UPHELD!!! Obamacare

[Lostbuckeye]

The law has some significant flaws but, it has some things that are worth keeping. One side wants the whole thing trashed and offers no alternative. The other says this is the best we can do and won't acknowledge its flaws or offer ideas to improve the bill. No law goes on the books perfect and many times legislation is produced to tweak the law. But with congress ruled by the fringes of both sides and huge political pacs we will see more of the same for the foreseeable future and we haven't even got to the mandated spending cuts which come due in a month. Meanwhile, the "silent majority" (I believe that's Rep. Pres. Richard Nixon's phrase) sits on the sideline watching the cat fight. But I wonder for how much longer.

Bottom-line, things were no better without this flawed law. We were all paying for the uninsured. Premiums were rising which causes small businesses to raise employee premiums or decrease/drop benefits or raise deductibles which in turn reduces consumer spending which causes layoffs. And on top of that, the small businesses can no longer compete for the quality workforce that will go work at larger businesses that can afford health benefits. This law could be a starting point to something that works. However that would require both sides of the aisle to compromise.

This country has not been this politically divided since the civil war and I'm not sure how to fix it. One would hope for rational minds to take over but, anyone unwilling to compromise is not rational. That's we have wars. Just my $.10.

 

[Jimbo]

The law has some significant flaws but, it has some things that are worth keeping. One side wants the whole thing trashed and offers no alternative. The other says this is the best we can do and won't acknowledge its flaws or offer ideas to improve the bill. No law goes on the books perfect and many times legislation is produced to tweak the law. But with congress ruled by the fringes of both sides and huge political pacs we will see more of the same for the foreseeable future and we haven't even got to the mandated spending cuts which come due in a month. Meanwhile, the "silent majority" (I believe that's Rep. Pres. Richard Nixon's phrase) sits on the sideline watching the cat fight. But I wonder for how much longer.

Bottom-line, things were no better without this flawed law. We were all paying for the uninsured. Premiums were rising which causes small businesses to raise employee premiums or decrease/drop benefits or raise deductibles which in turn reduces consumer spending which causes layoffs. And on top of that, the small businesses can no longer compete for the quality workforce that will go work at larger businesses that can afford health benefits. This law could be a starting point to something that works. However that would require both sides of the aisle to compromise.

This country has not been this politically divided since the civil war and I'm not sure how to fix it. One would hope for rational minds to take over but, anyone unwilling to compromise is not rational. That's we have wars. Just my $.10.

Actually they do offer alternatives.

Interstate competition.
Savings Accounts.
Tort Reform.

These were all things that could have been done but weren't.

-J

 

[jond]

I think it's funny how the republicans act like they have a plan.
If obamacare didn't happen, this subject, like social security, would go another 20 years without ANY change.
It's not perfect, but at least now we have a solution.
How about someone fixes social security next instead of crying about perfection?

I always think of this when people talk politics.
Seems about as real as pro-wrestling to me.


<iframe width="420" height="315" src="http://www.youtube.com/embed/hYIC0eZYEtI" frameborder="0" allowfullscreen></iframe>

 

[kookoo4nsx]

I believe employers can dump employees if the employer pays 8% of the salary into the pool.

I also heard that small business can now "dump" their employees into the "system" and not responsible for their health insurance. Anyway the whole thing is kind of confusing with one side saying it'll save money and one side saying it'll cost money. I sense lots of Politics with this bill.

 

[nsxalot]

Carlin tells it like it is. Get your news from more than one place and TV is not the place.

Lance

 

[nsxalot]

you don’t want to get a life threatening problem there... treatment is long than life expectancy

If we could just keep all of the poor out of line then we can see the doctor so mush faster.

Lance

 

[Keahistight]

Where did these conclusions come from? This sounds like speculation.

Not at all. This is a reason that many laypersons ignore but nearly every private practitioner hates Obamacare.

EMR provision requires e-perscriptions and HIT requiring them to invest anywhere from $40K - $140K on systems so the Government can track them. You are a doctor who pays for everything and gives good care. You then get hit with a "requirement" to spend $100K and get tracked on everything you do. (which BTW is the ultimate Govern. spy into our lives). If you don't you are fined in increasing amounts. This coupled with raising malpractice costs, excellent care that you arent "approved" to give causing you to dumb down your practice, and all the other fees you incur ... It will become such a burden that you wont care anymore and will take a dumb-down salary position at a hospital. The winner is the big guy.
There are hundreds of articles on this out there in the medical world.

The medical degree and profession as a whole is also downgraded. When government pannels and administrators can make standards and de facto decisions over a medical professional ... that's a problem. Fruthermore, if its a standard, you don't have the choice to go to another provider or practitioner for another option. Will pursuing medical school be as rewarding or draw the best and brightest?

I can't support the dumbing down of the profession, downgrading of the medical degree, removing personal choice, compulsion of increased spending in every arena, increased wait times and sub-par treatment.

Final question ... and it's important: Have the administrators and rule makers of this program taken the Hippocratic Oath ... to do no harm ... Simply creating broad treatment programs and standards and handcuffing the doctors hands violate this provision.

 

[nsxotic911]

If we could just keep all of the poor out of line then we can see the doctor so mush faster.

Lance

+1:biggrin:

 

[SFNSXguy]

This is a reason that many laypersons ignore but nearly every private practitioner hates Obamacare.

To put this as politely as possible: BS.

 

[docjohn]

on a macro level and as a broad generality,in the 80's and 90's doctors figured out that they could provide and own the same tests and procedures that hospitals relied on for thier profits,thus sprang up the myriad surgical centers/independant imaging centers where the docs owned and self refered.....stark laws narrowed this but still allowed groups of docs to own imaging and testing in thier office,which has been exploited......the key fact is that reimbursement was similar to what the hospital was payed..thus thier was no incentive for patients to have this done at the hospital.Hospitals started to fail and were bleeding taking care of the uninsured....shift to current time where now we see the results,and more importantly the government and ins companies are trying to swing the pendulum the other way.Reimbursements for many of the high end tests like ct and mri are dropping up to 60% on the outpatient side if not owned by the hospital ,,but the hospital is still getting top dolar, so the ability for docs to get easy financing from the equipment companies and start a new center to compete with the hospitals is going away.This and the fact that there has been tremendous consolidation in the hospital market with for profits buying old systems on the cheap is also squeezing docs ability to maximize income.For profits take every last ounce of money out of thier market to satisfy stockholders.Very different from the old school health system satisfying bond holders.The bottom line is that medical costs start with the cost of the equipment and that is not going down as much as reimbursements.some day the pendulum will swing the other way again........but the days of the solo practitioner are dwindling,doctors will need to respond to all these pressures by joining ever larger groups to share costs/exert influence on payers.How this will impact the delivery of care and to you the consumer is open to debate.

 

[Keahistight]

To put this as politely as possible: BS.

We can change it to "many" or "a majority" if you prefer. Please keep in mind I specified private practitioners.

 

[BD]

Well I can tell you guys in MA, where you HAVE TO buy insurance, I am getting mine through the commonwealth and not privately anymore. It is cheaper, for the same coverage. In fact, it is the same company. I can get coverage through the commonwealth of MA, provided by my choice of insurer.. blue cross, Harvard pilgrim, neighborhood health, and a few others... or I can call them up privately and get my own, having nothing to do with the state. But it is more expensive if I do it on my own.

I mean whatever it is, it is working here. It's also less for me to insure my employees this way than it is for me to get them a group policy. So I like it, whatever it is. I have saved about $100/month on my own policy, I have about 98% of my old coverage.

What is the % of the illegals in your state? What is the % of people in poverty in your state?

The reason why it is constitution for the states to dictation is because smaller states that can afford it can decide. Now we have a Federal Government in charge of all 50 states, multi layer bureaucracies created to suck up the "tax" dollars before it reaches the end users, AND they can increase that tax if the cost is out of control, which will be.

We will all be treated like a piece of postal mail, if they mess up the delivery, they wouldn't even apologize.

 

[TURBO2GO]

What is the % of the illegals in your state? What is the % of people in poverty in your state?

The reason why it is constitution for the states to dictation is because smaller states that can afford it can decide. Now we have a Federal Government in charge of all 50 states, multi layer bureaucracies created to suck up the "tax" dollars before it reaches the end users, AND they can increase that tax if the cost is out of control, which will be.

We will all be treated like a piece of postal mail, if they mess up the delivery, they wouldn't even apologize.

My state didn't suddenly change once having mandatory health care became law. The number of illegals didn't change, nor did the poverty rate. And once in became law the sky didn't fall, the cost of my healthcare for me and my employees improved.

Anyway no one is going to change opinions here. I am happy someone is at least trying to do something about this out of control monster. I am going onto more interesting threads. :smile:

 

[BD]

My state didn't suddenly change once having mandatory health care became law. The number of illegals didn't change, nor did the poverty rate. And once in became law the sky didn't fall, the cost of my healthcare for me and my employees improved.

Anyway no one is going to change opinions here. I am happy someone is at least trying to do something about this out of control monster. I am going onto more interesting threads. :smile:

I guess you failed to understand the question, something the conservatives have been asking. The % of illegals in California, Arizona, Texas, New Mexico are all much greater than the state you live in. Therefore, if EVERYONE is covered and can go see a doctor WITHOUT showing their legal status, your state will have much LESS financial impact.





BTW, how is Fisker doing?

 

[TURBO2GO]

I guess you failed to understand the question, something the conservatives have been asking. The % of illegals in California, Arizona, Texas, New Mexico are all much greater than the state you live in. Therefore, if EVERYONE is covered and can go see a doctor WITHOUT showing their legal status, your state will have much LESS financial impact.





BTW, how is Fisker doing?

Vance what's with the rolling eyes and the fisker comment? I thought we are having a civil discussion, I try to be courteous and polite despite not agreeing with you politically. Do you really want to know or are you just trying to jab at me in some way because I like that car?

It's not mine, it is my friends, and he still loves the car. I asked him if he would do it all over again knowing of the issues fisker has had and he said absolutely. Even surprised me. Maybe I will do a photo shoot with my nsx and his car.

 

[CarterK]

I guess you failed to understand the question, something the conservatives have been asking. The % of illegals in California, Arizona, Texas, New Mexico are all much greater than the state you live in. Therefore, if EVERYONE is covered and can go see a doctor WITHOUT showing their legal status, your state will have much LESS financial impact.





BTW, how is Fisker doing?

We already pay for the healthcare of the uninsured and undocumented via the costs of Emergency room visits.

I just really hope that in light of the ACA being upheld we can get some progress on extending tax cuts (at least temporarily) and avoiding the "fiscal cliff". If all of these things hit our economy at once we are going to be in trouble.

 

[passline]

doctors will need to respond to all these pressures by joining ever larger groups to share costs/exert influence on payers.How this will impact the delivery of care and to you the consumer is open to debate.

OMG! does that mean having to deal with HR??

 

[LJSB]

It would seem to me:
1) Hospitals would fare better under this plan.
2) Health Insurance companies would fare better under this plan.

I would expect that those who do not purchase health insurance would still get proper service with them being subsidized by the paying people in the system.

 

[DocL]

We already have a government controlled healthcare system. It's called Medicare and Medicaid. How many of you here are provided care by that system? How many of you are paid by the system?

 

[Juice]

I am agreeing with you! My point was there is a political perspective to this as well. The court is not acting in vacuum.

Edit: To clarify: Roberts could have stopped at noting that the Commerce clause could not be used to mandate. But he "chose" to go further and rationalize the ACA mandate based on the constitutionality of using the power of Congress to tax. Did he need to make the argument for the President when the President and his Congress said it was not a tax. Of course not. But he did and one can only speculate why he chose to do so - until one day he gives his reasoning.

And yes President Obama argued that this law was not a tax - and was he making this case as a constitutional scholar or as purely a politician? I suspect the latter even if he was wearing an academician's hat/robe.

Hrant, I find it amusing how many people can't follow to the conclusion you are leading them to. Your posts have been most insightful. I appreciate your understanding of the subtleties of political warfare.

 

[TURBO2GO]

There's all kinds of misinformation on this thread, I wonder how many get that nothing is really changing, this was only UPHELD to a challenge, the law has been in place for a while now. All this "we have to insure all the illegals" and stuff is ridiculous. We do not have universal healthcare. What we have is a half-ass, weak few laws that try to mildly curb some of the most outrageous practices that insurance companies have had. It could have been much better and much more comprehensive, but in the end, the insurance companies lobbied and got their way and kept their monopoly. The issue is that any tiny dent in their bottom line is too much, and that is all this challenge and hoopla are about.

 

[druby]

A big issue with health care reform that was mentioned but not in detail is how this will impact jobs. The law requires businesses that have more than 50 FTE's (full time employees) to offer coverage and the cost to the employee cannot be more than 9.5% of income, otherwise the business has to pay a $3,000 excise tax (which is not deductible) per employee. The health plan also cannot have a deductible of more than $2,000 which is higher than many plans offered these days. I am in the benefits business, one of my clients has 150 employees. he owns a fast food franchise. he covers his managers but not the folks work 30-35 hours per week as he cannot afford to do so. Under the law he has to cover them at the 9.5% maximum cost to them. he said the answer to him is easy as the penalty would be $360,000 which he doesn't have. Instead he will cut all those employees hours down to 27 hours cutting their pay by 30%. I have quite a few clients that are looking at laying employees off or cutting hours in 2013 to prepare for these penalties that apply in 2014. Another paid is the MLR (minimum loss ratio) that the insurance companies have to rebate back. It is the employers responsibility to find how much of the rebate is applicable to each employee 9including ex-employees) based on how much each person paid and get their application portion back to them. We had to make an excel spreadsheet for our clients to help them with the calculations. It is their problem finding ex-employees and sending them the money.

 

[bee_are_bee]

A big issue with health care reform that was mentioned but not in detail is how this will impact jobs. The law requires businesses that have more than 50 FTE's (full time employees) to offer coverage and the cost to the employee cannot be more than 9.5% of income, otherwise the business has to pay a $3,000 excise tax (which is not deductible) per employee. The health plan also cannot have a deductible of more than $2,000 which is higher than many plans offered these days. I am in the benefits business, one of my clients has 150 employees. he owns a fast food franchise. he covers his managers but not the folks work 30-35 hours per week as he cannot afford to do so. Under the law he has to cover them at the 9.5% maximum cost to them. he said the answer to him is easy as the penalty would be $360,000 which he doesn't have. Instead he will cut all those employees hours down to 27 hours cutting their pay by 30%. I have quite a few clients that are looking at laying employees off or cutting hours in 2013 to prepare for these penalties that apply in 2014. Another paid is the MLR (minimum loss ratio) that the insurance companies have to rebate back. It is the employers responsibility to find how much of the rebate is applicable to each employee 9including ex-employees) based on how much each person paid and get their application portion back to them. We had to make an excel spreadsheet for our clients to help them with the calculations. It is their problem finding ex-employees and sending them the money.

I have a very reliable source that tells me that over the next five years or so a major California medical system will lose about 10-20% income as a result of this law. 60% of the system's operating expenses are workforce. Guess where the cuts will come in order to offset these revenue decreases? Yup, staff. I've been told that the process will happen over the next three or so years. This type of thing has been talked about for several years only for people to ignore it. I obviously won't reveal my source but this person is very close to me and is pretty much the "horses mouth."

This law does very little in the way of solving the problem of rising cost, just shifts who pays those costs and will create even more problems that will prompt the same people who caused it to intervene and "do something" about it.

 

[bee_are_bee]

Also, just because something is "cheaper" to you doesn't mean it costs any less. All it means is what a person pays out of pocket isn't commensurate with the real cost of the service or commodity and the difference is subsidized by someone else (tax payer).

 

[SFNSXguy]

It's amazing how little most Americans know about the Affordable Care Act, yet that doesn't keep them from talking about how bad it is.

Same things were said about Social Security and Medicare -- and like those the Affordable Care Act will need 10-15 years to be fine tuned.

Medicare For All would have been better, but impossible to pass with this Congress.