Obamacareless begins...

[BraveUlysses]

Ummm did you miss this in my post, I covered that already. And I was not referring to companies that develop medical technology, I was referring to countries that have benefited by getting access to better and better medical technology, that would not have been developed in a 100 years in their respective country but were here, because we have been footing the development bills.

This is a narrative you've created in your head that has no basis in reality.

[mikeedler]

Why do you think all the foreigners come here to get a MD, then dont go back home to practice full time?? Right they can make more money here in the US in a decade than than practicing in many of their home counties for a century. You start pulling the invectives out of the system, the best and brightest talent will go else where for a career, because lets face the cold reality here, the only reason most people want to become a MD is all about the cash flow.

that is a bunch of crap. It was actually all over the German news last week, that a HUGE problem in Germany is all of the foreign doctors in Germany leading to a problem of patients not fully understanding what they should through bad translations.
So if what you are saying is true, why all the foreign doctors in Germany?

All the greedy bastard should go.

[Q5Quint]

"we have been footing the development bills."
And yet we are still ranked low in service... to our own people. Should we stop funding for-profit companies and focus on the health of our own citizens?


So will this still pay for my zoloft, viagra, and adderol prescriptions?
When weed gets legalized will it pay for my cancer treatments?

Will giving more money to 'big-med' (big pharma? not sure what to call this industry) help, hurt, or should we start giving more money to a direct service ie state-run services?

I enjoy quotes like these:
"Germany has Europe's oldest universal health care insurance system, with origins dating back to Otto von Bismarck's Social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889."
"Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. Despite attempts to contain costs, overall health care expenditures rose to 10.7% of GDP in 2005, comparable to other western European nations, but substantially less than that spent in the U.S. (nearly 16% of GDP).[22]"

[herbivor]

So if the ACA, (a republican plan BTW) is not a good start, then what is a solution that will 1. Lower healthcare costs ?
2. Expand healthcare to everyone who needs it?

Those two things are important and necessary, so arguing against either is a losing argument.

[mrsleeve]

This is a narrative you've created in your head that has no basis in reality.

Umm really what rock is it that you live under??

http://www.huffingtonpost.com/kenneth-thorpe/medical-advancements-who-is-leading_b_807796.html

While there are many opinions about our nation's health care system (particularly in Washington), there's one overwhelming area of consensus -- the United States leads the world in medical innovation.

In addition to the best and brightest practicing medicine and state-of-art medical facilities, we have benefited from having the best and, usually, the earliest access to the latest medical technologies and innovations. In large part, this is because they were discovered, developed and produced here in America..........................

However, despite our advantage in this space, it's clear that "it's ours to lose." Other nations, China and India in particular, are aggressively pursuing the economic development that comes from this highly-skilled sector by adopting policies that attract private investments.

[rwh11385]

Ummm did you miss this in my post, I covered that already

I read it but didn't think you provided any logic that all companies in the world, regardless of where they are located, only make money because of the United States system and all others are the bane of their existence.

It's going to be tragic that ACA will destroy the entire world's pharmaceutical industry because it now follows the socialist ideals of '90s Republicans.

The will make all the money here, since in their home counties, reimbursement is not much more than cost to manufacture,

Where's your data to support your statement about them not having profit margins elsewhere? They certainly make sales in other countries.

Here's Sanofil sales:

Novartis:


I guess developing countries want medicine too. Same story for GSK: http://www.gsk.com/investors/annual-...l-summary.html

And maybe you could explain the difference between their system and our Medicaid and Medicare systems. Should our government be paying significantly more for drugs so pharma companies can make greater profits, at the expense of the deficit? Is our growing deficit for mandatory spending and increasing insurance premiums the only thing keeping drug companies in the business of making new drugs?

[rwh11385]

"we have been footing the development bills."
And yet we are still ranked low in service... to our own people. Should we stop funding for-profit companies and focus on the health of our own citizens?


So will this still pay for my zoloft, viagra, and adderol prescriptions?
When weed gets legalized will it pay for my cancer treatments?

Will giving more money to 'big-med' (big pharma? not sure what to call this industry) help, hurt, or should we start giving more money to a direct service ie state-run services?

I enjoy quotes like these:
"Germany has Europe's oldest universal health care insurance system, with origins dating back to Otto von Bismarck's Social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889."
"Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. Despite attempts to contain costs, overall health care expenditures rose to 10.7% of GDP in 2005, comparable to other western European nations, but substantially less than that spent in the U.S. (nearly 16% of GDP).[22]"

Yeah, but citizens don't lobby the politicians that make the decisions that impact them... the companies that make profits off higher premiums and what the government pays for pills do.

http://www.cdc.gov/nchs/data/hus/hus07.pdf

Overall, private health insurance paid for 36% of total
personal health expenditures in 2005, the federal government
34%, state and local government 11%, and out-of-pocket
payments accounted for 15% (Figure 6). The share of total
expenditures paid out-of-pocket has declined from 27% in
1980 to 15% in 2005 (Table 125). This decline resulted from
an expansion of benefits in both private health insurance
plans and in government programs.

And 2010:



I guess the fact that half of health care expenditures are paid by governmental sources is ignored when saying that the ACA is the government take over of health care. It's the biggest customer and we ought to get more for our money. But people obviously are going to lobby against it if it takes that money away from their profits.

The American Republic will endure until the day Congress discovers that it can bribe the public with the public's money. -Alexis de Tocqueville

Likewise, our system can be corrupted by companies bribing Congress with the money that Congress pays them.

KenC did a good job talking about ways the ACA attempted to make US health care more efficient and better outcomes. A lot of it is documented best practices and what tests are necessary, etc. This would mean less waste and less expense for the government, and hopefully eventually a control for the run-away deficits from mandatory spending, with health being a huge driver - particularly with baby boomers retiring.

[FL318is]

that is a bunch of crap. It was actually all over the German news last week, that a HUGE problem in Germany is all of the foreign doctors in Germany leading to a problem of patients not fully understanding what they should through bad translations.
So if what you are saying is true, why all the foreign doctors in Germany?

All the greedy bastard should go.

Actually Mrsleeve is right. Apparently Germany shares the same MD predicament.

[ficklerx]

what happened to letting the market take care of it? shouldn't we reward the hospitals that are capable of surviving and thriving rather than continuing to support the ones who require millions of dollars in government subsidies to operate?

Uncompensated care is a large portion of why these entities can not be profitable. In the past this care was partially funded by DSH payments from CMS. The ACA cuts that funding by $500 million beginning 2014 and escalating to a $4 billion reduction by 2020. This is a based on a huge assumption that uncompensated care will significantly decrease with implementation of ACA.

Meanwhile, the CBO is estimating 30 million AMERICANS without coverage. That means the ACA will provide coverage for less than half of the current AMERICANS without coverage (estimated to be ~50 million). This does not account for the uncountable illegals who make up a significant portion of the current uncompensated care.

Why so many? Because employers can pay a $2k fine to not cover you and your family. Welcome to the exchanges. CBO estimates that premiums for 'Bronze' coverage (the minimum for an individual to avoid a fine) is $4500-5000 yearly for individuals and $12k+ for families.

It's much cheaper to pay the $1200 tax for no coverage and just go to the ER when needed. While employers and individuals have choices to pass the buck, the hospital does not. And, we are back to the status quo without the DSH payments.

All of the above can be easily googled for reference.

[rwh11385]

Uncompensated care is a large portion of why these entities can not be profitable. In the past this care was partially funded by DSH payments from CMS. The ACA cuts that funding by $500 million beginning 2014 and escalating to a $4 billion reduction by 2020. This is a based on a huge assumption that uncompensated care will significantly decrease with implementation of ACA.

Meanwhile, the CBO is estimating 30 million AMERICANS without coverage. That means the ACA will provide coverage for less than half of the current AMERICANS without coverage (estimated to be ~50 million). This does not account for the uncountable illegals who make up a significant portion of the current uncompensated care.

Why so many? Because employers can pay a $2k fine to not cover you and your family. Welcome to the exchanges. CBO estimates that premiums for 'Bronze' coverage (the minimum for an individual to avoid a fine) is $4500-5000 yearly for individuals and $12k+ for families.

It's much cheaper to pay the $1200 tax for no coverage and just go to the ER when needed. While employers and individuals have choices to pass the buck, the hospital does not. And, we are back to the status quo without the DSH payments.

All of the above can be easily googled for reference.

Wow, I sure hope that if uncompensated care is an issue for hospitals no one is telling people to go to the ER in lieu of getting themselves coverage.


I have an important question - what existed before ACA to encourage employers to have health insurance coverage for their employees?

Wait... there was just wanting to attract quality employees that made most companies adopt health insurance benefits? So by the logic of some people an employer who had enough incentive in just having competitive benefits will now pay a fine to "save" on what they were providing previously without a punishment for not having said coverage?

Some companies are talk, but I know I'd switch jobs if my work ditched health insurance to "save" by paying a fine for no longer offering what they do currently.

[ficklerx]

Wow, I sure hope that if uncompensated care is an issue for hospitals no one is telling people to go to the ER in lieu of getting themselves coverage.

The economics of affordable insurance will continue the status quo. Insurance is currently available to anyone who has the money to afford it. The CBO's estimates show that the premiums will not be affordable in the future. And, using the ER for primary care is what the uninsured do now. The MSM crucified Romney for citing that fact. Why will that change? Hospitals agreed to lower DSH payments in exchange for lower uninsured. 75% reductions in payment with a 30% reduction in the uninsured will not pay the bills.

As far as your question, the wage freeze enacted in 1943 by the War Labor Board lead to the popularization of health insurance as a way to attract workers since benefits were unaffected by the freeze. ~70 years later this change has created the monster that health insurance is a 'right' that should be provided by your employer. At this point there is no shortage of workers. Skilled workers, maybe, but not workers in general. And, not all jobs require significant skill.

The $2000 fine will always be cheaper than the cost of coverage. At this point companies will treat the fine as a business decision. Companies who hire in competitive job markets will have a choice to make, higher wages or better benefits. If not, employees may go elsewhere to seek just compensation.

[rwh11385]

The economics of affordable insurance will continue the status quo. Insurance is currently available to anyone who has the money to afford it. The CBO's estimates show that the premiums will not be affordable in the future. And, using the ER for primary care is what the uninsured do now. The MSM crucified Romney for citing that fact. Why will that change? Hospitals agreed to lower DSH payments in exchange for lower uninsured. 75% reductions in payment with a 30% reduction in the uninsured will not pay the bills.

As far as your question, the wage freeze enacted in 1943 by the War Labor Board lead to the popularization of health insurance as a way to attract workers since benefits were unaffected by the freeze. ~70 years later this change has created the monster that health insurance is a 'right' that should be provided by your employer. At this point there is no shortage of workers. Skilled workers, maybe, but not workers in general. And, not all jobs require significant skill.

Wow, I never knew that... oh wait... thanks for the repost.

http://www.presidency.ucsb.edu/ws/index.php?pid=16171
100 - Executive Order 9250 Establishing the Office of Economic Stabilization.
October 3, 1942

Wage and Salary Stabilization Policy

1. No increases in wage rates, granted as a result of voluntary agreement, collective bargaining, conciliation, arbitration, or otherwise, and no decreases in wage rates, shall be authorized unless notice of such increases or decreases shall have been filed with the National War Labor Board, and unless the National War Labor Board has approved such increases or decreases.

7. In order to correct gross inequities and to provide for greater equality in contributing to the war effort, the Director is authorized to take the necessary action, and to issue the appropriate regulations, so that, insofar as practicable no salary shall be authorized under Title III, Section 4, to the extent that it exceeds $25,000 after the payment of taxes allocable to the sum in excess of $25,000. Provided, however, that such regulations shall make due allowance for the payment of life insurance premiums on policies heretofore issued, and required payments on fixed obligations heretofore incurred, and shall make provision to prevent undue hardship.

Since when are all workers equal and interchangeable?

Companies that need skilled workers won't be able to cancel their health insurance without losing them to the competition. Maybe you don't think companies care to keep workers, but I see more concerned about being a 'employer of choice' these days than before when people were treated more like a commodity.

The $2000 fine will always be cheaper than the cost of coverage. At this point companies will treat the fine as a business decision. Companies who hire in competitive job markets will have a choice to make, higher wages or better benefits. If not, employees may go elsewhere to seek just compensation.

Before ACA, NO FINE was sure as hell cheaper than $2000. Zero dollars was certainly less than the cost of coverage. But yet, employers still provided health insurance benefits. You are not demonstrating good logic that an increase in the repercussions to dropping coverage will instantly result in a reduction of health insurance benefits.

Employees have always been able to seek employment elsewhere for better compensation, and typically consider the entire package - just as companies consider the total cost of an employee, not just their wage.

[mrsleeve]

I will leave this right here

http://finance.yahoo.com/news/florida-restaurateur-to-impose-surcharge-for-obamacare.html

[ethrtyiS]

^ there are a lot of companies doing this. they have to. either lay off employees, close locations/close business or raise their prices. papa johns will be doing the same.

so for the ones who say oh it's free healthcare yada yada. nope. you will be charged yearly and you will be fined if you do not want the service. in addition, a lot of the things around will be increasing their prices/laying off workers to compensate. so no, your health is not free. the private companies that are already offering healthcare have programs for those who cannot afford it. yes it may not be perfect, but there are already companies doing so. hopefully years after people who were for this and for obama realize the stupid mistake they made by wanting such an idiotic policy. that, or they are going to have to work twice as hard to earn something for themselves to be able to buy health insurance.

[FL318is]

^ there are a lot of companies doing this. they have to. either lay off employees, close locations/close business or raise their prices. papa johns will be doing the same.

so for the ones who say oh it's free healthcare yada yada. nope. you will be charged yearly and you will be fined if you do not want the service. in addition, a lot of the things around will be increasing their prices/laying off workers to compensate. so no, your health is not free. the private companies that are already offering healthcare have programs for those who cannot afford it. yes it may not be perfect, but there are already companies doing so. hopefully years after people who were for this and for obama realize the stupid mistake they made by wanting such an idiotic policy. that, or they are going to have to work twice as hard to earn something for themselves to be able to buy health insurance.

You just hit the bottom line.

So that being said, IF I don't loose my job, I will wait for you ppl either in the building, the unit or the ER. Remember to bring your obamacareless policy and be sure to take a number. NEXT!

If I loose my job I will be the guy next to you waiting for care. By the way, don't bleed on the floor. There are less hard working ppl (willing to do whatever job they can to make a living) to clean up your mess.

Have fun with it. Peace out.