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[Particle Physicist]

It would be hilarious if the store owner came out and said "What can I say, Obamacare is going to be great. After years of having to get creative to control healthcare premiums, now we'll be able to simply cut the government a check for $2,500 per employee and they can buy from the exchange."

If anyone doesn't think small business owners are going to do this, they are deluding themselves. They might not want to be first, but a lot are in line to be second.

Health insurance should be decoupled from employment anyway.

 

[GhaleonEB]

It should be pointed out that the healthcare bill was designed to facilitate the unwinding of the employer based healthcare system. That's the entire point of opening up the exchanges to all businesses a few years after they open. It starts with the individual and small group markets, then gradually pulls in the larger employers.

This was done as an acknowlegment that the system is already unwiding, and to provide both a better system to move toward and to help speed the process up. So arguing that the employers would shift to the exchanges once they're up is stating the obvious. That's the entire point of the exchanges.

 

[empty vessel]

ROTFLMAO

Let me catch my breath here.

I was intending my remark to be a criticism, but if the law was in fact intended to destroy linking health care to employment, then it's a genuine feather in the administration's hat. I don't typically give the administration or congressional Democrats that much credit, though.

 

[mckmas8808]

The tradition of employer based health care. It's expected now. Obama's goal seems to be to decouple that expectation and instead make people expect the government to pay for it.

But how does this law that goes into effect in 2.5 years change the thought process of traditional employer based health care? What I've read, it doesn't. It'll still be expected that businesses will offer health care insurance if you are permanent with a company.

 

[Spokker]

Just like most workers now earn minimum wage?

Most workers earn above the minimum wage.

 

[Gaborn]

Yes, that will be true for some employers, but some employers will presumably offer better benefits to attract more desireable workers, so I don't see any reason to think that most workers will be offered the minimum required benefit. In fact, I'd expect employers to use health insurance as a basis to compete on compensation as the value to the employee is less transparent than straight wages or salary.

I think it's probably fair to say the businesses most likely to be affected as I describe are smaller. Big corporations with nearly unlimited funds will always be able to woo the best and brightest with big incentive laden packages but I think you're being widely unrealistic with employers using the exchanges "compete" on compensation. Most businesses can barely afford health care costs and it's not like those costs are gone entirely for the employer. They're already going to be expected (Demanded really) to pay a significant amount to the government per employee, and THEN you think they're going to be able to afford compensation packages to everyday workers?

mckmas - But they don't have to anymore. Obama promised "your health insurance will not change" ... but the law does nothing to allow that to be true. The law requires a minimum level of care and requires employers to spend a certain amount per employee. It says nothing about punishing employers who, for example reduce insurance or scrap it entirely except that employers will have to pay the government the money instead of the insurance comkpany.

 

[balladofwindfishes]

The tradition of employer based health care. It's expected now. Obama's goal seems to be to decouple that expectation and instead make people expect the government to pay for it.

Which in the long term is the better option.

 

[reilo]

The tradition of employer based health care. It's expected now. Obama's goal seems to be to decouple that expectation and instead make people expect the government to pay for it.

Awesome. I'm all for it, as should everyone.

well at least you were just laughing instead of laughing at me. that would have stung more.

I don't see how that is mutually exclusive.

 

[Gaborn]

Awesome. I'm all for it, as should everyone.

I don't see how that is mutually exclusive.

Nope. I'm not in favor of it and fortunately a majority of americans still reject this philosophy.

 

[Kosmo]

So the question is why don't these same businesses decline to offer health care now since there's no penalty at the moment? Why did they offer health care in the 2000s or the 90s?

That why they could save the $12k a year and give their employees a $2k raise to shut them up?

Because employees would not be able to qualify for government (e.g. Medicaid) healthcare, while under Obamacare they will - especially since the threshold is so high, something like a family of 4 making less than $80K a year would qualify for subsidy.

Though I do look forward to getting in as a patient at a boutique physician's office, because this is where things are going to go. Healthcare will get worse for everyone overall, while those in the Top 10% will get primo care with the top physician's opting out of government care in exchange for taking only a limited number of patients, but offering services that are above and beyond (e.g. house calls, guaranteed same day appointments, etc.).

Some offices already work like this, but I think Obamacare will accelerate it.

 

[Spokker]

Which in the long term is the better option.

Might be the better solution, but we don't know how the current plan will turn out. Rather than reinvent the wheel, the nation would do well to pick and choose the best qualities from a variety of capitalist democracies that have acheived universal health care and enjoy better health outcomes than we do.

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/

Can you copyright a national health plan? Let's just steal someone else's.

 

[reilo]

Nope. I'm not in favor of it and fortunately a majority of americans still reject this philosophy.

Well, that's only a problem if your thinking is perpetually confined to the Industrial Revolution. I just hope society moves away from it.

 

[balladofwindfishes]

something like a family of 4 making less than $80K a year would qualify for subsidy.

WOAH THERE

When does that little number go into effect? Because my family qualifies for that and we'd use that over my dad's garbage employer insurance, right now!

 

[Gaborn]

Well, that's only a problem if your thinking is perpetually confined to the Industrial Revolution. I just hope society moves away from it.

Insulting people because they disagree with you. Niiiiiiice.

 

[eznark]

Not a big fan of Suze Orman, but yeah, for a lot of people it probably is.

Me neither, but I was just watching a funny "life of a financial adviser" video and it mentioned her. You got the gist.

 

[mckmas8808]

Because employees would not be able to qualify for government (e.g. Medicaid) healthcare, while under Obamacare they will - especially since the threshold is so high, something like a family of 4 making less than $80K a year would qualify for subsidy.
.

But whose to say that people would rather be put in the government exchanges? Maybe they'd rather have insurance policies that other businesses offer and would take a job with another company because of it.

I'm not saying they will, but that it shouldn't be a forgone conclusion that 80% of the country will be on some form of government "handled" health care plan by 2020.

WOAH THERE

When does that little number go into effect? Because my family qualifies for that and we'd use that over my dad's garbage employer insurance, right now!

2014. Unless some kind of f'ed up way the GOP stops its funding before then.

 

[reilo]

Insulting people because they disagree with you. Niiiiiiice.

I wasn't insulting. I was being observant. What I said was perfectly valid and truthful.

Give me one good reason why employee-based health insurance is a good or preferable method to deliver health insurance beyond the fact that it was concocted during the industrial revolution to spur job employment.

 

[Dude Abides]

I think it's probably fair to say the businesses most likely to be affected as I describe are smaller. Big corporations with nearly unlimited funds will always be able to woo the best and brightest with big incentive laden packages but I think you're being widely unrealistic with employers using the exchanges "compete" on compensation. Most businesses can barely afford health care costs and it's not like those costs are gone entirely for the employer. They're already going to be expected (Demanded really) to pay a significant amount to the government per employee, and THEN you think they're going to be able to afford compensation packages to everyday workers?

They will compete on health care on the exchanges for the reason they do currently - the employer understands the costs of the benefits better than the employee does. How many times have you demanded an SPD in an interview? This information asymmetry gives the employer an advantage over the employee with regard to the value of the compensation package and they will want to maintain it.

 

[Gaborn]

They will compete on health care on the exchanges for the reason they do currently - the employer understands the costs of the benefits better than the employee does. How many times have you demanded an SPD in an interview? This information asymmetry gives the employer an advantage over the employee with regard to the value of the compensation package and they will want to maintain it.

I'm sure that employers will adapt if they are forced to, I am unconvinced that the bulk won't just reject the entire process and have the government do all the work.

Reilo - if you say so. Seems pretty insulting to assume the majority of Americans are luddites simply because they disagree with that position.

As for a good reason? Because it doesn't put the costs on people who are not affected by your health care issues.

 

[Dude Abides]

I'm sure that employers will adapt if they are forced to, I am unconvinced that the bulk won't just reject the entire process and have the government do all the work.

I think they will pursue their self interest in maintaining the negotiating advantage they currently have over their employees.

 

[Dr. Pangloss]

Not this crap again. Till you guys have some real world evidence that employers are going to drop employees, then all of this is a farce. As it has been show time and time again, companies in Massachusetts have not dropped workers. Also, until tax deductions for offering healthcare to your employees is removed, no company is going to drop that expense in order to pay more taxes. This is all conjecture from a disputed poll. Where are the real world examples of employers dropping people? Also, it has been the conservative position to move away from the employer centric market to an individual one to increase competition, responsibility and entrepreneurship.

 

[Krauser Kat]

Will they still reject it when they no longer have to worry about HC when they get fired or change jobs.

 

[eznark]

I think they will pursue their self interest in maintaining the negotiating advantage they currently have over their employees.

The current climate gives them every advantage they could ask for (unless they're hiring in the trades), they don't need to rely on information inefficiencies and won't have to for a number of years.

 

[mckmas8808]

Reilo - if you say so. Seems pretty insulting to assume the majority of Americans are luddites simply because they disagree with that position.

As for a good reason? Because it doesn't put the costs on people who are not affected by your health care issues.

You think the average american will understand the real cost of health care if you made them pay 100% of the cost (instead of 35% they do now)?

 

[Dude Abides]

As for a good reason? Because it doesn't put the costs on people who are not affected by your health care issues.

I'm starting to think you may not fully grasp the concept of insurance.

 

[reilo]

Reilo - if you say so. Seems pretty insulting to assume the majority of Americans are luddites simply because they disagree with that position.

I didn't call them luddites. I said that their world view is shaped by the fact that they believe the country shouldn't advance beyond the Industrial Revolution.

Just the mention of Women's Suffrage probably makes your blood boil. (That's a joke, don't get offended now).

As for a good reason? Because it doesn't put the costs on people who are not affected by your health care issues.

Health insurance does that already! That's not even a reason, that's just bullshit. Why the hell do you think health premiums keep going up? It's not because of the healthy people entering the market. Good grief.

 

[Skiptastic]

Nope. I'm not in favor of it and fortunately a majority of americans still reject this philosophy.

Can I be in favor of decoupling health insurance from employment and not be in favor of the federal government being an option? Because I'd be in that camp. Let people buy it on their own and let it be tax deductible. Or let the states handle their citizens as they see fit.

I'm sure that's wrong for a number of reasons, but I'd be in favor of that to begin with and, if that doesn't work, moving towards a national model.

 

[eznark]

Can I be in favor of decoupling health insurance from employment and not be in favor of the federal government being an option? Because I'd be in that camp.

high five (I think that is probably where Gaborn falls as well...though with his type of libertarian you can never tell. Shifty eyes and apparently hates women!)

 

[reilo]

Can I be in favor of decoupling health insurance from employment and not be in favor of the federal government being an option? Because I'd be in that camp. Let people buy it on their own and let it be tax deductible. Or let the states handle their citizens as they see fit.

You can do that already. But good luck being able to afford it if you are an average income earner.

I'm sure that's wrong for a number of reasons, but I'd be in favor of that to begin with and, if that doesn't work, moving towards a national model.

It already doesn't work.

 

[empty vessel]

I'm starting to think you may not fully grasp the concept of insurance.

Didn't you get the memo? Insurance is socialism so the entire concept is rejected by true conservatives.

 

[eznark]

You can do that already. But good luck being able to afford it if you are an average income earner.


It already doesn't work.

That is because prices are perverted by the government incentive given to employers to offer the insurance. Remove that and you'll see a huge influx of affordable packages for individuals and families.

Hell, I pay for my own insurance now and it's not hateful.

 

[Dr. Pangloss]

Can I be in favor of decoupling health insurance from employment and not be in favor of the federal government being an option? Because I'd be in that camp. Let people buy it on their own and let it be tax deductible. Or let the states handle their citizens as they see fit.

I'm sure that's wrong for a number of reasons, but I'd be in favor of that to begin with and, if that doesn't work, moving towards a national model.

You just describe a reverse mandate. Taking the tax deduction from the employer and giving it to individuals creates an economic incentive to purchase insurance. Those that don't buy any have to pay more taxes for the government to cover them because they are not getting a deduction. Obamacare instead of giving everybody the deduction kept it for businesses because that is where most individuals receive it. I would be fine with removing the mandate and having everyone that purchase healthcare getting a deduction. But that's social engineering and its wrong to pick winners and losers.

Edit: Also any lost of healthcare from one's employer is a lost in earnings by the individual. What I would be afraid of is the removal of the benefit without any corresponding increase in wages for that individual.

 

[balladofwindfishes]

2014. Unless some kind of f'ed up way the GOP stops its funding before then.

Ugh, that's too far away.

Should have happened immediately.

 

[reilo]

That is because prices are perverted by the government incentive given to employers to offer the insurance. Remove that and you'll see a huge influx of affordable packages for individuals and families.

Hell, I pay for my own insurance now and it's not hateful.

I think prices are perverted by the absurdly high for-profit model that is the health insurance agency. That's another step we need to take: make all health insurance providers non-profits.

 

[gcubed]

That is because prices are perverted by the government incentive given to employers to offer the insurance. Remove that and you'll see a huge influx of affordable packages for individuals and families.

Hell, I pay for my own insurance now and it's not hateful.

pushing the workforce into the exchange makes things cheaper as well. My only issue is that the some thousands of dollars the employer pays for my insurance would just disappear, and none of that savings would go to me when i have to pay for my own insurance.

 

[eznark]

I think prices are perverted by the absurdly high for-profit model that is the health insurance agency. That's another step we need to take: make all health insurance providers non-profits.

Why have non-profits at all? Surely a new bureaucracy would be better.

 

[reilo]

Why have non-profits at all? Surely a new bureaucracy would be better.

Now you're just being snarky for no reason.

 

[mckmas8808]

That is because prices are perverted by the government incentive given to employers to offer the insurance. Remove that and you'll see a huge influx of affordable packages for individuals and families.

Hell, I pay for my own insurance now and it's not hateful.

How are they perverted? You mean that if it wasn't given as a tax incentive to businesses, then what would happen?

Ugh, that's too far away.

Should have happened immediately.

That's a money problem. We didn't have the money to start it right a way.

 

[balladofwindfishes]

Why have non-profits at all? Surely a new bureaucracy would be better.

A private company can be just as tied up, inefficient, wasteful and corrupt as a bureaucracy, and given the choice between private health insurance and a bureaucratic alternative, the alternative is miles better than what I currently have as insurance.

 

[eznark]

How are they perverted? You mean that if it wasn't given as a tax incentive to businesses, then what would happen?

Individuals would be cheaper to employ (as there is no longer an incentive to provide the most expensive compensation beyond salary), you'd be able to demand a higher salary (in a good economy obviously) and individuals would set market prices for insurance.

Now you're just being snarky for no reason.

Women's suffrage make eznark angry!!

 

[Skiptastic]

You just describe a reverse mandate. Taking the tax deduction from the employer and giving it to individuals creates an economic incentive to purchase insurance. Those that don't buy any have to pay more taxes for the government to cover them because they are not getting a deduction. Obamacare instead of giving everybody the deduction kept it for businesses because that is where most individuals receive it. I would be fine with removing the mandate and having everyone that purchase healthcare getting a deduction. But that's social engineering and its wrong to pick winners and losers.

Edit: Also any lost of healthcare from one's employer is a lost in earnings by the individual. What I would be afraid of is the removal of the benefit without any corresponding increase in wages for that individual.

I'm in line with your thinking on the second part, but I'm not sure I agree with the first part. How is picking winners and losers when it would be the individuals deciding? Isn't it better to say that the government deciding who to buy from and who not to buy from is more picking winners and losers?

I'm just trying to think through the impact of making different incremental changes. I'm not hugely informed on health care (shit, I am young, fairly healthy, don't have any dependents and work for a huge corporation that gives me some options at the beginning of the year, so fuck if I think about health care usually) so I like talking out the ramifications to see what would work and what wouldn't. More of an Opiate-esque thought experiment without the formal structuring.

 

[mckmas8808]

I think prices are perverted by the absurdly high for-profit model that is the health insurance agency. That's another step we need to take: make all health insurance providers non-profits.

I'm serious when I said this......but that's honestly un-American and a stupid idea.

 

[mckmas8808]

Individuals would be cheaper to employ (as there is no longer an incentive to provide the most expensive compensation beyond salary), you'd be able to demand a higher salary (in a good economy obviously) and individuals would set market prices for insurance.

But individuals would not be able to set market prices. Businesses will. Just like the banking industry, you'll probably end up with 8 big insurance companies that would all work with an understanding that profit is the first goal and that individuals don't really have a choice when it comes to health care like they do with TVs or microwaves.

 

[balladofwindfishes]

Individuals would be cheaper to employ (as there is no longer an incentive to provide the most expensive compensation beyond salary), you'd be able to demand a higher salary (in a good economy obviously) and individuals would set market prices for insurance.

you might be able to demand a higher salary, but you certainly wouldn't get it.

My dad's work cut 10,000 dollars from each employees health benefits and gave them some shoddy 5,000 HSA account which is like not having insurance at all. They did this with the promise that they needed to do it in order to continue giving raises and bonuses at the rate they were.

The next month they announced they canceled bonuses and put raises on hold.
It's been 3 years since then. They now only contribute 500 dollars towards their employees HSA accounts.

Employees tried to fight for their benefits back and were told no. The human resources rep is the secretary for the CEO and is useless. People have threatened to leave and have been told to leave.


This is why I hate corporations and never, ever trust them for anything. It's why I hate the health care system.

My brother has a minor heart condition. He should have a 2,000 dollar scan every year. Doing this every year instantly drains our 2,000 dollar HSA account, leaving us with nothing. Because of this, he cannot however, have this test done.
My HSA will no longer allow for 12 month prescriptions. They have to be for one month or 3.
Every time my mom needs her anxiety pills refilled, the doctor has to check her. With a 12 month supply, this is done on her yearly check-up (which, thanks to the evil "Obamacare" is now covered cost free by our HSA). With a 3 month supply that the HSA requires she does, it costs 25% more, and requires a 100 dollar doctor visit every 3 months.


Now you see why I am bitter, distrusting and outright disgusted at conservatives, corporations, and America in general. They have abused my family the last 10 years, and I am growing extremely tired of it.

And now people discuss how buying insurance on the market will "encourage responsibility" or whatever. Give me a break. I don't need a lesson in responsibility. I need medicine. And I need medicine NOW

 

[reilo]

I'm serious when I said this......but that's honestly un-American and a stupid idea.

Huh? It wasn't un-American before the 80s when all health insurance was non-profit.

un-American lol.

What a stupid ideal to hold up to.

 

[Gaborn]

But individuals would not be able to set market prices. Businesses will. Just like the banking industry, you'll probably end up with 8 big insurance companies that would all work with an understanding that profit is the first goal and that individuals don't really have a choice when it comes to health care like they do with TVs or microwaves.

many employers don't offer dental insurance, it's considered COMPLETELY separate from health insurance for most people. Is it cheaper or more expensive to see a dentist as a result?

 

[balladofwindfishes]

many employers don't offer dental insurance, it's considered COMPLETELY separate from health insurance for most people. Is it cheaper or more expensive to see a dentist as a result?

I haven't been to a dentist in almost 10 years because of this very fact

 

[Dr. Pangloss]

I'm in line with your thinking on the second part, but I'm not sure I agree with the first part. How is picking winners and losers when it would be the individuals deciding? Isn't it better to say that the government deciding who to buy from and who not to buy from is more picking winners and losers?

I'm just trying to think through the impact of making different incremental changes. I'm not hugely informed on health care (shit, I am young, fairly healthy, don't have any dependents and work for a huge corporation that gives me some options at the beginning of the year, so fuck if I think about health care usually) so I like talking out the ramifications to see what would work and what wouldn't. More of an Opiate-esque thought experiment without the formal structuring.

Sorry Skiptastic. I was being sarcastic. I think its okay for the government to promote responsible actions and discourage irresponsible ones. For instance saving for retirement gets the benefit we just described. I'm sure many people agree on the general concepts of everyday things like more competition and individual responsibility. It's just that we diverge on the government's role in making sure everyone is taken care of.

 

[Gaborn]

I haven't been to a dentist in almost 10 years because of this very fact

out of pocket dental care is very reasonable, especially when compared to out of pocket health care generally.

 

[balladofwindfishes]

out of pocket dental care is very reasonable, especially when compared to out of pocket health care generally.

it's easier to go without it than to find the funds for 5 people to see the dentist. Costs may be "reasonable" but it's unreasonable when 5 years ago insurance covered it for no extra cost.