Health Care

[Uncle Mxy]

Here's a reasonable summary of the trumped-up numbers that some corporations will claim the new healthcare reform law will cost them:

http://ftalphaville.ft.com/blog/2010...-the-hangover/

Note that the hit to companies who take this Medicare Part D subsidy is spread out over the lifetime of its current and future retirees -- decades. But, with asset-based accounting, the cost has to be added up immediately. Imagine if you were told that your broadband bill was going up by $5-10/month a few years from now, then declaring you have a $5-10k loss today and you had to make major changes in how you spend money. That's roughly equivalent to what's going on here. Insight into what the "real" costs will be like 10-20+ years down the line is poor, but that doesn't stop beancounters from recalibrating the asset values based on what they know.

[xanadu]

this is a pretty good schpeal on some of the obvious early cracks:


http://globaleconomicanalysis.blogsp...dividuals.html

That article is a load of shit. it is just a subsidy shift from one group to another. If the govt. hadn't jacked up the costs of medicare by subsidizing private insurance through medicare advantage in the first place, these companies would have had to pay those costs anyways. Businessfolk sure get pissy when their subsidies are taken away. i guess its only socialism if someone else benefits.

Let's take a look at this right wing "brilliance"

I ran the same simulation for the company I retired from.

They can save $607,000 by terminating the health insurance plan, offset by a fine of $200,000.

If cost savings were distributed to employees as raises, employees would presumably be able to purchase non-Cadillac plans with better benefits, and some potential savings. If there are minimum benefit schedules, then price would be the major consideration in buying health insurance.

This argument is incoherent. Apparently, his company's plan is so shitty that the company could drop the plan, take a $200,000 tax penalty, and increase wages based on the savings. Then, individuals could purchase a better plan "with some potential savings" despite that $200,000 fine and despite the fact that the employer gets a huge tax break for providing insurance, a tax break unavailable to the employees in the individual market.

Seriously, this is the best you can come up with. This isn't my preferred bill, but it is a step in the right direction. The US pays vastly more for health care than any of those "socialist" countries, yet has shitty health outcomes. This suggests to me that we have, in fact, the worst fucking health care system in the developed world dollar for dollar. Anything to standardize and better spread risk in the system should lead to the savings on the whole.

Essentially, most of the arguments are based on companies saving money because health care costs are more than the penalties. So fucking what, are they asking for a bigger penalty? Employees are not going to be pleased if their health care is dropped just because it is cheaper than paying penalties. Hell, if all health care were bought and sold on properly regulated exchanges, i'm sure costs would go down for everyone.

[xanadu]

Ha, that article about supposed unintended consequences is even more ridiculous than i thought. It basically just disallowed corporations from claiming bullshit tax deductions for money received directly from the govt.

http://www.nytimes.com/2010/03/27/te...s/27phone.html

Under the 2003 Medicare prescription drug program, companies that provide prescription drug benefits for retirees have been able to receive subsidies covering 28 percent of eligible costs. But they could deduct the entire amount they spent on these drug benefits — including the subsidies — from their taxable income.

The new law allows companies to deduct only the 72 percent they spent.

The more insurance moves out of the sphere of employer control the better we'll all be.

Edit: I hadn't seen mxy's post before my 2, but i think it goes beyond his reasoning, because the tax breaks were a government error (loophole) in the first place. it is not like these companies are victims here. anyways, also kudos to the dems for taking away bank welfare in the form of guaranteed student loans.

[Uncle Mxy]

b-diddy, the initial cut of Social Security was such that, in practical terms, only white males were covered. Medicare was amended a year after it was passed to deal with significant loopholes and other fucked-uppedness. This is the start. not the end. There will undoubtedly be refinements to healthcare reform as the evitable and inevitable loopholes rear their ugly heads. No one was going to get it right on the first try, and there's going to be constant recalibration to get things closer to "right", as there is with most government programs.

[DennyMcLain]

What is needed:

Tort reform, to stem frivolous malpractice suits and curb hospital insurance costs.

Basic healthcare packages for illegal immigrants who file for citizenship. It's a problem that's not going away, so make the best of it (excludes Canadians).

Line item procedures, where having a medical procedure is like buying a car -- everything is itemized and transparent (so scalpel blades don't cost $100 ea.)

Umbrella plans for local Chambers of Commerce, so even the smallest business can offer the most basic health care for their employees.

Make local politicians accountable for regional health care campaigns. When Martin Luther King Hospital (King/Drew Hospital) went under last year, I blamed the local congressmen, such as Mark Ridley Thomas, who'd rather blow his load on getting an NFL team to LA than protecting the area hospital/trauma center.

[geerussell]

it just incentivized healthy individuals to just not have health insurance, and wait til something bad happens.

This is precisely why they also the mandate that so many people are up in arms about. To prevent people from gaming the system and just waiting until they got sick to buy coverage.

[geerussell]

Umbrella plans for local Chambers of Commerce, so even the smallest business can offer the most basic health care for their employees.

There is a tax subsidy for businesses with fewer than 50 employees. Not quite the same thing but it does at least target the smallest businesses.

[geerussell]

The more insurance moves out of the sphere of employer control the better we'll all be.

I couldn't agree more.

[b-diddy]

That article is a load of shit. it is just a subsidy shift from one group to another. If the govt. hadn't jacked up the costs of medicare by subsidizing private insurance through medicare advantage in the first place, these companies would have had to pay those costs anyways. Businessfolk sure get pissy when their subsidies are taken away. i guess its only socialism if someone else benefits.

Let's take a look at this right wing "brilliance"



This argument is incoherent. Apparently, his company's plan is so shitty that the company could drop the plan, take a $200,000 tax penalty, and increase wages based on the savings. Then, individuals could purchase a better plan "with some potential savings" despite that $200,000 fine and despite the fact that the employer gets a huge tax break for providing insurance, a tax break unavailable to the employees in the individual market.

Seriously, this is the best you can come up with. This isn't my preferred bill, but it is a step in the right direction. The US pays vastly more for health care than any of those "socialist" countries, yet has shitty health outcomes. This suggests to me that we have, in fact, the worst fucking health care system in the developed world dollar for dollar. Anything to standardize and better spread risk in the system should lead to the savings on the whole.

Essentially, most of the arguments are based on companies saving money because health care costs are more than the penalties. So fucking what, are they asking for a bigger penalty? Employees are not going to be pleased if their health care is dropped just because it is cheaper than paying penalties. Hell, if all health care were bought and sold on properly regulated exchanges, i'm sure costs would go down for everyone.

its not the taxing of subsidies, its the fact that the gov just gave employers an incentive to cut health insurance. since it appears i have to have health insurance regardless, what do i care if a job offers insurance? but for my company? in my situation, i believe my boss pays between 6 and 10 thousand dollars per employee for insurance. under obama care, they can pay a 2000 dollar fine instead, and uncle sam will suddenly have a bigger cost than expected. we have about 50 employees, lets say insurance is 8k, thats 300k savings a year thanks to obama... if thats what they ended up doing. 300k savings for my boss, not america, thats a debit to america.

whats the fix? raise the penalty, right? well, many jobs cant afford to pay for health insurance. i dont know how much the subsidies will counter this, but even at a penalty of 2k, jobs that other wise would have existed simply wont. raise the penalty, more jobs vanish.

[gusman]

I love the question "How is it possible that the richest, most economically developed nation on Earth doesn't provide free healthcare to all its citizens?" Well dummies, it is the richest nation because we've never done stupid shit like give healthcare to everyone in it. Most people have to have an incentive to work,... simple as that. A great country takes a step back with this bonehead move.