Health Care

[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.

[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.

[Uncle Mxy]

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.

The Scandinavian countries enjoy our GDP per capita, and have had socialized healthcare for decades. The Japanese famously managed to kick our butt productivity-wise back in the '80s, with a big boost from the socialized healthcare and other guv'mint aspects we set up for them post-World War II. We're too big to have it as well-off as the smaller countries?

[xanadu]

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.

1. There are more efficient ways to increase jobs than provide subsidies for private insurance for retired persons.

2. Employers have traditionally provided insurance because a) they could spread risk across employees vs. the individual market where risk would not be spread and b) there is a big tax break to provide insurance.

The new law increases incentives for employers to provide insurance by instituting the fine (+ the already available tax breaks). This is not a disincentive to provide insurance. On the other hand, the govt. is trying to make it easier for individuals to get their own insurance. This may lead to a decrease in employer provided insurance, but so what. In the long run, we're better off if individuals are not dependent on their job for insurance.

3. boo-fucking-hoo that employers lost their govt. handout through the new law. The fact that employers are threatening to cut off their retirees based on the change from a law instituted in 2003 demonstrates that it is ridiculous to rely on employers to provide insurance in the first place. We always hear about wasteful spending. This seems like wasteful govt. spending to me.

[b-diddy]

1. There are more efficient ways to increase jobs than provide subsidies for private insurance for retired persons.

2. Employers have traditionally provided insurance because a) they could spread risk across employees vs. the individual market where risk would not be spread and b) there is a big tax break to provide insurance.

The new law increases incentives for employers to provide insurance by instituting the fine (+ the already available tax breaks). This is not a disincentive to provide insurance. On the other hand, the govt. is trying to make it easier for individuals to get their own insurance. This may lead to a decrease in employer provided insurance, but so what. In the long run, we're better off if individuals are not dependent on their job for insurance.

3. boo-fucking-hoo that employers lost their govt. handout through the new law. The fact that employers are threatening to cut off their retirees based on the change from a law instituted in 2003 demonstrates that it is ridiculous to rely on employers to provide insurance in the first place. We always hear about wasteful spending. This seems like wasteful govt. spending to me.

i think your missing my point? 1) the bill is going to destroy jobs. not great jobs, but jobs nonetheless. 2) one of the costs the bill probably isnt considering the firms that will drop health insurance in favor of letting uncle sam flip the tab. my understanding is that the gov planned on the private sector carrying the the load, and expanding on it to fill in the cracks. right now firms pay insurance because workers will go to a firm that does if theirs doesnt. but if it doesnt matter if your job offers insurance, and the fine is far cheaper than actually providing it (it is, as far as i know) then uh oh. well, uh oh if you care about the cost of this bill. my distinct impression is that almost no one does.

[xanadu]

i think your missing my point? 1) the bill is going to destroy jobs. not great jobs, but jobs nonetheless.

The bill just takes away a govt. subsidy that was ill-conceived in the first place. Your position seems to be that all government subsidies must be locked in place, regardless of how efficient those subsidies are. The revision of subsidies will always be met with claims about job losses. However, job gains can more than offset losses if subsidies are used more efficiently. Anyways, how many jobs are "destroyed" by the inefficiencies of our current health care system? No other country spends close to the amount we do for health care.

2) one of the costs the bill probably isnt considering the firms that will drop health insurance in favor of letting uncle sam flip the tab. my understanding is that the gov planned on the private sector carrying the the load, and expanding on it to fill in the cracks. right now firms pay insurance because workers will go to a firm that does if theirs doesnt. but if it doesnt matter if your job offers insurance, and the fine is far cheaper than actually providing it (it is, as far as i know) then uh oh. well, uh oh if you care about the cost of this bill. my distinct impression is that almost no one does.

You still haven't explained why imposing fines on companies makes them more likely to drop coverage of employees. Wouldn't they be more likely to drop coverage without the fine? It doesn't make any sense.

Nonetheless, if the long term consequences of the plan lead to a Dutch-style system of individuals purchasing insurance through regulated insurance exchanges, I would have no problem with that. There is no inherent advantage to employer provision of health insurance if you can generate large risk pools without employer based coverage. Right now, we do not have an efficient mechanism for risk pooling. However, that is an aim for the bill.

Anyway, the entire conservative argument against health care reform is premised on the idea that there are no data for alternative approaches to health care. However, there is plenty of evidence that the US approach is both more expensive and less effective than every other first-world country. The do-nothing approach just leads to continuing this trend.

[b-diddy]

The bill just takes away a govt. subsidy that was ill-conceived in the first place. Your position seems to be that all government subsidies must be locked in place, regardless of how efficient those subsidies are. The revision of subsidies will always be met with claims about job losses. However, job gains can more than offset losses if subsidies are used more efficiently. Anyways, how many jobs are "destroyed" by the inefficiencies of our current health care system? No other country spends close to the amount we do for health care.

i havent been talking about the subsidy at all.

i dont see how the old system could have destroyed jobs at all. if i was a small startup, i could offer a job and simply not offer health insurance. if someone wanted the job, regardless, then there was a job. now, that employee has to generate atleast 2k profit a year, or it doesnst make sense to hire them.

You still haven't explained why imposing fines on companies makes them more likely to drop coverage of employees. Wouldn't they be more likely to drop coverage without the fine? It doesn't make any sense.

Nonetheless, if the long term consequences of the plan lead to a Dutch-style system of individuals purchasing insurance through regulated insurance exchanges, I would have no problem with that. There is no inherent advantage to employer provision of health insurance if you can generate large risk pools without employer based coverage. Right now, we do not have an efficient mechanism for risk pooling. However, that is an aim for the bill.

prior to the bill, an employer offering insurance was a significant benefit that would differentiate it from one that did not. after the passing of this bill, does that matter anymore? if not, and its cheaper to pay a fine than pay insurance (it is), then the gov just incentivized companies to stop paying health insurance.

whether it is better to not have employers be involved in the process, maybe. but this bill was a hybrid that counted on employers to do the heavy lifting. if that doesnt happen, the cost of this thing is even more out of projection than it already is.

Anyway, the entire conservative argument against health care reform is premised on the idea that there are no data for alternative approaches to health care. However, there is plenty of evidence that the US approach is both more expensive and less effective than every other first-world country. The do-nothing approach just leads to continuing this trend.

just be careful that the cure isnt worse than the disease. the dems didnt pass *this* bill because it was so great, it was out of political expediency, and the belief that something had to be done. while i think the conservatives were wrong to dig in and oppose everything, they had every right not to support an action they were against. something democrats could take a leason from.

anyway, it reminds me of a line from lawrence of arabia. something like:
"but we cant just do nothing!"
"why not? its usually best."