So has Obamacare worked? Has it not? Is it helping or hurting?

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palehorse

Lifer
Dec 21, 2005
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What provision of the ACA do you think is motivating this change?
It's probably the "dependents" portion that conveniently omits any requirement for spouse coverage. Sactoking has explained that potential issue here on several occasions.
 
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palehorse

Lifer
Dec 21, 2005
11,521
0
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Upper middle class is the demographic targeted to pay for the lower class and those who are currently uninsurable. There aren't enough wealthy to do it via health insurance cost transfers and the Republicans have enough Senators to prevent the Democrats from simply enacting a sizable wealth transfer via taxes, so tag, you're it. Be thankful you at least have one benefits-generous employer between you, although losing dual coverage (which is inevitable - it's not fair that you have dual coverage) is going to hurt. But remember the proggie mantra - good financial planning on your part includes setting aside some money for him too.

The trade-off is that the poor and the uninsurable will have health insurance, or likely better health insurance if they have it now.
I believe you are correct, sir.

It's too bad they didn't include "mandatory access to free lubrication" in the ACA's long list of mandates...
 

fskimospy

Elite Member
Mar 10, 2006
83,717
47,406
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It's probably the "dependents" portion that conveniently omits any requirement for spouse coverage. Sactoking has explained that potential issue here on several occasions.

So you think that the lack of a requirement in the ACA to cover spouses is the reason why they are dropping spousal coverage... even though there is no requirement to cover the spouse under current law either.

So the ACA continuing on exactly in the same manner as current law is the cause. That makes absolutely no sense.
 

fskimospy

Elite Member
Mar 10, 2006
83,717
47,406
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Who cares what provision is causing companies to make changes? The fact of the matter changes are coming starting January 2014 and companies are looking to save where they can no matter is if costs the person being insured more in premiums (ie two separate plans vs one family plan).

Well if you think the ACA is causing that change, there should be something in it that you can point to.

Companies have been looking to save on health costs in all sorts of ways (including dropping spousal coverage) for years before the ACA was passed. That's what happens when you have a decade of health care inflation at twice the rate of regular inflation (or more).
 

sactoking

Diamond Member
Sep 24, 2007
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So you think that the lack of a requirement in the ACA to cover spouses is the reason why they are dropping spousal coverage... even though there is no requirement to cover the spouse under current law either.

So the ACA continuing on exactly in the same manner as current law is the cause. That makes absolutely no sense.

I'm not advocating this as a position but it is possible that the creation of the exchanges has brought in a psychological "backstop" that allows employers to more readily justify dumping spouses.
 

fskimospy

Elite Member
Mar 10, 2006
83,717
47,406
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I'm not advocating this as a position but it is possible that the creation of the exchanges has brought in a psychological "backstop" that allows employers to more readily justify dumping spouses.

Anything is possible, but I'm not aware of any evidence for an increase in the rate of spousal coverage drops since the ACA has been passed.
 

sactoking

Diamond Member
Sep 24, 2007
7,507
2,703
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Anything is possible, but I'm not aware of any evidence for an increase in the rate of spousal coverage drops since the ACA has been passed.

I'm not either, but we probably won't know until late 2015 or 2016 at the earliest. That's assuming that most employers subject to the ACA early renew in late 2013 to bypass most of 2014 and don't see material plan design changes until late 2014 or early 2015.
 

TridenT

Lifer
Sep 4, 2006
16,810
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The reason many doctors seem to hate it, especially the older ones, is because of the new technology they have to use. Many of them don't even know how to type. They will learn it and leverage it more efficiently as time goes on.

It's really similar to how computers were introduced to the workplace and forcing every employee to learn how to use word/excel, etc rather than using paper and pen for everything.

This.

I've worked with many doctors who use the latest and greatest technology. Generally, the younger ones are like, "This is fucking awesome! So easy to manage all this data now and send to other people around the campus" and the older ones are like how you would imagine... barely can type and need an assistant for everything that involves a computer or phone. I've seen plenty of older doctors who are giz-wiz's though. I think it's the ones who complain a lot that give it a bad rep and make it seem like all doctors hate it.

It's like most systems... it takes some time to learn but eventually you're more proficient with it. And, of course, some people are hopeless...
 

werepossum

Elite Member
Jul 10, 2006
29,873
463
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I'm not advocating this as a position but it is possible that the creation of the exchanges has brought in a psychological "backstop" that allows employers to more readily justify dumping spouses.
Perhaps, but another explanation might simply be that the free goodies required by the ACA make it more important to determine exactly who has the obligation as the primary insurer. If one has double coverage, only one insurer will be required to provide free birth control, free checkups, etc. It is therefore to the insurer's benefit to determine if a spouse has insurance through his/her own employer, so that insurance gets designated as prime for the spouse.

I have seen this already with a coworker whose wife has excellent and heavily subsidized insurance. BCBS made him drop our insurance (which he used as supplemental insurance) even though both policies were BCBS. Evidently the loss in premiums is less than the additional payouts in his case as surely the freebies are one per person no matter how many policies one has. Or perhaps there are mandated pay-outs that make spousal coverage worse for the insurer.
 

Zorkorist

Diamond Member
Apr 17, 2007
6,861
3
76
This.

I've worked with many doctors who use the latest and greatest technology. Generally, the younger ones are like, "This is fucking awesome! So easy to manage all this data now and send to other people around the campus" and the older ones are like how you would imagine... barely can type and need an assistant for everything that involves a computer or phone. I've seen plenty of older doctors who are giz-wiz's though. I think it's the ones who complain a lot that give it a bad rep and make it seem like all doctors hate it.

It's like most systems... it takes some time to learn but eventually you're more proficient with it. And, of course, some people are hopeless...
They probably hate it because it is bull shit, and has nothing to do with helping a person.

-John
 

Zorkorist

Diamond Member
Apr 17, 2007
6,861
3
76
The younger ones, are all about living high as they can. Communist, Socialist... as long as the little pigs aren't me.

-John
 

PhoKingGuy

Diamond Member
Nov 15, 2007
4,689
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They probably hate it because it is bull shit, and has nothing to do with helping a person.

-John

As usual, Trident is a shithead.

I'm a young physician, EMR is good in theory, terrible in execution. Things take forever to do, most of the programs used are terribly coded with GUI's out of the mid 90's.

Most things require paper backup anyway so you're stuck doing the same thing twice. Writing a paper chart then transferring it to the computer.

Not everyone can afford a 50k+ setup with ipads, integrated/installed workstations, etc.
 

TridenT

Lifer
Sep 4, 2006
16,810
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As usual, Trident is a shithead.

I'm a young physician, EMR is good in theory, terrible in execution. Things take forever to do, most of the programs used are terribly coded with GUI's out of the mid 90's.

Most things require paper backup anyway so you're stuck doing the same thing twice. Writing a paper chart then transferring it to the computer.

Not everyone can afford a 50k+ setup with ipads, integrated/installed workstations, etc.

The doctor that I go to doesn't use paper when I'm there. While I'm there, they just type what they want into a computer. They're a pretty big hospital too with many campuses... I've seen the programs they use and actually sat there with them while they type it in. I'll admit, they're not great (Cosmetically, superficially, otherwise they actually seem snappy) and could use some refining but they look way better than paper records. I can't remember what they were using. Something with stars in the launch logo (I think it might have been some EPIC software).

Your experience is not universal truth. The above was my personal experience and not my professional experience. (Which is that I've supported people on these systems before)