Unions no likey Obamacare now

[fskimospy]

.... except this isn't about a 'tax on the cadillac plans'. The unions are not complaining about that (at least not yet), they are whining because businesses are doing exactly what any logical person would do given the framework of the obummercare fiasco. They are reducing work hours so they can escape costs and administration headaches. The workers lose the healthcare they have, and at the same time collect smaller paychecks because of reduced weeks.

Of course many intelligent people predicted that's exactly what would happen, but now the useful idiots are starting to learn that they screwed themselves.

I actually agree that the employer mandate should be changed or eliminated and it probably will be. It's hilarious to me that you think identifying a problem before implementation and acting to fix it is some sort of fiasco. As I said before though, you aren't interesting in solving problems as you mentioned before. It's pretty gross and immature, but hey, that's you.

 

[poofyhairguy]

We are headed for rationed health care. That is the only way we as a country can control costs.

Unpossible politically.

Most of the rationed care would be related to the elderly and baby boomers (who are about to be elderly). The elderly and baby boomers are the most likely demographics to vote, so nothing gets done.

Heck, the elderly and baby boomers are what is bankrupting all of America. A retirement age of 69 (aka that is when you can get SS and Medicare) would basically fix the deficit problem, but we can never have that because the elderly won't deny themselves and baby boomers are determined to "get theirs."

America is f*cked.

 

[fskimospy]

Unpossible politically.

Most of the rationed care would be related to the elderly and baby boomers (who are about to be elderly). The elderly and baby boomers are the most likely demographics to vote, so nothing gets done.

Heck, the elderly and baby boomers are what is bankrupting all of America. A retirement age of 69 (aka that is when you can get SS and Medicare) would basically fix the deficit problem, but we can never have that because the elderly won't deny themselves and baby boomers are determined to "get theirs."

America is fucked.

That doesn't really fix the deficit problem at all. What that does is push care for the elderly in those years in two ways. 1.) Back onto the less efficient private system, which would increase costs or 2.) backload care that would be consumed once the person hit 69.

The only cohort this would save money on are those who don't have private health insurance and die somewhere between 65 and 69. This is a terrible idea.

 

[sourceninja]

So this whole part time thing confuses me.

If they cut everyone's hours part time, they have to hire more workers to make up the difference. I was under the impression that the law was not "part time workers do not need insurance" but rather that you had to offer insurance if you had the equivalent of 50 full time workers. So by having 100 part time workers, they will still have to provide insurance...

 

[Zebo]

No worries he's kicking down the road the meat of the bill.

 

[werepossum]

I think the employer-based system was on its way out anyway - with or without ObamaCare. When I started at the company I work for now, there were NO premiums for health care (15 years ago). Now the premiums are over $400/month, the copays are much higher, etc... American corporations are eagerly waiting for the day when they can dump health care for their employees.

We are headed for rationed health care. That is the only way we as a country can control costs. Every other country is doing it and it completely inevitable that we will as well.

We already have rationed care, for everything desirable that costs time or treasure is inherently rationed. Right now the USA rations health care by availability via insurance and by cost, whereas countries like the UK ration health care by availability via queue and by lowering the quality of care one receives. (I.e. one sees a nurse rather than a doctor and standards are lowered for each level of provider.) But yes, I agree we're moving toward a system where government controls and rations all health care. That's why Obamacare had such corporate support. Large companies have trillions in health care commitments for current and past employees; if they can offload that cost onto taxpayers that would be an incredible boost to profitability and competitiveness.

I've previously linked a study on MRIs for Canadian heart patients. It's one of the things Canada has been working on, for right at 50% of heart patients needing an MRI dropped out of queue before their 12+ month wait was up. Some died, some became too sick to survive the surgery for which the MRI would have provided approval, some went to other countries, and some dropped out without leaving a trail. In the USA the wait is typically less than a week, even for those without insurance. (In Canada one's pet could get an MRI same day, amusingly enough.)

Which system is better depends largely on one's circumstances. If a Canadian is languishing in Canada waiting for an expensive procedure with a long queue, the American system looks mighty good. If a Canadian has a routine medical need in Canada and gets quick attention at little or no cost, the Canadian system looks mighty good. If an American has good insurance and gets immediate access to the best care in the world, the American system looks mighty good. And if an American has no insurance and cannot get expensive but non-critical care or gets good medical treatment but at the cost of financial ruin, the Canadian system looks mighty good. It's all a matter of one's current circumstances.

 

[werepossum]

Unpossible politically.

Most of the rationed care would be related to the elderly and baby boomers (who are about to be elderly). The elderly and baby boomers are the most likely demographics to vote, so nothing gets done.

Heck, the elderly and baby boomers are what is bankrupting all of America. A retirement age of 69 (aka that is when you can get SS and Medicare) would basically fix the deficit problem, but we can never have that because the elderly won't deny themselves and baby boomers are determined to "get theirs."

America is f*cked.

I'm 52, last of the boomers, and my retirement age is already 69. By 2029 it will probably be 80.

 

[Jhhnn]

Gasp... who could have possibly foreseen such things? Oh, just about anyone who wasn't a complete gullible moron.

Hopefully the GOP doesn't give them the opportunity to "tweak" or change anything to suit their base. You made your bed, now lie in it.

Wishing for the Nation to fail, as usual.

 

[Hayabusa Rider]

The tax on 'cadillac plans' was widely discussed. If you don't remember it you just weren't paying attention.

I do remember. They were generally portrayed as being had by rich entrepreneurs while the rank and file were given second class care.

I doubt the rank and file knew they were targets. Now it's true that they may not have been paying attention and thought better days were ahead. Well honesty and plain speaking aren't requirements in politics.

I'm reminded of a little story of a woman who carried a near drowned serpent in her bosom until it recovered whereupon it bit her. She said to the snake, "I cared for you and saved your life but you bit me and I be like to die".

As the viper slithered away it said the last words she ever heard-
"Woman, what's you complaining about? You knew I what I was before you picked me up".

Some just never learn.

 

[poofyhairguy]

That doesn't really fix the deficit problem at all. What that does is push care for the elderly in those years in two ways. 1.) Back onto the less efficient private system, which would increase costs or 2.) backload care that would be consumed once the person hit 69.

The only cohort this would save money on are those who don't have private health insurance and die somewhere between 65 and 69. This is a terrible idea.

Putting those people back in private insurance pools with healthy young people will lead to lower costs. Plus the costs are on private books for those older folks, not public ones.

Those without private care probably qualify for medicaid.

And those who are retired and aren't eligible for medicaid? They can pay. I know many millionaire elderly that use medicare "because they paid their dues and taxes over the years." They can pay.

 

[fskimospy]

Putting those people back in private insurance pools with healthy young people will lead to lower costs. Plus the costs are on private books for those older folks, not public ones.

This is not accurate. Medicare's costs are lower than private insurance. You are saving the government money while costing the country as a whole more money in total. This is counterproductive if your goal is to reign in cost.

Those without private care probably qualify for medicaid.

And those who are retired and aren't eligible for medicaid? They can pay. I know many millionaire elderly that use medicare "because they paid their dues and taxes over the years." They can pay.

That's an argument to means test medicare (also a bad idea), not raise the medicare age.

 

[Spungo]

We are headed for rationed health care. That is the only way we as a country can control costs. Every other country is doing it and it completely inevitable that we will as well.

That's probably a good thing. With the profit motive currently in place, doctors and surgeons are encouraged to do things that are not medically necessary. Child birth is one example of this. The US has an incredibly high rate of c-sections because it costs a lot more and people are willing to pay it. The number of unnecessary tests and medical procedures would drop dramatically if certain cost controls were in place.

Insurance companies do a pretty good job of beating down medical costs. They get a bill for $1000 and they manage to haggle it down to $300. Governments in Canada and Japan take on this role. You'll notice that drugs in Canada are much cheaper than the US because all drugs go through the government and the government demands bulk discounts. In Japan, the costs of medical procedures are tightly regulated. The government will say you can't charge more than X amount for procedure Y.

 

[poofyhairguy]

This is not accurate. Medicare's costs are lower than private insurance. You are saving the government money while costing the country as a whole more money in total. This is counterproductive if your goal is to reign in cost.

Not if you believe like I do that at that point private insurance companies will begin to cut costs on elderly care. Nurses for doctors, caps on coverages, that sort of thing.

Government doesn't want to roll back what Medicare covers because old people vote and politicians need to be elected. Insurance companies' primary customers are the employers who want good care for cheap.

Some private insurance company will make a push in that direction and the market will follow. Their profit is the price we pay for being in a democratic society that lacks real leadership and where all politics are personal.

 

[sactoking]

So this whole part time thing confuses me.

If they cut everyone's hours part time, they have to hire more workers to make up the difference. I was under the impression that the law was not "part time workers do not need insurance" but rather that you had to offer insurance if you had the equivalent of 50 full time workers. So by having 100 part time workers, they will still have to provide insurance...

The part-time equivalent calculation is only used to determine if you're subject to the mandate. If it's determined that you are subject (50+ employees, full-time and equivalent) then penalty only applies to actual full-time employees, not equivalents. Then end result is that a business with 100 people each working 20 hours is subject to the mandate because it has 50 full-time equivalents but pays a penalty of $0 if it doesn't provide insurance since none of the employees individually are full-time and eligible for benefits.

 

[Jhhnn]

The part-time equivalent calculation is only used to determine if you're subject to the mandate. If it's determined that you are subject (50+ employees, full-time and equivalent) then penalty only applies to actual full-time employees, not equivalents. Then end result is that a business with 100 people each working 20 hours is subject to the mandate because it has 50 full-time equivalents but pays a penalty of $0 if it doesn't provide insurance since none of the employees individually are full-time and eligible for benefits.

Yeh, but zero full time employees is totally unlikely. Even the managers would have to be part time.

 

[fskimospy]

Not if you believe like I do that at that point private insurance companies will begin to cut costs on elderly care. Nurses for doctors, caps on coverages, that sort of thing.

What you are describing here has been available to insurers for the most part for years. It has not led to them successfully lowering costs. There is no particular reason to think that would change. So still, what you're saying just isn't backed up by reality.

Government doesn't want to roll back what Medicare covers because old people vote and politicians need to be elected. Insurance companies' primary customers are the employers who want good care for cheap.

Some private insurance company will make a push in that direction and the market will follow. Their profit is the price we pay for being in a democratic society that lacks real leadership and where all politics are personal.

This dynamic, if true, should have led to lower per patient costs across the board for private insurance. It hasn't.

 

[glenn1]

This is not accurate. Medicare's costs are lower than private insurance. You are saving the government money while costing the country as a whole more money in total. This is counterproductive if your goal is to reign in cost.

That's an argument to means test medicare (also a bad idea), not raise the medicare age.

Even if we stipulated lower Medicare costs for sake of this discussion, you overlook 2 major things:

1. Physicians aren't obligated to accept Medicare patients, therefore lower cost is moot if you can't find a supplier. Many are now refusing to do so due to the low compensation rates.

2. Whether quality of care and outcomes suffer in Medicare compared to the alternatives. Studies say that Medicare has worse outcomes than private insurance, and for that matter worse outcomes than people with no insurance at all. So whether it's cheap or not, sometimes you get what you pay for.

So if all you care about is that you get "universal coverage" and not whether it is actually available or actually worth having, then I guess your approach works fine.

 

[fskimospy]

Even if we stipulated lower Medicare costs for sake of this discussion, you overlook 2 major things:

1. Physicians aren't obligated to accept Medicare patients, therefore lower cost is moot if you can't find a supplier. Many are now refusing to do so due to the low compensation rates.

We aren't stipulating lower costs, the costs are lower. Additionally, plenty of physicians and hospitals accept Medicare.

2. Whether quality of care and outcomes suffer in Medicare compared to the alternatives. Studies say that Medicare has worse outcomes than private insurance, and for that matter worse outcomes than people with no insurance at all. So whether it's cheap or not, sometimes you get what you pay for.

So if all you care about is that you get "universal coverage" and not whether it is actually available or actually worth having, then I guess your approach works fine.

You didn't even read your own abstract, much less the study.

It says that private insurance has the best outcomes overall, (unsurprisingly considering its costs have grown at almost a 50% faster rate than Medicare) but Medicare has superior patient outcomes to uninsured people and Medicaid recipients. In fact, as compared to the uninsured, both Medicaid and Medicare have dramatically superior outcomes.

The question has never been how we can get the best care regardless of cost, we already know how to do that. It's how we can get the best bang for our buck. You should really read for understanding before you link something as opposed to trying to find the first link that you think supports what you already want to believe.

 

[sactoking]

Yeh, but zero full time employees is totally unlikely. Even the managers would have to be part time.

True, but when you calculate the penalty for not offering insurance you get to deduct the first 30 full time employees from your count. A company with 30 full time and 40 half time employees has 50 full time and FTE employees but still pats a penalty of zero as the half timers aren't eligible and the full timers all fall under the deduction.

 

[Hayabusa Rider]

We aren't stipulating lower costs, the costs are lower. Additionally, plenty of physicians and hospitals accept Medicare.



You didn't even read your own abstract, much less the study.

It says that private insurance has the best outcomes overall, (unsurprisingly considering its costs have grown at almost a 50% faster rate than Medicare) but Medicare has superior patient outcomes to uninsured people and Medicaid recipients. In fact, as compared to the uninsured, both Medicaid and Medicare have dramatically superior outcomes.

The question has never been how we can get the best care regardless of cost, we already know how to do that. It's how we can get the best bang for our buck. You should really read for understanding before you link something as opposed to trying to find the first link that you think supports what you already want to believe.

"The best care regardless".
I'm a provider. Tell me what we see and what we know then how to achieve it.

 

[Darwin333]

already covered here I believe.

But I'll add

This is what the dem's want...

more unemployed, more on government funded health care.

a population that is entirely dependent on government. Dependent on the generous democrats giving them benefits, vs the evil republicans that want to take them away

LOL!

Yeah... thats exactly what they want.

 

[werepossum]

We aren't stipulating lower costs, the costs are lower. Additionally, plenty of physicians and hospitals accept Medicare.



You didn't even read your own abstract, much less the study.

It says that private insurance has the best outcomes overall, (unsurprisingly considering its costs have grown at almost a 50% faster rate than Medicare) but Medicare has superior patient outcomes to uninsured people and Medicaid recipients. In fact, as compared to the uninsured, both Medicaid and Medicare have dramatically superior outcomes.

The question has never been how we can get the best care regardless of cost, we already know how to do that. It's how we can get the best bang for our buck. You should really read for understanding before you link something as opposed to trying to find the first link that you think supports what you already want to believe.

I used to be a big supporter of giving the poor and uninsured Medicare. Tennessee did just that, and it damned near bankrupted the state within a few years. When people get something expensive and desirable for free, they consume a lot more of it.

 

[IGBT]

so I guess Mizz.Nancy was right. You have to pass the bill to find out what's in it.

 

[Incorruptible]

So first unions liked it and now are against it. Did the idiots even read the bill? Of course not. Bunch of selfish morons. They should face the luxury tax for their stupidity.

 

[poofyhairguy]

What you are describing here has been available to insurers for the most part for years. It has not led to them successfully lowering costs. There is no particular reason to think that would change. So still, what you're saying just isn't backed up by reality.

No, as it is now people over 65 (who get most of the care in America) get medicare. Private insurance is the "premium option" compared to Medicare. The floor is Medicare, and most reimbursement is tied to Medicare (IE "We pay Medi rates plus 30%").

If Medicare was a shadow of itself, the private market would create a new floor. I think that floor would be lower than medicare is today.

What they have proven they will do is screw people out of care for a buck- pre-existing conditions, caps and the like. Time to turn that heat onto the elderly care system.

This dynamic, if true, should have led to lower per patient costs across the board for private insurance. It hasn't.

Again, because its a premium option today.