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Sorry guys.  I shouldn't have asked you to dig so deep as to defend or question your beliefs in such a simple, logical, and public way.  It is only met with obfuscation or silence.

I still do need to know if it is even worth it, so along the day, in the moment, would any of you save a Coke Brother from a burning Chevy Volt?
Mike
 
MicDaddy said:
I'm just dumbfounded how we got okeydoked under the guise of affordable health care for this "insurance bill"

It's an insurance law, it's not about your healthcare.

Me and a friend were discussing the shift of labor overseas and have found that some ~5% of the equation is "labor".  Migrating and implementing factory operations to pinch at 5%? ...I feel it's not so much about the cheap labor as it is about the overall expense of doing business in the USA.

Mic, we actually got okey-do-fi-diddle-dee-dee-okeyed and that is part of the issue.  The Patient Protection and Affordable Care Act legislation, outsourced by it's name sake to the eevil insurance companies, administration hacks, and House democrats, passed the Smellosi controlled house with a party-line vote and never made it to the Senate floor for a "tea saucer as a kee-yoo-weling plate"* debate.  The hot tea was put to a cloture vote on The Silent Night of DECEMBER 24, 2009 long before the future Junior Senator of the Great State of Massachusetts, the 41st vote against, Scott Brown stuffed the ballot boxes and won on january 19, sworn-in february 4 2010.  It was slamped through the Senate and it went straight to House-Senate "reconciliation committee" and slimed over to 44 to sign. 

This all happened over 4 years ago and it's time we should just move on.

Okey-dokey ;-?
Mike

* Attributed to the late Senator Robert Carlyle Byrd, born Cornelius Calvin Sale Jr.
 
hodad said:
Just to add imfo:  House Repubs had called insurers to testify today, but the news did not suit the Republicans (or match bogus numbers mentioned earlier in this thread):
http://www.businessweek.com/news/2014-05-06/insurers-say-most-obamacare-customers-paying-first-premiums
http://thehill.com/policy/healthcare/205471-gop-struggles-to-land-o-care-punches

I was appreciating the relative calm the last few days.

The data showing that 80-90% have paid their first premium is far from a ringing endorsement. That means some 10-20% haven't even paid the first premium. While interpreting this going forward may depend on your perspective, whether this portends a better or worse future revenue stream is TBD.  So we do know that we have a smaller fraction of the young healthy uninsured population participating, and 90% or less of those who did sign up actually paying.

Still too early to make a future determination, but that is exactly what the insurance companies will have to do when they announce 2015 rates. 

It is sad that congress is all about getting some slam dunk several second long sound bite for the evening news, and not actually getting information by asking thoughtful questions, but that first derivative abstract view is how most of the public view these matters. 

The whole contempt of congress against Lerner is because she took the 5th only "after" making her opening statement and declaration of innocence, so she got in her good sound bite and denied them their bad sound bites. The 5th amendment is not about sound bites, IMO she can take the 5th any time she needs to. While that whole IRS scrum is far from resolved. 

I dislike political maneuvering.. there are some real issues at hand. This is far from the top news even for congress today...There was Yellin testimony (housing is weak), and they are trying to seat a select committee to investigate benghazi, and file contempt citation against Lerner and others... If this is not messy enough, Monica Lewinsky crawled out of the shadows for another 15 minutes of fame..  arghhhhhh

JR

PS My orthopedic specialist still hasn't reviewed my MRI scan from a week ago monday, but i can't blame this on ACA... Just health care in the rural south.
 
sodderboy said:
Thanks for the linkzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

And that's exactly why no one has any interest in trying to "enlighten" you. 

 
I don't think you, or they CAN.  They are silent because they cannot refute the simple, dumbed-down (for myself) points I made.  You link stats that could have been achieved at even greater numbers with a one page bill increasing the income cap on Medicaid, which would have been passed with HUGE bipartisan and national support.  But there was no one page bill because there is not enough space for the "Stick It To Them" byline and necessary legislative obfuscation.  So this is a source of achievement?  I'll remind you that we are in the Candyland phase of this monumental legislation with all of the gimmies flowing.  All of the mandates have been delayed for years by the act's namesake.  Lets see some stats when the individual and employer mandates go into gear.  Or the Cadillac Plan tax. 

You have to think two steps ahead of the trail of MSG laden crisps they are laying for you.

And Paul Krugman?  How can I be enlightened by someone I have been reading for almost two decades, using him as a contrarian indicator?  I  make financial decisions based on the OPPOSITE of what he says, trends he predicts and they have been correct.  If that's all you got, then yes, there will be no enlightenment. 

Believe what you want, and don't bother questioning it.
 
sodderboy said:
  You link stats that could have been achieved at even greater numbers with a one page bill increasing the income cap on Medicaid, which would have been passed with HUGE bipartisan and national support. 

What alternate universe do you live in?  There is absolutely no way such a bill would have garnered HUGE bipartisan support.  Two words:  debt ceiling.  One word:  sequester.  Two more words:  SOCIALIZED.  MEDICINE. 

No way in the world  any bill like that gets GOP support.  And yet you think it would, which is another reason there's no point in trying to "enlighten" you. 
 
Arguing hypotheticals adds heat but not light to the discussion.

There was common agreement that the healthcare system was challenged and in need of reform (to manage rate of cost increases), not much agreement about which direction to move it to accomplish that improvement.

I remain unconvinced that this first pass will turn out well, but it will take years to play out and provide un-challengible evidence for the true believers. By then we will be too invested in this direction to tear it up and start over.

We need to save out energy for figuring out how to make this not suck so bad. We can not continue to borrow and spend like this, we need to come up with a sustainable model. Taxing healthcare to pay for healthcare will result in less healthcare not more. 

Unfortunately marshaling public opinion is a more binary all or nothing exercise. It will be interesting to see how the Senate turns out in Nov, and how the courts deal with our chief executive's selective enforcement and significant alteration of the ACA without returning to congress for legislative approval. 

JR

 
That is what they did anyway, just not in as big a jump as they should have.  The states STILL have their sCHIP programs etc. and those income caps were lifted.  PLUS we got thousands of pages of smoke and mirrors, with some of the mirrors temporarily removed.  How does the "exchange" get funded anyway but by increased taxes and re-direction of existing funds?  That and the increased rates the already insured have experienced the past few years.  US Healthcare filed with NYS for small group rate increases, and it looks like my group goes up 22% in just one year if they get the increase.  Not Affordable for me.
 
JohnRoberts said:
The other tool in the government tool box to manage scarce resources (medical care) is rationing. While they don't exactly say no, they make you wait so long for healthcare you can die waiting.
http://www.cnn.com/2014/04/23/health/veterans-dying-health-care-delays/ The veteran's healthcare system another poster boy for government management of healthcare, is dealing with new charges of some 40 veterans who died while waiting for doctors appointments.  This is still a developing story, so lets not over react to the headline, this may be an isolated case of one horribly mismanaged region, or it could be a warning of things to come. Time will tell.

It has been interesting to watch this story develop and it does seem instructive about government operated health care.

So far not only have the bad headlines been reinforced with more data but this does not seem isolated to only one region.

It now appears that the secret waiting lists were used to game a bonus system, so simultaneously while veterans received sub standard wait times, their providers received bonuses for faked good results. (This is fraud and probably criminal. )

This seems pretty common with public bureaucracies that lack the discipline of managing their own money where real results and customer satisfaction matters. When dealing with profits and losses, you can not fake results for any duration.

I won't even dwell on the highly unionized angle. and any number of disturbing anecdotes.

In the context of fixing this and anticipating reforming ACA I would contrast government run healthcare like the VA with Medicare, where government pays private providers to deliver health care.

Note: Medicare is severely challenged by government attempts to set prices arbitrarily too low, which will result in scarcity of providers willing to play. This pales in comparison to the abuses seen inside the VA health system, where they just re-write the results.

JR

PS: I really hate politics. I have a primary election next week and a long held senate seat is being contested by a tea party candidate. It did not take very long at all for them to get down into the gutter and start slinging mud. Some of the public appeals are insulting to anyone who understands government. Why am I not surprised? 
 
JohnRoberts said:
hodad said:
JohnRoberts said:
[edit- raising the minimum wage to $10.10 will not help the economy, or help employment. just lead to fewer entry level positions and more automation...  /edit]

JR

You have no hard data to back this up.  I can tell you for a fact that lowering taxes on the wealthy doesn't help the economy--we've had a dozen or so years of that, and the only thing that's changed is that the rich are richer.
And how is the current anti-business environment working out?

This whole class warfare is a red herring. While not perfect 1:1 the highest incomes are earned by people creating the most wealth, they also create jobs as consequence of creating this wealth.

One universal truth about taxes is whenever you tax something you get less of it. This has long been applied for sin taxes to get less smoking or less drinking by taxing booze and
e cigarettes. When you tax people creating wealth you get less wealth creation.

Government taking wealth and giving it to unproductive sectors of the economy will just dissipate that wealth. It may be a fun ride while it lasts but eventually you run out of "other peoples money".

And the poor, well, they're poorer.  The concentration of wealth at the top has led to a stagnant economy with falling wages. 
The stagnation is not caused by the concentration of wealth, but by anti-business policy in taxation and regulation, and even negative messaging. What business leader feels confident about the future and his costs.

You can not get blood from a stone, and forcing a Macdonalds to pay $10+ to menial workers, without the ability to raise the prices of the food enough to cover the extra cost, simply will not work. Instead we will see more automation and elimination of more of those jobs.

When I was a teen I worked for $1.25 /hr minimum wage (yes I'm old). These entry level jobs serve a useful purpose.  Being a greeter at Walmart should not be the primary job of a family's bread winner. It is good job for some kid learning how to work, or some retiree to make a few extra bucks.

The fact that bread winners are working in these menial jobs is just more evidence of the administration's failed economic policy.


Cutting the estate taxes will do nothing but lead to a whole bunch more Paris Hiltons.  And we all know what a job creator she is.
I did not suggest this, and heard an economist recently frame cutting the estate tax as undesirable because it would not change behavior, people would still die and accumulate wealth while alive. I dislike it when people inherit a family business and have to sell it because they can afford the taxes.

I think the government should claw back entitlement largess from estates when people die.
Your arguments rest on ideology, not reality.
Huh...  While I concede economics is a soft science it is very much based on reality. I invite you to read The wealth of nations by Adam Smith, pretty much a catalog of facts that demonstrates how markets work. albeit hundreds of years ago, but the market economics is still the same.
  It's easy to point at a Pfizer-Astra Zeneca merger, but the fact is most of these corporations are already hiding billions in the Caymans and other tax havens.  And at some point they'll sucker another president into giving them a tax amnesty on all that hidden money, and just like last time it'll do nothing to stimulate the US economy. 
No the point is that US corporate taxes are not competitive, even compared to UK, historically a higher tax nation than the US. Yes companies already have piles of money held off shore to avoid onerous tax laws here... We do not need to give business a better deal than other western countries, we just need to be competitive with other nations. It should not be a good use of their time to engineer tax avoidance. Level the playing field between US and other countries so business can spend 100% of their attention on growing their business, and we will see huge capital investment and job growth here.

If you want equality, look at Cuba... no productive business sector, everybody is poor..but equal.
Concentrating the wealth in the hands of the few is not working--it is a demonstrable failure, empirically proven.  Your ideas may sound good in your head, but the empire's crumbling as your beloved plutocrats fiddle.
The irony is that Obama's policy and the current fed has increased the distance between wealthy and poor. The whole fed policy is to inflate assets (to avoid deflation), and the poor do not have assets (duh). Obama is talking the talk to get votes, but if he really cared for the poor he would support business and grow the economy creating more jobs. He is the most divisive leader I can remember.

I will be glad when he retires back to civilian life.

JR

@SSL yes Apple is the poster boy for tax avoidance, I think they are currently based in Ireland or something like that. We need to make all this financial engineering academic with a (more) level playing field. I doubt we can match the deals that Ireland set up when they were hurting, but we just need to match most major western countries to make it not worthwhile to do such deals just to reduce taxes..
Well I do agree with you.. Some of his policies are not right and is effecting the country badly..His tax policies are pretty tough to understand,
 
The tax policy fits a certain world view and seems more about redistribution and class warfare than growing the economy. What worries me is a pattern of tax conversions I see developing, where large international companies take their offshore retained earnings and buy a foreign company to change their tax address. We need those companies to stay american based and invest that money here.
=====
In an attempt to stay on topic, the insurance companies are starting to assess the first year of ACA, and are finding the initial round of insured were less healthy than anticipated suggesting they would need to raise prices for next year. 

This does not get much coverage in the press because there are so many other distractions, as the unintended consequences from several years of bad policy break out all over. SCOTUS has pushed back over his abuses of executive privilege, declaring his recess appointments to NRLB as illegal invalidating all their decisions since then.

and the beat goes on....

JR 

PS: My personal health insurance (Medicare B) experience is about $700 out of pocket so far for my knee diagnosis, medicare picked up the rest ($1200-1500). For some unexplained reason the insurance denied paying for the Xray but approved the MRI. They seem horribly managed with bills coming from several different offices, with no explanation of charges. If it's hard for me to keep this straight and I'm the patient, I can imagine it being ripe for fraud.
 
Wow was I wrong!  My insurance went up 37.7% YOY.  Close to $5K extra out of pocket each year.  A major portion of that is money that will not be moving locally anymore.  It all adds-up.  But my broker said it didn't matter because I will get bumped anyway because a corp with two spouse employees and 1099 contractors is not eligible for group coverage. 

What should be a highly competitive market for medical insurance has been reduced to three choices for "health insurance" for an independent person living downstate in New York: the exchange, and two privates.  As far as I see, the opposite of all the lofty promises is happening for me: less competition, less affordability, less choice.  It is ponderous that NY is subsidizing insurance for "folks" making up to $62K per year.

For all the freebees, exempted union members, and exempted corporate workers, exempted government workers and politicians there are others who really get the shaft. 
Mike



 
sodderboy said:
It is ponderous that NY is subsidizing insurance for "folks" making up to $62K per year.

For all the freebees, exempted union members, and exempted corporate workers, exempted government workers and politicians there are others who really get the shaft. 

Yeah, like the couple who accidentally made $62050 who get no subsidy at all, when they thought they were making $61075 and got a big cut.  And the people who each make 32K and accidentally got married. 
 
My insurance through Freelancers Union has increased by less than 10% since I got it four years ago. I'm in New York State. I have no subsidies and I've made more than 62k a year for the last four years. My premium is $345/month for a single person 47y.o. Pretty good health. No chronic issues
 
New York State is a hard state to set those kind of subsidy numbers. 62k if you live downstate (NYC environs) doesn't seem like much money. In Buffalo or The Adirondacks you'd like like a king.
 
It looks like I made the mistake of paying all the invoices I got for my recent medical adventure (x-ray and MRI of my knee). I apparently double paid the deductibles, and remarkably (so far) I have not been credited back for my (2) over payments.  (I'm shocked).  ::)
======

OK moving forward, another  unintended consequence of the ACA mandate to computerize all medical records, doctors are tasked with data entry for procedures and medical notes. If they try to enter the data in real time while interviewing patients they lose eye contact with the patients and suffer lower quality communication (important for good medical care).  Alternately if the doctor enter the computer data off-line it takes more unproductive time out of their day that they do not get compensated for.

I hope technology will step up and help minimize the pain of computerizing this point of contact, but this will get worse before it gets better as ACA will soon vastly expand the number of medical codes that must be correctly enumerated to perfect payment.

JR

PS: For another unintended consequence that should have been obvious to the government pukes, we have seen a large number of big banks sued big dollars, for making arguably "bad" home loans to consumers who could not pay them back. Now in a case of history repeating itself, the government through Fannie and Freddie are trying to encourage these same banks to make more low quality loans to low quality borrowers to stimulate housing and the economy, but the banks are thinking, "fool me once shame on you, fool me twice shame on me", so now the banks are refusing to make low quality loans that may come back to haunt them later. I do not consider this a bad thing. Banks should not make low quality loans ever, and the government should not encourage them to do that. You can't have it both ways.
 
Ad rem: my health insurance with Aetna in Florida went up 33% in one year and then they dropped me completely last month due the the new health care reform act.  I haven't searched for new insurance or looked into Obama Care yet. I'm surprised the didn't keep me on and just hike the rate again.
 

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