible for coverage from Walmart, the costs of the plans that the company offers are unaffordable for many hourly associates, who earn an average of just $8.81 per hour. Walmart’s 2012 Associate Benefits Book, distributed to employees, advertises Medicaid and CHIP premium assistance programs for employees who eligible for Walmart’s health insurance but are “unable to afford the premiums.” The book then lists contact information for assistance programs by state.
In a “NOW with Bill Moyers” interview from December 19, 2003, former Walmart Manager Gretchen Adams said the company encouraged associates to enroll in public assistance programs: “The personnel office will generally keep lists for their territory, for their town –because so many of the associates cannot afford the healthcare. So being that whenever they do have an issue or a problem that comes up and they come to the office then they – personnel has a list of the state agencies so that we could have some place to send these associates.”
Despite over $12 billion in profits, former President and CEO Lee Scott admitted in 2005, “In some of our states, the public program may actually be a better value – with relatively high income limits to qualify, and low premiums.”
In fall 2011, Walmart made it even more difficult for associates to get quality health care for themselves and their families. Beginning with the 2012 enrollment period, Walmart rolled back health care coverage for part part-time employees and raised premiums for full-time employees by as much as 63% for non-smokers and their families and as much as 162% for smokers with families. . For employees earning $8.81/hour working an average of 34 hours per week, some of Walmart’s 2012 healthcare plans would cost between 77% and 104% of the employee’s annual gross income.
July 4, 2012 at 4:20 pm #762409
dobroParticipantFrom right wing commentator David Frum…
The Republican Plan B is to repeal Obamacare on Day 1 of a Romney presidency.
Good luck with that.
First, today’s Supreme Court decision will make it a lot harder to elect Mitt Romney. President Obama has just been handed a fearsome election weapon. 2012 is no longer exclusively a referendum on the president’s economic management. 2012 is now also a referendum on Mitt Romney’s healthcare plans. The president can now plausibly say that a vote for the Republicans is a vote to raise prescription drug costs on senior citizens and to empower insurance companies to deny coverage to children for pre-existing conditions. Those charges will hurt—and maybe hurt enough to sway the election.
July 4, 2012 at 4:55 pm #762410
DBPMember>>President Obama has just been handed a fearsome election weapon.
So true, dobes! But will Obama use this weapon? Or will he wimp out once again?
The fact that we’re still having to fight this battle is testament to what a timid advocate the President has been. We should be marching in the streets over this, with the President in the lead — not hashing it out over an Internet forum with a bunch of people who hate our guts.
[Sigh]
July 4, 2012 at 5:31 pm #762411
kootchmanMemberIt is your wish that it not be an economic referendum. There will be 2 billion dollars worth of PAC money that will decide what the issues are. I am a senior citizen. I have taken as careful a look as most .. and I am not willing to trade away the economic prosperity of two successive generations for what he offers. Still, and yet, there is the little matter of 16 and more than 20 trillion in deficits if he is re-elected. Not one hint from the left about what they intended to do about it. Nothing. It’s ignored as if they are children that won’t look in the dark closest at night for fear of the “monster” therein. There is too much reliance on serendipity. He would love to use the weapon… he is trying. Over and over and over again. If you were for Obamacare last year, you are for it this year.. if you were against it last year, you are against it this year. It’s not a game changer. who can best handle the economy is the election. I am sure you will here more of that to come. Seniors don’t scare that easily.. the model of terrified bermuda short cladded old farts with comprehension difficulties is no more.
July 4, 2012 at 6:29 pm #762412
kootchmanMemberHuh? who has this? Anywhere, except government employees? So basic healthcare is… ‘free” helathcare?
Basic healthcare =
¶ Low/no premium
¶ Low/no deductible
¶ Check-ups covered at 100%
¶ Basic outpatient procedures covered at 100%
BHO – Roberts confirmation hearings, US Senate 2005
“I will be voting against John Roberts’ nomination. I do so with considerable reticence. I hope that I am wrong. I hope that this reticence on my part proves unjustified and that Judge Roberts will show himself to not only be an outstanding legal thinker but also someone who upholds the Court’s historic role as a check on the majoritarian impulses of the executive branch and the legislative branch.”
July 4, 2012 at 6:39 pm #762413
DBPMemberJuly 4, 2012 at 6:57 pm #762414
JanSParticipantwell, now, DBP…what constitutes a “senior citizen”? over 50? over 55? over 60? over 65? You get medicare at 65, but some consider “senior” as a much younger age. I say, you’re as old as you feel. It’s just a number :D
July 4, 2012 at 7:19 pm #762415
kootchmanMemberNope, I am not. Don’t need it. I doubt it will be solvent much longer. They just raided it to the tune of 500 billion to pay for Obamacare.
July 4, 2012 at 11:03 pm #762416
megMemberHere’s a view from the medical front line. Does it contribute to the “health care” discussion? I think it does.
My partner & I had made plans to slaughter and process this a.m. While we were working, he accidentally sliced his hand through his glove, deep enough to need some stitches. We dropped everything and headed to the nearest ER. Got there and went through the intake paperwork and then a quick initial exam. After an x-ray, he’s told “We are really busy so you will need to wait to see a doctor.” Fine, we sat and waited. Several hours passed by, and then finally an ER Nurse was sent in, in place of a doctor. Apologizing for the long delay, she explains (like everyone else has) that the ER has been incredibly busy this a.m.
What follows is brief conversation that happened in the 5 minutes my partner was being treated:
Partner: Is everything okay? You guys extra busy from the holiday?
ER Nurse: We are stable for the moment, all Airways are Clear. Now, we can focus on stitching up your hand. No, unfortunately this busyness is not holiday related and not unusual anymore.
P: Airways are clear?? What’s that?
ER: Heart attacks. We had over 6 heart attacks arriving within a few hours of each other.
P: Is that high?
ER: Unfortunately no. The number has been growing so fast that it’s mind-boggling. We have at least that many, maybe more, all the time. I’ve been in ER for several decades. I’ve seen the acceleration. It’s not just the elderly anymore. It’s all ages. Children and teenagers are coming in, young adults, and younger middle-agers. People who *never* used to have heart attacks. They are coming in with heart attack — more and younger than ever.
ER: (in a whisper) It’s what I call “The French Fry Factor”.
P: Fries, yep. Crap as nutrition. Yeah we’re aware.
ER: It’s such a HUGE problem. And everyone in this ER is dealing with it, first-hand. We know what’s wrong with “health care”. We in ER are ALL just sick about it – sick about the fact no one wants to deal with the cause, with what’s happening, and drug companies are keeping people sick. We see ALL this.
ER: (very emphatically) We are on the Front Line. We are not sitting in Some Doctor’s Office!
P: French Fries, and what else?
ER: Refined foods, processed foods, sugar in everything. Heart attacks, coronary disease, obesity, chronic disease.
P: You guys are great at this here (holding sliced up hand). You are pros at treating accidental wounds and stitching me up when my hand is sliced and gushing blood!
ER: (huge smile) Yeah, we are GREAT at this! No one does it better. Trauma and injury: absolutely the best use of our skills. It’s too bad no one wants to talk to us in the ER front line to see what’s the real health crisis we’re dealing with, to ask what we see. No one wants to ask us what is happening, who is coming in the door, and what do we think about it.
July 4, 2012 at 11:53 pm #762417
kootchmanMemberAh, the great sensitivity to the issue. Diet and nutrition are the first line of defense. But that puts the onus on individual responsibility… it doesn’t fit the conventional political strategy of effortless rewards.
July 5, 2012 at 2:26 am #762418
megMemberYes, to personal responsibility. Yes, to being well informed about the role of nutrition in healing and maintaining robust health. Yes, to knowing that one’s digestion is about enzymatic breakdown and bacterial fermentation – and is not a calorie “combustion engine”. Yes, to understanding your liver’s health and how eating refined carbs and sugars impacts it. blah blah blah. Most definitely, yes to all that.
But what about the food science industry, and laboratory high-tech research, evermore cleverly teasing out sophisticated ways to maximize food reward by manipulating our brain pathways to bring about more and more powerful addictions? Food rewards as binding as high-tech drugs, for the sole purpose of selling more corporate product by overwhelming your brain’s biology? What about THAT responsibility? Not instead of, in addition to.
Is it possible to start with slapping a heavy tax on the most glaring products, or ingredients?
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