Good news for us re: Obamacare/ACA

Krill- good post but I'm not sure why my post precipitated it. Your post had nothing to do with what I said. I was not complaining about the ACA but was commenting on what I think would need to happen to actually get runaway costs under control.

 
JJHusker1 said:
I would agree that many of them are lavishly compensated. But, I believe a good portion of that lavish pay is driven by all that extra schooling, on going education, and excessive malpractice insurance costs.
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You're right about the education costs (both time and money) but the reason why malpractice insurance is expensive is because there is a lot of malpractice. Doctors are quite lucky that the vast majority of people harmed by substandard care don't file a malpractice claim.

JJHusker1 said:
I know some in the system myself and, as you say, they are generally disgruntled with the system even though they are profiting greatly from it. But, they also tend to take more days off, vacation more exotically, and live at a higher level than most other occupations.
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True, but they probably also work more hours in a given year than most other occupations.

JJHusker1 said:
I know our family physician is retiring early primarily so he does not have to deal any longer with the changing nature of the system.
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How old is he? There is quite the generation gap for the 55+ crowd. They seem particularly averse to the new EMR systems . . . despite the potential benefits.

I suppose it's something like trying to teach a grandparent how to use a smart phone.

 
Presenting any of the problems with the British or Canadian healthcare system only further obfuscates what few people seem to understand. Their systems are completely ran by the government, and judging by how poorly we've ran the VA system over the years, it would indeed by horrifying to think how our government would run that type of system. But, that's not what anyone outside maybe some extreme left-wing bloggers want to see happen. Maybe read up on other types of systems that more closely resemble what we have with mixed-market providers and various mechanisms for ensuring universal insurance coverage.

http://en.wikipedia.org/wiki/Healthcare_in_Germany

http://en.wikipedia.org/wiki/Healthcare_in_Switzerland

http://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands

 
Here are the types of things that make me scratch my head.

I am good friends with a guy who owns a company that sells home medical equipment. (ie....wheel chairs, respiratory equipment, walkers...etc.) This company is a decently sized company. A large part of the business that he has grown is selling products to nursing homes. He also fills oxygen tanks...etc.

NOW....his business has really taken a hit. Why? Because the government has put in regulations that now doesn't allow him to even bid on the contracts that he has had for years. It's something about the company has to be a national company and not a regional company. Don't ask me what exact law/regulation...etc it is because I don't know. But, this guy is pretty dang honest with me on these issues and he is extremely concerned about his business.

He has customers calling and begging him to bid on the contracts because he has done such a good job. AND....get this....he is cheaper than the bids they are getting. But, the government says....NOPE!

Now, if we want our health care system to service MORE people at lower costs......why would they then limit who can bid on certain contracts to the point that a good/healthy company who provides lower cost service can't even bid on the contracts?

 
BRB- I'm going to tell you something you already know. These are exactly the types of things that happen when our government gets involved in "business" decisions. Policies that affect the real bottom line get placed way down the list to things that advance someones agenda or pay back certain support. It's precisely why the government getting involved in healthcare will not result in better or cheaper care. The military wasn't buying those $900 toilet seats because they were better or worth it. It was probably just the result of a bunch of rules and regulations made by people that couldn't profitably operate a lemonade stand in their front yard. There is a reason people go into politics. If they could do anything useful, they would be doing that instead.

 
Anecdote- We do some steel fabrication in our business. A disabled, retired veteran, who lives one block from our shop, wanted/needed a handrail leading up his front walk and porch. It was a piddly $500 job. But, he had access to veterans affairs funding which would require us to do it to their specs with submittals, inspections, the whole shootin match. To comply with their BS, it went to a $2000+ job. He was unable to pay anything and the govt was willing to go to $2000. The kicker was I would have to sign a statement that said our fee was usual and customary to perform the work. I told him I could not sign that in good conscience because it would not have been true. Also, the nature of the job made it impossible to comply with ADA requirements. I turned down the job that we literally could've walked to. That was three years ago and he still doesn't have the much needed railing. All because of head in a$$ government regulations and rules.

 
Conservative elites had two options when Democrats began to adopt their policy ideas: Declare victory or declare war. Key figures like Gingrich could’ve stepped before the cameras and chortled about Democrats giving up on single payer and slinking towards conservative solutions. For Hillary Clinton to run in 2008 with Bob Dole’s health-care plan was an amazing moment in American politics. For Barack Obama to reverse himself on the individual mandate and embrace the Heritage Foundation’s approach to personal responsibility was further proof that Democrats had lost the war of ideas here. Republicans could have declared victory and, by engaging constructively, pushed the final product further toward their ideal.​

They chose war instead. And that meant eradicating any trace of support for the policies they had come up with.

That effort was extraordinarily successful. Republicans quickly convinced themselves they had always been at war with Oceania — excuse me, the individual mandate. But plausible health-care plans are hard to come by. Even the plans that weren’t exactly like Obamacare were too similar to Obamacare for comfort. And so, five years later, even leading Republicans haven’t really come by another one. There’s a gaping hole where the party’s health-care plan is supposed to go. Of course the public doesn’t trust Republicans on the issue. Republicans don’t even know what they’d do.
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http://www.washingto...blogs/wonkblog/

 
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Noonan’s column is a beautiful example of a writer so intent on criticizing Obamacare that she’s missed the fact that the law is doing precisely the thing she wants done. A reasonable reader of Noonan’s column would end up loathing “Obamacare” and hoping for a replacement that looks like, well, Obamacare.. . .

That would make it seem like people who don’t support single payer — a group I assume includes Noonan, and all elected Republicans — should be very interested in making Obamacare workable. Yet the opposite seems to be the case.
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http://www.washingtonpost.com/blogs/wonkblog/wp/2013/08/20/peggy-noonan-attacks-obamacare-for-doing-what-peggy-noonan-wants-obamacare-to-do/

 
Small-business hiring and confidence about the future are rising, a signal of the economy's growing strength and diminishing concerns about employee insurance coverage required by the new health care law.
Job creation at small companies has almost doubled in the past six months, reaching 82,000 jobs at firms with 49 or fewer employees in July, payroll processor ADP says. Borrowing by small businesses and sales of franchises have also climbed, indicating businesses are willing to take on new expenses and risk.

. . .

The gains are beginning to shift the terms of the debate over the health care law. Under the law, businesses with 50-plus full-time-equivalent workers must offer insurance to people working 30 hours a week beginning in 2015. That mandate has not deterred hiring as feared, some economists now say.

As more data come in, the law's impact can't be seen in hiring statistics, says Mark Zandi, chief economist of Moody's Analytics: "I was looking for it, and it's not there." Zandi's firm manages ADP's surveys of overall private-sector job creation.
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http://usatoday30.usatoday.com/NEWS/usaedition/2013-08-21-Obamacares-impact-on-jobs-looks-smaller_ST_U.htm

 
More on cost control mechanisms:

An early cost-sharing program in Massachusetts designed to cut costs for private Blue Cross Blue Shield patients also lowered costs for Medicare patients who were seen by the same providers, according to a study published Tuesday in the Journal of the American Medical Association.
An ACO, for any one needing a quick refresher, is a network of doctors and hospitals that shares responsibility for providing care to a specific group of patients. The idea is to pay the providers for the quality of the services they provide, rather than the volume and move away from the system we have right now, which usually pays doctors a set fee for every medical service provided.

To make that work in practice, an ACO is offered a bonus if they give high quality care at a reduced cost. But if they fail to hit certain quality targets or do not manage to reduce the cost of care, they will be paid less.

. . .
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http://www.washingto...-be-contagious/

 
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Well my company received health insurance renewal information today. Our renewal date is January 1st. However, we have the option of renewing sooner, Dec 1 or Nov 1, which would buy us another year before being subjected to ACA changes. The real meat & potatoes;

If we renew Nov 1, premiums increase 13%

If we renew Dec 1, premiums increase 14%

If we renew Jan 1 (when the ACA aka Obamacare is in effect) premiums increase 38.8%

Boy, things are really looking up. Now to decide if we renew in December and drop health insurance next December or just get it out of the way and drop it now. This Obamacare deal is just great. Actually, I really don't care. Dropping it will save me a ton of time worrying about it and comparing plans.

 
We should remove employers from healthcare entirely anyway. It's absurd to put this burden on employers. Why don't we require employers to provide group food plans for their employees? Or group housing? Group transportation?

 
knapplc said:
We should remove employers from healthcare entirely anyway. It's absurd to put this burden on employers. Why don't we require employers to provide group food plans for their employees? Or group housing? Group transportation?
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it is an odd system that has really hamstrung employers and individuals.

 
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