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Healthcare Reform For (Rich) Dummies... From The Marine Retailers Association Of America
If there is anyone whose opinion on healthcare reform matters, it is the MRAA, or the Marine Retailers Association of America. Feel free to venture a guess as to why the people who buy (and sell) yachts are the most critical component to any Obama financial plan. So if you care about how the new health care bill looks like from the perspective of those slightly more privileged, here it is, in simplified, bulletized form, to spare you combing through over 2,000 pages.
A lot has been written and reported on the newly passed health care
bill, but there remains many questions about "How the health care bill
is going to specifically affect small businesses such as marine
retailers?"
MRAA has provided a bullet point summary of the health care bill to
help address this question. It has been prepared by the Norman-Spencer
Insurance Agency.
However, MRAA also wants to highlight some very specific aspects of
the new law in this opening introduction. As you will note, the law
goes into effect in several stages over several years. For example, in
2010, there is no real effect on small business, except a tax credit
becomes available of up to 35% of the company's health care cost
through 2012 when the insurance exchanges go into effect. This tax
credit is for small businesses which already provide health care
coverage of employees and begins to phase out when the number of
employees reach 25.
In addition, the Medicare tax on wages rises from 1.45% to 2.35% in
2013 and small businesses with fewer than 50 employees are not required
to have health insurance for employees. Businesses with greater than 50
employees that do not provide health care coverage must pay a fine up
to $3,000 per employee over 30 employees. Government subsidies to small
business increase in 2014, for example, businesses with 10 or fewer
employees and average annual wages of less than &20,000 receive a
tax credit of up to 50% of the employer's contribution.
Many of the provisions of the health care law are being challenged
in courts, state legislatures, and on Capitol Hill in Washington. It is
unclear how it will shake out over the next few years, but MRAA will
continue to closely watch the developments.
Health insurance law changes:
2010
- Subsidies begin for small businesses to provide coverage to employees.
- Insurance companies barred from denying coverage to children with pre-existing illness. Adults are NOT covered for pre-ex on individual plans until 2014.
- Children permitted to stay on their parents' insurance policies until their 26th birthday.
2011
- Set up long-term care program under which people pay
premiums into system for at least five years and become eligible for
support payments if they need assistance in daily living. - Taxes and fees
-
Drug makers face annual fee of $2.5 billion (rises in subsequent
years). No prohibition for direct pass through of costs to consumers.
2013
Taxes and fees
- New Medicare taxes on individuals earning more than
$200,000 a year and couples filing jointly earning more than $250,000 a
year. - Tax on wages rises to 2.35% from 1.45%.
- New 3.8% tax on unearned income such as dividends and interest.
- Excise tax of 2.9% imposed on sale of medical devices.
- Cost control
- Medicare pilot program begins to test bundled payments for care, in a bid to pay for quality rather than quantity of services.
** 2014 ***
- Create exchanges where people without employer coverage, as
well as small businesses, can shop for health coverage. Insurance
companies barred from denying coverage to anyone with pre-existing
illness. - Requirement ("Individual Mandate") begins
for most people to have health insurance. Subsidies begin for lower and
middle-income people. People at 133% of federal poverty level pay
maximum of 3% of income for coverage. People at 400% of poverty level
pay up to 9.5% of income. (Poverty level currently is about $22,000 for
a family of four.) - Medicaid, the federal-state program for the poor, expands to all Americans with income up to 133% of federal poverty level.
-
Subsidies for small businesses to provide coverage increase. Businesses
with 10 or fewer employees and average annual wages of less than
$25,000 receive tax credit of up to 50% of employer's contribution. Tax
credits phase out for larger businesses. - Taxes and fees
-
Employers with more than 50 employees that don't provide affordable
coverage must pay a fine if employees receive tax credits to buy
insurance. Fine is up to $3,000 per employee, excluding first 30
employees. - Insurance industry must pay annual fee of $8 billion (rises in subsequent years).
- Cost control
-
Independent Medicare board must begin to submit recommendations to curb
Medicare spending, if costs are rising faster than inflation.
2016
Taxes and fees
- Penalty for those who don't carry coverage rises to 2.5% of taxable income or $695, whichever is greater.
2017
- Businesses with more than 100 employees can buy coverage on insurance exchanges, if state permits it.
2018
Taxes and fees
- Excise tax of 40% imposed on health plans valued at more than $10,200 for individual coverage and $27,500 for family coverage.
h/t David
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I have one simple question; why the hell is everything so overcomplicated when it comes to America. I mean 90% of world countries have simple universal health insurance with no bullshit schemes built in it, no tax bullshit complexities no nothing. In the USA healthcare borders with schizophrenia (sometimes, but not always, a bad thing), and not just healthcare but also other matters of wide social significance. No wonder the drug/alcohol intake is so high in the USA; one needs something to cope with a shitty reality as that. No offense.
Because people think the unUnited States is some kind of small, pissant country like Canada which ahem, nationally, insures not even the population of Californica, 9% of the polycultural mishmash that comprises this forsaken piece of real estate with a pop. growing to 400,000,000 then 500,000,000.
The interests multiply exponentially which is why when you compare the other world countries with ours you deny our variability, our tossed salad pastiche, and the fact that most of us don't give a shit about insuring those that can insure themselves.
Then you have the companies who just might be paying off some politicians to keep the status as quo as possible for them, like not permitting insurance companies to compete across state lines, and not having insurance commissioners who say fuck you to 39% rate increases.
That's why.
Who the fuck said anything about Canada. What the hell are you on about. I asked about the USA. If 700 million Europeans can have a compromise on practically everything (sans Greece and other forthcoming bailouts and other, less important, issues ) why is it so goddamn impossible to pass a law which would be widely beneficial and in the same time not ass-raping or fraudulent. Why is corruption built into the system via donations to potential and present congressmen and congresswomen. That's just to name a few without going into more significant matters which are and were discussed in this same place numerous time before and will surely be discussed again.
I figured the answer, "corruption", was enough. But to add to that, it's also the confusion between a right, and a good. Healthcare, and the "protection racket" called insurance, are goods, not rights. And now we have gov't guns pointed at us if we don't buy a good.
---
Does anyone disagree that non-denial of child coverage does not equal affordable coverage? That is, your child won't be denied, but it'll cost you!
---
Steve Forbes on Obamacare:
Generally I would think insurers would be happy to write policies for kids. Kids are relatively strong and healthy. You make money off of healthy people not sick people. There are rare diseases and broken arms but on average kids don't rack up a lot of medical bills compared to adults. If you could have a health insurance business that just insured juveniles I would think that would be a fantastic business model.
Unless they already have had cancer once, then they are a liability. This points out the failure of healthcare as a 'good.'
...still a good model because not that many kids get cancer but everyone pays premiums.
Why would parents choose to cover their children with a company other than their own insurer?
Unless their own insurer won't, which means other insurers will not want to as well.
I'm on about the stark realities of a country that cannot sustain a health care system overhaul that will absorb 50% of our GDP with 500,000,000 people on it. I use Canada because that is one that is referred to time and again as a model for us.
And comparing apples to apples, there is no EUROPEAN health care system, plan or scheme insuring 700,000,000 people. Is there?
You are seeking a world of Justice, CB, and you live in a world of loosely constructed 'rules' called laws which are as malleable as pie dough.
Why do you think medicare for all is more expensive then a private tax to an unregulated for-profit business? If you don't want people to abuse it, add a co-pay.
If the shit wasn't complicated and kept nice and simple, then we'd have to shrink our government now wouldn't we?
Now, for the folks swimming in our public drinking water, that just isn't an option.
That's such BS.
Barring corruption and other factors, healthcare costs rise IN DIRECT PROPORTION to population. It's not rocket science. If you've got 10,000 people probably get sick in total about 10 times more than 1,000 people. The bigger the population the more economy of scale you get though, so it should in fact be CHEAPER to provide healthcare to more people than it is to less people.
"Deny our variability" - more BS. You think the other countries are a bunch of homogenous drones?
The US spends more per capita on healthcare than any other country. Given the economies of scale the US SHOULD be able to provide at least the same quality healthcare as a country like Canada, but for less.
There you go again comparing us to a country that has less people than our Californica.
No country is more diverse than the U. S. and will diversify even more with a national health care insurance plan. Soon the entire salary of the producers will be earmarked just to pay for health care.
It's usesless to reply to you who can't do math.
Can't do math? You're making such a baseless argument.
You're arguing that because the US is bigger than other countries, that what can be done in other countries can't be done in the US. I say bullshit.You've never heard of economies of scale?
Diverse? You think the US is the only diverse country on the planet?
You say costs will increase exponentially with size... How!?
There's reasons the US probably can't do healthcare like Canada, or Australia but size alone absolutely isn't the reason. One of the reasons is people being too stubborn to accept that sometimes other peoples (countries) ideas are better than their own. Another is that way too many people have their finger in the healthcare pie, with a lot of lobbying $$ to spend to make sure it stays there.
As I said before, The US spends more per capita on healthcare than any other country. I assume you know what per capita means, do you really think the disparity is just because the US is 'Big and Diverse'??
Never said size alone. That is one factor and an important one. Size as in population. No government program, in a complex society like ours, can insure 500,000,000 people as Massachusetts does with 6,000,000 people. And they cannot do it without Federal subsidy.
The notion of insuring 500,000,000 people without massive upheaval that a majority enjoy now is insane.
On the other hand a central fascist government can do anything it wants. Catastrophically, disastrously, fatally but they can do it. Welcome to the health care of a Big and Diverse society.
For those of us that can, it would be wise to opt out and find a private way of obtaining the health care that we have now. For sure if you don't include yourself out of TheBamsterCare program, you will die young and in pain.
"The notion of insuring 500,000,000 people without massive upheaval that a majority enjoy now is insane."
Who said anything about insuring 500,000,000 people?
Why do insurance companies need to be involved? That's just one of the things that hasn't made any sense at all to me with Obamas changes... Essentially forcing individuals to become customers of insurance companies, when the goal of the insurance companies is to make a profit, not provide efficient healthcare.
When you have 500,000,000 people, you are spreading out your risks very thinly over a very large population. You can pretty accurately forecast what % of people will get what diseases, what the total cost to care for these will be etc. You can't do any of that with a small population. In a real public healthcare system the government pays the healthcare costs - what value does the insurance company add?
For cost effective health care you have to cut out all stakeholders currently makign a profit from the status quo. People buy insurance so they can share their risk with all the other people that buy insurance, the insurance company makes a profit for providing that service. When you have 500,000,000 people all somewhat interested in the health of the other 499,999,999 (at it's very simplest, a healthier population = higher GDP) and you're able to spread the risk of any one of them getting sick across the other 499,999,999 what value does the insurance company add?
I've brought up the statistic a bunch of times and you haven't commented on it - the US currently spends almost 2X per capita on health care that the next highest developed country spends. If you think the level of healthcare available in the US is 2X better than any other country then I have to assume you've never left the US (or gotten sick outside the US). So where's the inefficiency? My guess is it's in the insurance companies pockets, so why not cut them out?
As for dying young and in pain... I'm lucky. If I fall on hard times and am afflicted with a chronic terminal (EXPENSIVE) disease, I'm welcome in a country that will take care of me. In the meantime I'll keep arguing as to why I think everyone in this country deserves (and could have) the same here.
Medicare already covers the most expensive portion of the population - over 65. Privatize gains, socialize risk (loss).
Medicare cost has been going up hockey stick style and is about to go to Andromeda. We'll see if medicare isn't a dead drowned cat in about 5 years.
That's true. The only way to (possibly) fully fund it is to take money currently being paid to private insurance by people who are low risk and put it into the medicare fund, and to make Grandma and Grandpa start paying (part) of their share.
"No" is a simple and uncomplicated component of universal health insurance which will eventually become a major feature of the American system as well.
A single, third party payer = rationing, every time, always. Better for some perhaps, others, not so much.
Because American culture is/was "all about" the individual as opposed to the group, there will be a lot of kicking and screaming and half-measures along the road to the centralization of healthcare and any/everything else.
You've heard of FUBAR? Well, I'll coin the term CBAR....complicated beyond all recognition. You see, here in the USA, we have all this money to fund all sorts of academics and bureaucrats who can "modify" and "improve" everything. Why have a simple plan, when you can create a complicated work of art?! Why buy one, when you can have two at twice the price?!
It's simply because we have the money (now, but not much longer) to do so.
Don't worry, by the time TPTB have screwed around with this long enough, it will look like hell, and perform moreso. Just give us time to catch up with the rest of the world!
Right you are. I don't know who said the following (sorry my brain is not working at full capacity at the moment); the more complicated a civilization/society becomes the more vulnerable it becomes and thus the chances for it's collapse increase proportionally to the amount of new regulations/laws it passes. This pattern follows all civilizational declines starting with Persia and running up all the way to the British empire. My point is to successfully handle all of the burden imposed by new laws/regulations more productive individuals which could contribute society in other ways are now employed by the state ... well you can see where this is going. Again, look no further then the Roman Empire or if you wish just throw a quick glance on EU/USA or any of the social components such as financials or in this case healthcare.
The proliferation of laws and decrees attempting to prop up a failing system are one indication of decline and possible collapse. Read Joseph Tainter's The Collapse of Complex Societies. Societies exist as problem solving units. Usually they adopt a particular "hammer" view that helped them solve their first problems then they retain that "hammer" view even when it becomes less and less useful over time. Each solution to each subsequent crisis increases complexity, which increases the cost of maintaining the society. Eventually the cost becomes higher than the benefit and the society collapses.
Or, to put it in the sarcastic humor of the late Robert Heinlein, "Throughout history, poverty is the normal condition of man. Advances which permit this norm to be exceeded — here and there, now and then — are the work of an extremely small minority, frequently despised, often condemned, and almost always opposed by all right-thinking people. Whenever this tiny minority is kept from creating, or (as sometimes happens) is driven out of a society, the people then slip back into abject poverty. This is known as 'bad luck.'"
Everything MUST be complicated in the US.
The masses must be confused at all times.
Health & Malpractice Insureres enjoy an anti-trust exemption. This situation goes back 60 years. Until this situation is ended, cost will continue to spiral upward unchecked. THERE IS NO COMPETITION AND PRICE FIXING IS THE NORM.
Marine dealers and retailers. Now there is another dead industry. Lets hear what they have to say.
"The masses must be confused at all times."
I think that's about the best reason there is. If you create a complicated mess the person it disadvantages the most is the little guy. It's like the tax system... Does all that complexity help Joe average filing his annual return? Hell no. Does it help a gazillionaire individual/company that can pay a team of bean counters to shuffle things here there and everywhere? Hell yes.
Exactly. And its tax time too! Apparently those H&R Block ads are working??? I feel like going down to the supermarket (where the H&R Block office is!) and telling the guy I want mine medium rare.
"But finance is complicated" Bullshit. Hiring all the math majors into Wall Street instead of deploying them into science and technology does not mean finance is complicated.
Lying and stealing is complicated because of all the lies you need to keep track of.
+1
Complexity creates obfuscation and is key in confusing people. If things were simple it would be obvious to everybody how crooked the system is. Sunshine is their enemy.
I respectfully submit that all the phase in subterfuge is purely political. Overlay the 2010, 2012, and 2014 elections and the mess is much clearer.
CB: we're not European. That should give you enough insight into the matter.
Because those in charge of a Superpower can do anything they want, even to its own population. Special Interests run everything, it is not a Democracy, it is not a Republic. It is a Captive State to be fleeced.
My simplistic answer: Because if everyone were treated exactly the same, there would be no need for legislators.
I have seen this report before. It was an information disemination project, prepared for manufacturers of seagoing vessels. Essentially, what does the new health care plan mean for the owners of companies that build boats - or anything for that matter. I found it very helpful because it was the first time I could actually make sense of the plan, being that I am an idiot.
This whole Rube-Goldbergian health care law is designed for one thing - failure. In guaranteeing future failure, the goobermint can then step in and institute a true eurosclerotic universal access system. That's the real goal. A universal single-payer system is unpalatable at this time to the American sheeple, so this is the fastest way to incrementally "git 'er dun".
Hey Cheeky, no offense to you, but everyone of those wonderful socialized medical systems is totally and completely bankrupt. And getting worse every day.
The US legislation is complicated because it is designed to control and control requires lots of little levers. The other healthcare systrems added controls over many years. When trying to catch up to dictatorship and a totalitarian ethic, a lot of eggs need to get broken.
CB
the USA is plutocratic oligarchy.
the system must always payoff the folks at the top otherwise it breaks down. what you propose would be possible in a democracy, which we don't have.
it's that simple.
the dumb-asses in this country will never get it... so the political and investing class keep cooking up these fantasic schemes.
i hope this explanation helps
maybe if the money spent on malpractice insurance instead went towards actually caring for sick people, this wouldnt be such a big deal.
the european systems arent exactly enviable - but it is easier to get taken care of generally (as with in Canada). Of course, major surgeries or treatments are a different matter, but 90% of the population just needs basic healthcare and a few options.
I want my doctor to be afraid to make mistakes. He isn't working on my car. There are enough mistakes in healthcare to warrent keeping doctors as honest as possible. The only thing they understand is mistakes make them a risk and they have to pay higher premiums for insurance. It makes sense to me.
Yes, because doctors are just bumbling idiots who have no pride, ego or brains, and their only motivation to avoid screwing up is their constant terror that each little mistake will directly hit them in the wallet in a clear, urgent and effective way. Definitely, yes, that's it.
As someone who has worked with doctors and liability insurance for almost a decade now, you're smoking something that probably won't be legalized even in California. Here are the two main problems with your little theory:
1) By and large, doctors take enormous pride in getting all the answers right. Knowing that they screwed something up would hurt many of them more psychologically than having to pay a couple $1000 extra a year.
2) Doctors tend to view all premium increases as being 100.000% attributable to a mixture of evil plaintiff's lawyers and greedy insurance companies. Very few of them will view a premium increase as having anything to do with their quality of care.
But go ahead and spout one wrong side of a "debate" in which both of the publicly discussed "sides" are so wrong it's silly. (I am not an advocate for most "tort reform" laws either, for separate reasons - primarily that they are a giveaway to insurance companies that will harm patients with little or no benefit to providers.)
Blah Blah Blah.
Maybe the doctors in the institutions you worked with felt that way and are that way, but they are the exception. There are shitty doctors. The last thing a person that spent 200,000 on an education and 10 years of their life wants to be told is that they are a shitty doctor and unfit to practice.
Speaking of institutions.....................
ditto
Maybe I am missing something. My impression is that bad physicians are tougher to get rid of than pedophile priests. How many physicians have you worked with have lost their job do to critical mistakes?
Feature creep. Comes in any organization which deals with issues on a piecemeal basis. Pity that policy can't be designed in a modular manner, but chaos doesn't lend itself to these kinds of solutions.
This plan is the worst of both worlds - the worst parts of private medicare and the worst parts of Europes socialised healthcare.
Way to go Barry O. The Great War against the ambitious continiues. Unless youre already in a very wealthy position , trying to fight your way to the top and provide the best for your family is becomming a pointless endevour. Settle for mediocrity everyone , its what your leaders want.
"This plan is the worst of both worlds - the worst parts of private medicare and the worst parts of Europes socialised healthcare."
It's a fucking joke is what it is, but it still manages to divide the country. People are busy arguing over whether or not this plan is good or bad, when regardless of whether or not it passed the system is fundamentally broken.
All you've done here is maneuver between pastiche and mishmash.
Transgress.
will the new plan cover Dramamine, so you can read through the bill without getting motion sickness?
No,that drug is experimental and the advisory panel says the costs outweigh the benefits. Get used to hearing that.
None taken. Now to amuse Cheeky further before the Champions League kickoff.....
What if I split my 50 employee business into 2 separate, 25-employee businesses? Do I avoid the $3000 fine if I fail to cover them.
Better yet, I will split them into 5 10-employee operations and get tax incentives to cover them.
I guarantee you will see this. Complete horsesh*t.
Of course, this also gives a big incentive for smaller businesses to stay below the feared 50-employee level. Just what we need at this level of unemployment. And God only knows how temporary workers will be dealt with..... and She ain't talking.
What you propose are legitimate tax avoidance schemes. I salute you, Captain !!
I bet Walmart will figure it out somehow.
They'll "sponsor" an exemption into the law very soon.
<sarcarm mode="full on">
Only the suckers that are not represented in congress pay taxes.
</sarcarm>
Oh, they could also tell their full-time employees that because of the downturn they will need to resign and be re-hired as "consultants".
http://www.minyanville.com/special-features/articles/save-walmart-costco...
Walmart already has it figured out. You can't afford healthcare (or much of anything) on a walmart salary, so the taxpayer is already subsidizing walmarts employment costs. This healthcare bill doesn't change that, it just might make it official.
I think leasing employees will come back in vogue, with groupings small enough to qualify for "incentives".
That's already being done by some larger companies, to lower benefits overhead cost. Companies will pay a premium to pay for someone else's employees to work for them.
I cannot believe they kept the penalty for not carrying insurance so low. It is going to be so easy to game the system and come out ahead that its not even funny.
It isn't clear what the 40% tax is in 2018, does it mean if you but a health plan that will cover over 10K of medical coverage you get taxed 40% on it? What if the insurance companies decide to jack up prices like Wellpoint, we could be f'ed both ways?
Sure healthcare was a non-functioning scam that needed real reform, but this isn't real reform.
The "tax" is really just an elimination of a tax break. Basically, the benefit becomes taxable income.
Correct me if I'm wrong, but since the 40% tax is not indexed to inflation, surely everyone will be paying it by 2018. And since most people won't be in a 40% tax bracket, this is worse on the consumer than elminiting the tax break for employer insurance. Right?
I figure my only hope is to become one of them, so I'm angling to be appointed the County Death Panel Commissioner for my area. It'll be me
who approves/disapproves your triple-bypass, or your kidney transplant. For a nominal fee I can move your name closer to the top of the list for hip replacements, etc.
I think everyone misses the point here. There will be rationing yes but not "death panels" just policies. If you are X age with Y condition you will either qualify for Z therapy or not. It will be more complicated than that but it will be a government written decision tree that largely dictates patient treatment, not physician judgement with all the positives and negatives associated with the medical art of treating each separate individual as a unique case. Ezekiel "remaining-quality-life-years" Emanuel has been cooking up formulas for years in anticipation of this glorious epoch that is now upon us.
Doctors may have some leeway to treat outside the guidelines but it will add points to their scorecard which will penalize them above a certain level.
I'm very close to stamping your application DENIED! , Mercury. Don't piss me off.
I'm sorry perchp but that's just the policy.
Is there anything else we can help you with today?
Have a nice day!
or as the irish would say
“good luck”
This situation already exists in workers' compensation systems in every state of the union. One of the main sets of tenants for many states' WC system are the ODG guidelines; they set the standard for spawn-of-consultant beuraucratic rubbish.
Not exactly true. Doctors can treat outside the guidelines, but will not get reimbursed, which effectively denies the care.
True, those would be treatment guidelines but I was thinking of cost guidelines. Right now insurers in at least some situations score doctors by how much their treatments for a given condition cost vs. other docs treating the same condition. Docs in the top whatever percentile take a reimbursement hit and are thus incentivized to get closer to the mean. More referrals to the expensive specialist by the primary doc is what gets the primary doc in hot water regardless of the outcomes of those referrals.
If lots of people is some small town start showing up at the doctor's office with suspicious looking lumps on them and that doctor (wisely) refers all of them to get MRIs or biopsies or whatever his "cost score" (or whatever they call it) is going to go through the roof. Even if all those lumps turn out to be cancer and that leads to the discovery of some buried toxic waste in that small town... that primary care doctor has just screwed himself. Anyway, I expect that these kinds of measurement systems will be much more pervasive as the government gets more involved.
Who currently makes these rules for medicare?
Obama could have extended medicare/medicaid to people without insurance and be done with it. Instead he passes a bill that will ultimately benefit health-care industry at the expense of tax payers. Oh BTW, hell with all the republicans and tea-partiers who come out of this smelling worse than a week old garbage. What a bunch of morons.
Obama doesn't "do" such things or "pass a bill" himself. Congress does that. Obama can propose legislation, but Congress can ignore it if they like, and in any event he took a hands-off approach last year and got something probably even worse than what he would have proposed. You might want to study and actually understand how our government works, at least in a nominal, on-paper sense. The "what a bunch of morons" comment is quite ironic given your display of ignorance.
You're just hobophobic.
because, cheeks, they never set out to design a healthcare system that preserves outsized profits for the insurers, no matter what the costs.
which is what we have here -- they twisted this every which way to create loopholes big enough for starships to warp thru......
you know, its a complete joke, this idea that a plan that costs 10.5 per year for a family is a cadillac plan. i'm in a state held hostage by Wellpoint Anthem. It is the ONLY provider of individual plans, and ....
our plan -- which covers NOTHING -- and carries a 45K family deductible costs over 10K now....
For those who think the insurance companies are going to make money with this crap sandwich there was a very important bullet point left out of that list. In 2011 and beyond the insurance companies must pay out 80% of there premiums in claims. Currently the average is 65%, I believe, with the rest going to overhead and profit. I'm not in the insurance biz but I can't see how they are going to be able to maintain a profit with the pre-existing conditions(i.e. all loss policies) and only being able to use 20% of premiums for overhead and profit.
Dear RobD:
After the insurance companies get done ramming home 3 consecutive annual premium increases of 20% each, they will have plenty of latitude to meet this 80% ratio and still have awesome profits. Their fixed costs won't change too much in the mean-time. And revenues are only going up with mandatory insurance.
By the way, is 80% medical loss ratio or MLR plus claims processing cost? Who knows? And who decides?
In short, if you saw my post, this bill is a joke with tons of loopholes and unintended consequences. It was driven up out butts without any thought for all these complexities.
But..But..Obama said our premiums were going to go down $2300 or something!
Like I said I'm not in the biz so I will not argue the point, I just could not see how the insurance companies could take that big of hit and make a go of it.
They can't/won't, and that is the ultimate point of the bill. This mess is NOT about healthcare, it's about control. Classic central planning -- find an issue, exploit it, make it worse, then use that to justify further gov't intrusion.
Step 1: Drive the private insurers out of business or marginalize them to the point of ineffectiveness.
Step 2: Fill the new "need" with gov't programs, each more complex and costly than the last. New programs increase the population's reliance on gov't. Costs go up, quality of care and availability go down, and whaddayaknow, "We have to address this problem with another program."
Step 3: Wash, rinse, repeat.
Bismarck, Mussolini, Hitler, and Peron all did this exact process. Not calling Obamao a dictator (yet), but this is the same mindset of population control employed by persons of questionable humanity in the past, and the pattern is holding so far. Whether The One becomes a bloodthirsty slayer of his own people is up for debate, but you can't deny the groundwork being laid for control.
Good post. Though I think the bill was about new taxes more than anything else, with control in second place. Health care is merely the tool for these things, not the goal or focus.
Thanks -- I view taxation as equal parts control and wealth extraction; potAYto, potAHto.... :-)
Now there you go Captain, accusing the congressmen(and women) of actually being able to think of something other than what to say to improve their chances for reelection.
I am sure many in Congress, if they actually considered your statement, would consider it a little unfair.
repost.
Government is a “Tool” of the “Lobby”…
The Lobby is a “Tool” of whoever wields the “Lobby”
The “Lobby” today is used my Big Business (AAA rated Corps. / Banks) to ensure market share or more accurately that those businesses do not lose Market Share and hopefully they are able to grow their foot print thru legislation.
Our economy is not dependant on innovation… it is dependent on Lobby who survives on dollars from “AAA” Rated Corporations… Maintaining Market Share and thusly the circle is complete.
Regardless of who is elected the Lobby will continue to sway legislation; there are no exceptions for this rule.
Control the Lobby and you control the Government.
Kill the Lobby and the Voters are back in control of the Lobby (save the contributors?!).
How many layers can well come up with of legalized corruption? Lobby? Layered Campaign Contribution? Pac Monies? Fund raisers? And on… and on.
http://www.opensecrets.org/orgs/indivs.php
So, Obama? Who was cutting the Lobby off at the door of the white house?
http://www.google.com/#hl=en&source=hp&q=obama+anti+lobby&aq=f&aqi=&aql=&oq=&gs_rfai=&fp=a73b11f867dbecea
***Cough*** “Bullshit” ***Cough***
http://www.opensecrets.org/industries/mems.php
The President can do nothing without Congress… or the Senate… support.
So who controls the Government? And who control the Lobby? And who used Tarp Monies / Fed Window 0% rates to pay for the death of innovation in favor of the fight for middle market share maintenance, growth or control. Free market only works if you can afford to Lobby vigorously.
Behind The Sentiment Disparity: Main Street Vs. Wall Street
http://www.dailymarkets.com/economy/2010/03/15/behind-the-sentiment-disparity-main-street-vs-wall-street/
Anyone who says Obama is a Socialist? Or that Bush was not? or maybe that there is a difference between the two?
http://www.opposingviews.com/i/torture-under-obama-looks-a-lot-like-bush
Just for the fun of it…
http://wiki.answers.com/Q/Is_obama_related_to_bush
There will be “NO!” fundamental changes due to the Lobby and until all of the fractured weirdo groups pool resources and get on the same fucking page… nothing will change. To many chiefs and not enough Indians… that all want the bull pulpit for personal reasons which over shadows any good that could potential come from their speaking publicly.
Or so that would be my personal view and I am happy to go tit for tat with anyone who sees it differently.
repost...
$3.5 Billion dollars in lobby monies... since 1998... out of health professionals alone?
http://www.opensecrets.org/capital_eye/health.php
Health Sector Campaign Contributions and Lobbying Totals, 1989-2009*
Period Covered1
Total Contributions
To Current Members of Congress
Total Spent on Lobbying
All Years
$944,969,972
$376,172,916
$3,590,912,402
2009 Only
$57,029,709
$40,515,330
$576,402,070
Industry/Interest
All 2008
All 2009
Difference
Pct Change
Pharmaceuticals/Health Products
237066569$237,066,569
263377975$263,377,975
26311406$26,311,406
0.11111.1%
Insurance
153244224$153,244,224
163829335$163,829,335
10585111$10,585,111
0.0696.9%
Health Services/HMOs
62311507$62,311,507
72703045$72,703,045
10391538$10,391,538
0.16716.7%
Health Professionals
78021781$78,021,781
84606162$84,606,162
6584381$6,584,381
0.0848.4%
Hospitals/Nursing Homes
101910335$101,910,335
107106372$107,106,372
5196037$5,196,037
0.0515.1%
Misc Health
5866049$5,866,049
10348155$10,348,155
4482106$4,482,106
0.76476.4%
https://opensecrets.org/lobby/incdec.php
But it’s Obama Care? see the problem is... that you have been drinking the Kool-Aid as well... right verses left... left verses right... you are just as stupid as the rest of the sheep standing next to you… Baaaaaaaa… Baaaaaaaaaa!
There is no spoon... only the lobby that controls either, the left or the right.
Obama didn’t spend BILLIONS of his dollars so the poor could have "Healthcare"... Nor did the "Poor" write the check(s) that came crashing in to the Coffers of all of those nice people within the "Beltway".
Who benefits from the healthcare plan? the poor? or is there a 60% allowance for all monies to be dumped into the private sector? are the insurance companies really just feeding at the public trough like everyone else? isn’t the insurance companies turn? let me know if you need me to dumb it down for you some more.
Obama care… stealing sound bite from the “Fox” network isn’t helping you make a real case.
One of the unwritten laws of finance is that byzantine rules beget more byzantine rules. And healthcare reform should have been called a slight tax code tweak. Tweaks beget cheats.
No consideration was given to assisting hospitals, many of which are closing and have closed here in NY state and NY City. Lot of good it will do to have insurance if there's no place to accommodate you.
OK... so lets stay on that same path...
The weak will perish and the strong prevail....
Or doctors to see you.
The favorite line ER docs hear all the time. "I tried to go to the specialist about my problem, but he doesn't take my insurance."
Well, yeah. Medicaid. In NJ, used to pay $7.00 per visit. Now it's up to $21.00 I think.
Then, if you see the patient, you are gonna be spending over an hour because now they want test x, y, z, etc and every Rx imaginable (and especially for over the counter drugs, ie motrin, tylenol, vitamins,) because Medicaid will pay for it.
<sarcasm> Must be those greedy doctors. How dare they want more than $21 per visit for a patient. Nevermind the cost of running a business. You're a doctor, right? You must be rich(!)</sarcasm>
And yes, funny thing. Has anyone even considered tort reform??? Uh, no.
Too bad they (MRAA) didn't even get it right! They're just regurgitating the way it's "supposed" to work... To bad it doesn't: Children with Pre-existing not covered
Or did they "fix" it in reconciliation!?!? Morons...
Oh man this is such 'shoot first, ask questions later' BS. They're the frickin lobby and they don't know what the law is? Something tells me someone is not telling the truth here.
AHIP has been guilted into covering it it, for now.
There is no big secret to funding and providing national/universal/single-payer healthcare: control costs. Oh, is that socialism? Perhaps; but how is George Bush the Younger's bill to prevent states to group-buy pharma and supplies supposed to limit costs? Obama's big mistake was not coming straight out of his inauguration and eliminating that blank check for the pharma/healthcare industry. How does Canada save? Easy...the province of Ontario is the largest single North American purchaser of drugs because it's all one big bulk buy.
The U.S. just doesn't get it...you're bleating about socialism when yoour system is stacked to the teats with 'exceptionalism', namely special rules for business that excuse them from having to negotiate and compete.
Cheeky:
I agree with your assessment that we in the USA make everything too complicated. Probably the only way that we can keep growing GDP. Everyone has to hire a lawyer, accountant or a specialist to get anything done.
Warren Mosler, the economist running against Blumenthal in the Connecticut primary, has a ingenious solution for health care that would cover everyone and reduce health care costs.
1. Everyone gets $5,000 on January 1 each year to spend on health care.
2. $1,000 is for preventative care, and the other $4,000 is for all other health care needs.
3. If you need more than that you are covered by a form of Medicare.
4. At year end you get the unused portion of the $4,000 as a gift with no strings attached.
5. You are free to buy any private insurance or medical plan you wish.
There's no pre-existing conditions ban. Not really. There's a LAW. But what is the PUNISHMENT for breaking that law. A 5k fine.
So if your HMO sees that you need 100k in treatment costs, they can pay a 5k fine and drop you.
Nice change Obama. Not what I voted for. For that great gift, the deathpanels and everything else crooked in the system is maintained, plus now everyone is mandated to buy it. What a scam.
Anybody that screams socialism is an idiot. This is FACISM.
"Excise tax of 40% imposed on health plans valued at more than $10,200 for individual coverage and $27,500 for family coverage." -well in 2018 the average health plan for individuals might be 10,200 a year. Hell probably higher. So in 2018, whoever is actually footing the bill will have 40 percent more to foot.
Pay for quality is asinine. Sophistry at its finest. It sounds good, but in reality its bs. There are treatments that save lives, but, maybe only 1/2 the people are saved, or 1/4, or 2/3 . But, because they are only paid for QUALITY outcomes, they won't pay for the other half.
Well it's hit and miss. You won't know until the treatment is applied. A doctor or hospital can do everything by the book, but sometimes it just wasn't meant to be.....now the doctor/hospital for trying the correct procedure will not be reimbursed. But if the hospital knew that there was a 50 percent chance they weren't going to get paid. Do you think they'd even offer it to you as an option? Multiply that across all treatments and you get the scope of such folly and how it will kill many of us.
After all, denial of care is now determined by a statistical model. Just like AIG/Derivatives, cap and trade and everything else. IT'S BS. But they can say it's science, even though it's not. All gives a convenient out. It's not ME who is saying this, it's this scientific tool which is anything but science, nor anything but certain. The outputs are GUESSES. Medical treatment is REAL LIFE. Real life medical treatment is ALWAYS a 1. Statistical model outputs are either 0 or 1. Either it says it or it doesn't. So the fake bs meets reality and throws a caniption. With many to die needlessly, and foolishly.
I want REAL single-payer, under hill/burton standard (like we used to be before HMO's). Not this bs passed off as health reform but really is health deform. This is health reform, like finanical reform is financial reform. I can't believe the HMO's who provide CRAP, are going to get worse, yet be the best option for someone. Sad, really sad. Obama just sent my fellow democrats down the prim rose path just like Bush did for republicans. Sad.
If you give everyone $5k then it becomes basically $0k.
Every thing will just go up another $5k.
Why not just give $1,000,000,000,000,000,000,000,000.
Then who in the hell would need any rebates?
Because what it does is provide coverage, but at the same only encouraging using the Industrial Medical Complex when it really is needed. The way it is set up now, a woman will see her doctor every other week to get a prescription she does not need because she thinks the doctor is cute.
And if you think that we are simply going to need additional taxes to pay for it, google "Modern Monetary Theory" (MMT) and you will gradually understand that governments who have a non-convertible free floating currency do not have to tax in order to spend. Taxation is merely a monetary mechanism to tighten or loosen the economy. It is a shame that the economists that run everything today have no understanding of this and why they can never predict anything with any accuracy. With a slow economy, we should be lowering taxes (a payroll tax holiday holiday as Mosler proposes) versus raising taxes on everything.
So we are stupid to worry about ballooning defecits?
After all, we are in a recovery and the tax receipts should come pouring in any minute now.
where is my lighter?
Two questions: why wait an additional 4 years to begin considering ways to reduce Medicare costs, and why make it contingent on costs exceeding CPI?
Wait, this poses a third question:
Who the **** is in charge of this cluster****?
Canada health premiums
http://www.health.gov.bc.ca/msp/infoben/premium.html
Over $28000/yr income:
1 person $54/mo
2 persons $96/mo
over 2...108/mo
p.s. These are the US Senate Gang Of 6 who will write he Senate Healthcare bill, showing populations of their state and % of total US pop. :
Baucus; Montana; 0.967 Million; 0.3 %
Conrad; N.Dakota; 0.641 M. 0.2 %
Enzi ; Wyoming; 0.533 M. 0.2 %
Grassley; Iowa; 3.002 M. 1.0 %
Snowe; Maine; 1.316 M. 0.4 %
Bingiman; N.Mexico; 1.984 M. 0.6%
TOTALS 8.443 M. < 3 % [of 307,000,000 total population]
As with so many other programs. agendas, and proposals for the remediation of human ills advanced by governmental and social institutions, the absolute inconceivable ludicrousness of this particular program is made even more painful by the serious acceptance with which it is accorded. Most laughable in this regard is the comparison to compulsory automobile insurance which is being bandied about by the political spin doctors and various media whores as a justification for this lamentably transparent shell game. Evidently, your sorry broken ass has been granted the status of a regretably underperforming commodity freighted with unacceptable levels of risk and indemnity by the same Wall Street hucksters whose latest scheme is to buy up, bundle and securitize as much of the multi-trillion dollar pool of "life" insurance policies as they can manage from your fellow stiffs-to-be much like they did with home mortgages. As a market of last resort, these revenants from the dark side have pulled out all the stops in their headlong plunge into the abyss of their appalling and insensate greed. Having exhausted the last possible avenues of their desparate and rapacious financial exploitation and bereft of any other opportunity for satisfaction, these predators have descended like so many vultures into the realms of suffering and death and the crypt itself to extract from human flesh the last vestiges of the filth of lucre.
I'm surprised they left off the 10% sales tax on indoor tanning.
+1 for paying attention.
small business persons who never qualified for unemployment are suffering from eating disorders and need to be treated for pre existing conditions - stat.
" don't know who said the following (sorry my brain is not working at full capacity at the moment); the more complicated a civilization/society becomes the more vulnerable it becomes and thus the chances for it's collapse increase proportionally to the amount of new regulations/laws it passes. This pattern follows all civilizational declines starting with Persia and running up all the way to the British empire"
Offhand, I'd guess you are referring to Tainter: http://en.wikipedia.org/wiki/Joseph_Tainter
are Insurance companies rates capped?
I spit tea all over my screen laughing when I read that!
Thank YOU! for the laugh!
What about the crew on Larry Ellison's yacht, Rising Sun? Does that qualify as a small business and the subsidies that begin for small businesses in 2010?
http://www.marinetraffic.com/ais/datasheet.aspx?datasource=ITINERARIES&M...
I regret not giving up my citizenship in 1978 when I had the chance. Biggest mistake I ever made.
Then get the fuck out of my country you fucking pussy.... bitch, whine piss and moan... You should, coulda and / or woulda... there is no one holding you back! GET!
I think that anyone who does not want to make things better... or who wants to leave... should be shown the door!
You shoulda left in the 70's... you should have shot yourself in the 70's and reduced the carbon foot print of the planet by .00000000000000000000000000000001%
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