Universal Health care: What does it mean for us a citizens?
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out there;304064 wrote:
Is anyone aware of something Boehner said in the last few days? Do some searching, but he asked (I don't remember which voting it was) why there were so many new IRS agents being hired... but no more medical professionals. Seriously, if many hospitals are short-staffed, how are they going to handle MORE patients?Can't answer the first one about IRS agents, but I can tell you that the AMA restricts the number of students who can go on to get the doctorate in medicine. IOW only a small percentage of those who go to school for pre-med get into med school at the choosing of the AMA. In that case, the Dr's only have themselves to blame for the shortage.
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If you have employer supplied health insurance and the business is smaller than 30 employees you might be ok. If the business has over 30 employees you should cross your fingers that the employer will suck it up and absorb the extra costs and not lessen your plan or pass the extra cost on to you.
Rexwagon;303960 wrote:
So wtf does this mean if you already have a good health insurance plan?DaveH
'94 Supra- 7.77 @ 176mph -
First...it's 50 employees. 2nd the costs of insurance may go up due to the pre-existing conditions clauses and the fact that you won't be able to be dropped from health insurance because you are no longer healthy (that is the part that always killed me about insurance...you buy it for when you get sick, but when you do get sick enough they kick you out....That would be like saying you are going to lose your auto insurance because a drunk driver hit you) but there is an equal possibility that they would go down as the creation of health exchanges should (as was proposed/promoted by the republicans early in this process) breed competition within states making insurance plans more competitively priced. Add to that the number of younger/healthier Americans who will be entering the system and the risk pool should tilt more towards healthy. This should help bring the cost of insurance down as well. My bet is that it remains the same after all the pro's and con's to the cost of insurance.
The biggest problem with the bill is the same thing that is wrong with the healthcare industry in general: It is treating the symptoms (high insurance premiums) and not the causes (inefficiencies in hospital billing/crazy high malpractice insurance/over-medication or over-testing/drug costs here vs everywhere else in the world/etc....)
Until we get those other things under control, health insurance costs will never go down in a significant way.
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thrash;304008 wrote:
If you read Japanprobe and other english-language sources, you won't get such a rosy picture of hospital care in Japan. I remember a couple of stories about people are dying because hospitals are turning them away. Why? Because they don't feel they could do the procedure. What was the procedure? Childbirth. They put one woman in an ambulance and kept sending her from place to place; nobody wanted to deal with her.Have you asked any foreigners about their care in Japan? Dannychoo.com grew up in the UK,which has legendary shittyness in its national service. Ask him about how he likes Japanese care.
Japan's medical system is much, much worse off than the USAs.
Or here's a nice practical example of healthcare in Germany: When i was there, drugstores were closed sunday after dinner time. Hope you don't get sick on a sunday!
The current bill is going to change MY insurance. How can you say it's not going to really change anything? My current policy and compensation package at work is either going to change dramatically or my company is going to be spending a fuck ton of extra money, which is going to change somebody's employment.
I based Japans healthcare based on friends that I have who live there (and who have had kids there...and no, not at a military base). Same with the German health system.
Assuming your plan is BCBS (you work at Microsoft, right?) the two things I see potentially increasing your cost of insurance are "Pre-existing conditions will now be covered" and "No lifetime caps on benefits".
Since you are on an employer sponsored plan already, the pre-existing clause won't affect you a whole lot as MOST employer sponsored plans allow people with a condition such as diabetes into their plan anyway. I know of some that allow people with cancer into them. So there will be a marginal cost.
The caps on benefits will likely have a larger impact on what you pay, but that could/should be reduced by the requirement of everyone to have insurance. There will be more younger/healthier people paying in to insurance policies, in effect they are expected to be the equalizer for the caps on benefits.
Is it perfect? No. Is the world coming to an end because of it? Again, no.
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The bill has financial penalties for any business that continues to offer "awesome" plans. The fine/fee schedule was delayed a bit, and do not apply to union members. But everyone at a Fortune 500 company with "really good" benefits is going to be negatively impacted.
Most F500 companies self-insure. You aren't in their risk pool unless you work there. These people are getting the shaft from this bill, because it dumps huge financial penalties on their employers if they don't lessen the benefits provided to their employees.
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Trafik Jamz;304076 wrote:
Assuming your plan is BCBS (you work at Microsoft, right?) the two things I see potentially increasing your cost of insurance are "Pre-existing conditions will now be covered" and "No lifetime caps on benefits".You are wrong about everything. MS self-insures. So do most F500 companies. Health admin and re-insurance of last resort is provided by somebody or other..
Since you are on an employer sponsored plan already, the pre-existing clause won't affect you a whole lot as MOST employer sponsored plans allow people with a condition such as diabetes into their plan anyway. I know of some that allow people with cancer into them. So there will be a marginal cost.
A feature of my employer's plan [and most employer plans at big companies] is that there is no entry screening and no possibility of having coverage denied.
The cost increase will be due to the specific penalties assessed against companies that have high-benefit plans like Microsoft.
The caps on benefits will likely have a larger impact on what you pay, but that could/should be reduced by the requirement of everyone to have insurance. There will be more younger/healthier people paying in to insurance policies, in effect they are expected to be the equalizer for the caps on benefits.
That has nothing to do with it. The # of people paying into the MS plan remains the same: zero. The cost to MS of providing those benefits goes up tremendously because the bill penalizes MS for providing it.
Is it perfect? No. Is the world coming to an end because of it? Again, no.
It's far from perfect. It's a direct attack on my current compensation package that provides me with no benefits what soever. Like most modern government, it's the shitty steeling from the producing class to pander to the dependant voting class.
You don't know what the bill says or does. Unless you're asking questions, stop talking.
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Yes, those with "Cadillac Plans" may be subject to an excise tax based on several different criteria. Even though they are self insured, it is still administered by a major medical company. The underwriting is still based on the law of averages within the whole insured population (not just those within the company), however since MOST people who work for a F500 company already have coverage, they have already seen the advantages of a lower cost policy (relative to what you receive for benefits). Yes, your plan may well go up in price due to excise taxes. I don't like it either.
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thrash;304078 wrote:
You are wrong about everything. MS self-insures. So do most F500 companies. Health admin and re-insurance of last resort is provided by somebody or other..I addressed this in the next paragraph/my next post
A feature of my employer's plan [and most employer plans at big companies] is that there is no entry screening and no possibility of having coverage denied.
I've worked for Tyco, there is no entry screening, you are right, but they do not cover things such as pregnancy if you were pregnant prior to coming to work for them. They also don't cover someone who has cancer, even if they had coverage from a previous employer and no lapse in coverage.
The cost increase will be due to the specific penalties assessed against companies that have high-benefit plans like Microsoft.
I agree with you, I don't agree with the penalties/taxes.
That has nothing to do with it. The # of people paying into the MS plan remains the same: zero. The cost to MS of providing those benefits goes up tremendously because the bill penalizes MS for providing it.
I don't have the numbers on how much they will be penalized/taxed. If you do, I'd love to see them.
It's far from perfect. It's a direct attack on my current compensation package that provides me with no benefits what soever. Like most modern government, it's the shitty steeling from the producing class to pander to the dependant voting class.
You don't know what the bill says or does. Unless you're asking questions, stop talking.
I'm not disagreeing with you. I stated clearly that I didn't like it, but I am informed enough to talk about both the positives and negatives of the HCR. I don't know everything about it, but I do enjoy talking about it from both sides. And yes, I threw out some generalized statements regarding the affect of the bill (and I completely forgot about self insurance in my first response to you....I apologize).
Do you have a link that explains the tax/penalties of self-insured companies plans?
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Trafik Jamz;304072 wrote:
Can't answer the first one about IRS agents, but I can tell you that the AMA restricts the number of students who can go on to get the doctorate in medicine. IOW only a small percentage of those who go to school for pre-med get into med school at the choosing of the AMA. In that case, the Dr's only have themselves to blame for the shortage.AMA = basically a union. Good ol unions at work again to screw everyone else over.
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In a nut shell, yes, in thrash's case his plan will likely take a hit. I should have thought more about self-insured companies before I threw out my blanket statement. Keep in mind (again) that my views on if this was good/bad legislation leans towards bad. I think it could have been done better and w/o taxing/penalizing the "cadillac" plans.
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StangerBanger96;304084 wrote:
AMA = basically a union. Good ol unions at work again to screw everyone else over.Not going to disagree on this for the most part. Though someone asked WHY there weren't enough Doctors, I gave the answer. It's because THEY (or their board/union) limits the amount that can go on to med school. So they did it to themselves. Can't blame anyone other than the AMA and the Doctors in it for that.
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Sorry I got a bit testy.
The bill is going to negatively impact a lot of people, me included. The details of exactly how haven't been worked out yet. I'm actually writing a mail to our HR people asking what their timeframe is for announcing how this is going to affect US employees. THey probably haven't worked that out yet fully. Part of it is figuring out in precise detail what the final bill says and when that comes into full force [different parts happen at different times], and how my company will decide to respond.
In broad strokes, the bill says that I don't get to keep my current insurance without someone [either me or my employer] paying a big penalty. Neither me nor my employer are going to be thrilled to pay, and irrespective of which party pays some or all of it, that means less money to do other things, and some attendant financial adjustments.
The bill also says that part of the funding for the new benefits being given to other people will come from a new tax on my investment activity. Capital gains will now be subject to medicare taxes, and the effective cap gains rates will be going up.
My company compenstates me in a variety of ways: fantastic medical benefits being one of them, and issuance of company stock in a variety of ways being several more. All of this is going to change for the worse as a result of the health care bill.
My salary doesn't put me in the "250k" range (or is it "200k" now?) or whatever Obama was promising would be the starting line for "Sticking it to the rich", and just like i told you leading up the election, I'm going to get fucked by this even though i make nowhere near that much.
And just like I told you 2 year ago, his anti-investment mentality is one place I'll probably feel it most.
I've been contributing to my company stock purchase plan and receiving other stock based assets, and holding my positions in the stock market since I entered the full-time workforce over 10 years ago. As the tax rules change for the wose, I'm going to need to re-evaluate that.
This bill sucks. It doesn't give Obama supporters what they wanted, Obama has reneged on every promise he made about taxes and health care and openness to get this bill to happen, and it certainly doesn't benefit ME at all. The most likely outcome is that it materially damages me to the tune of thousands of dollars a year.
How can I be happy about that? No, thousands of dollars of my money simply evaporating hopefully isn't the end of the world for me, but it might be for some people. Hopefully it is the end of the world for Obama and the congress that passed this horseshit.
The unresolved abortion situation is going to need some more light shed on it. I told my wife the bill passed and all she asked about was if it provided for abortion funding. My wife told me she was willing to become a tax protester over the abortion issue. She generally isn't onboard with me becoming a radical but for that issue, she is. It remains to be seen how that pans out, but the bill doesnt' have the Hyde or Stupak language in it. To get anti-abortion guarantees, they're depending on Obama to sign an EO that somehow limits it. Obama is the most pro-Abortion president we've ever had, based on his previous voting history, and any EO can be overturned at any time by this or any future president. So it's looking pretty marginal at this point.
I know a fair number of people at work who are pretty fucking irate over this. Consider what that means. These are high earners with families and mortgages and kids and everything to lose, honestly. And they're starting to talk in the same language that I am. They're pissed off at the government. They want OUT of the federal machine. They DONT like what is happening.
What do you think is going to happen if this reaches a boil? When affluent conservatives and libertarians decide to revolt, do you think they're going to light dumpsters on fire? Or throw bricks through store windows?
I don't think this problem is something an election or a repeal can fix. The red/blue schism in this country is coming to a head and I know which side is better armed and I know how the professional armed forces vote in elections.
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thrash;304096 wrote:
To get anti-abortion guarantees, they're depending on Obama to sign an EO that somehow limits it. Obama is the most pro-Abortion president we've ever had, based on his previous voting history, and any EO can be overturned at any time by this or any future president. So it's looking pretty marginal at this point.So which has more weight, Congressional Law or EO?
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thrash;304096 wrote:
Sorry I got a bit testy.The bill is going to negatively impact a lot of people, me included. The details of exactly how haven't been worked out yet. I'm actually writing a mail to our HR people asking what their timeframe is for announcing how this is going to affect US employees. THey probably haven't worked that out yet fully. Part of it is figuring out in precise detail what the final bill says and when that comes into full force [different parts happen at different times], and how my company will decide to respond.
In broad strokes, the bill says that I don't get to keep my current insurance without someone [either me or my employer] paying a big penalty. Neither me nor my employer are going to be thrilled to pay, and irrespective of which party pays some or all of it, that means less money to do other things, and some attendant financial adjustments.
The bill also says that part of the funding for the new benefits being given to other people will come from a new tax on my investment activity. Capital gains will now be subject to medicare taxes, and the effective cap gains rates will be going up.
My company compenstates me in a variety of ways: fantastic medical benefits being one of them, and issuance of company stock in a variety of ways being several more. All of this is going to change for the worse as a result of the health care bill.
My salary doesn't put me in the "250k" range (or is it "200k" now?) or whatever Obama was promising would be the starting line for "Sticking it to the rich", and just like i told you leading up the election, I'm going to get fucked by this even though i make nowhere near that much.
And just like I told you 2 year ago, his anti-investment mentality is one place I'll probably feel it most.
I've been contributing to my company stock purchase plan and receiving other stock based assets, and holding my positions in the stock market since I entered the full-time workforce over 10 years ago. As the tax rules change for the wose, I'm going to need to re-evaluate that.
This bill sucks. It doesn't give Obama supporters what they wanted, Obama has reneged on every promise he made about taxes and health care and openness to get this bill to happen, and it certainly doesn't benefit ME at all. The most likely outcome is that it materially damages me to the tune of thousands of dollars a year.
How can I be happy about that? No, thousands of dollars of my money simply evaporating hopefully isn't the end of the world for me, but it might be for some people. Hopefully it is the end of the world for Obama and the congress that passed this horseshit.
The unresolved abortion situation is going to need some more light shed on it. I told my wife the bill passed and all she asked about was if it provided for abortion funding. My wife told me she was willing to become a tax protester over the abortion issue. She generally isn't onboard with me becoming a radical but for that issue, she is. It remains to be seen how that pans out, but the bill doesnt' have the Hyde or Stupak language in it. To get anti-abortion guarantees, they're depending on Obama to sign an EO that somehow limits it. Obama is the most pro-Abortion president we've ever had, based on his previous voting history, and any EO can be overturned at any time by this or any future president. So it's looking pretty marginal at this point.
I know a fair number of people at work who are pretty fucking irate over this. Consider what that means. These are high earners with families and mortgages and kids and everything to lose, honestly. And they're starting to talk in the same language that I am. They're pissed off at the government. They want OUT of the federal machine. They DONT like what is happening.
What do you think is going to happen if this reaches a boil? When affluent conservatives and libertarians decide to revolt, do you think they're going to light dumpsters on fire? Or throw bricks through store windows?I don't think this problem is something an election or a repeal can fix. The red/blue schism in this country is coming to a head and I know which side is better armed and I know how the professional armed forces vote in elections.
Indeed... This bill has brought the political fury out of individuals who in the past, have not been so voiced. To me, that is reason to believe this shit wont fly for long
I for one HAVE NEVER been one to debate politically or get caught up in this kind of crap... But when its something as radical as this, I just cant help my self..it has obviously put the extreme right wingers over the edge, but also the independents/people who choose to be logical over affiliation with a party...
I just dont think this is going to fly.. I hope it doesnt.
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Trafik Jamz;304094 wrote:
Not going to disagree on this for the most part. Though someone asked WHY there weren't enough Doctors, I gave the answer. It's because THEY (or their board/union) limits the amount that can go on to med school. So they did it to themselves. Can't blame anyone other than the AMA and the Doctors in it for that.It would be interesting to know if it's to keep the quality of the doctors high, or keep the demand for doctors high. I'm guessing the first...
DaveH
'94 Supra- 7.77 @ 176mph -
StangerBanger96;304098 wrote:
So which has more weight, Congressional Law or EO?I'm not sure there is an easy answer to this question, and if there is, I don't know it.
Let me elaborate: the congress can choose not to fund something that is done by Executive Order (EO). The "scope" of things allowed by EO is supposedly narrow. The executive branch can choose not to "do" anything about a law passed by congress.
For instance, congress maintains that pot is illegal, but Obama (something I agree with him on) has said that the DEA and the Obama justice department will not be bringing charges against people who are complying with their state laws regarding marijuana. So in places where medical marijuana is legal, Obama isn't willing to enforce the existing federal laws [or so he says, anyway].
That's an example of the conflicting checks and balances between the congress and the president.
Another example would be the gold confiscation of 1933. FDR signed an executive order that called for the confiscation of all privately held gold in the US. It was later deemed unconstitutional. The next year congress passed a law that worked slightly differently that acheived the same effect. (incidentally, that law wasn't repealed until the late 70s. During most of your grandparents lifetime, it was illegal to own gold except as ornament or decoration. Private gold ownership was outlawed by FDR so that the dollar could be taken off the gold standard and replaced with Federal Reserve Notes.)
The point about EOs is that they cover a kind of broad and arbitrary jurisdiction. For those of us with commie guns that take commie rounds, the big appeal of these is that milsurp ammo is very affordable. But milsurp ammo is something that is imported, and trade agreements and import/export is something the president can affect via EO. It would be perfectly legal for Obama to write an EO that completely banned the import of ammunition from other countries. This could go into effect overnight and that would be that -- no law, no 2A challenge, no nothing, and suddenly gun owners are left out to dry.
Of course, he [or the next president] could rescind the order at any time, or the congress or the courts could use their available tools to overrule or nullify the EO. But that stuff takes time and a compliant/willing congress or judiciary.
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I'm not disagreeing with you thrash. Can you please point me to some direct links that talk about this in more detail (I understand and trust you more than most others on here....I just want to be able to research it myself as well...can you point me in the right direction to get started?)
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