People are still fighting Obamacare?

NormanTheIntern wrote:
JC wrote:

The polls are reflecting the unease that people have because they don't understand the thing.

No. People understand all too well what's happening here: while restrictions and penalties for employers and insurance companies are being kicked down the road, the individual mandates and connected penalties are somehow still going into effect. How is that in any sense of the word good or equitable? Either Obama is selling out to special interests, or the law is structurally unworkable and broken.

You are overstating the case here. SOME restrictions and penalties have been kicked down the road. Many have not. The lifetime caps are gone. The pre-exisiting conditions clauses will all be gone come Jan. 1. Rescission is outlawed. You cannot be denied coverage by going to an ER that is out-of-network. And on and on.

And we're only starting to see the tip of the iceberg in terms of what happens when you incentivize businesses to keep people under 30 hours per week. That already double digit underemployment rate is going to spike. I realize the appeal of just claiming the people are too ignorant to understand, but they really do. Its not like the government screwing them is an unrcognizably foreign concept.

Nothing gave the incentive to businesses to keep workers under 30 hours. The claim from the CEO of Papa John's that the end was nigh because of Obamacare and that he had to - HAD TO - reduce hours in order to turn a profit was pure unsupported spin. He admitted himself that he would have to raise costs on pizzas by about $0.20 max. Katy bar the door! A whole, whopping $0.20 per pie. There wasn't a single person I heard of or knew who said they would abandon Papa John's because he would raise the price $0.20. In fact, it was just the opposite. Almost every person I know had no problems paying an extra quarter so someone could have decent health care.

In fact, the little pizza joint near my home put up a sign saying that he would not reduce hours but would be raising prices by $0.50 per pie come Jan. 1 so that his workers could have decent health insurance. The response was overwhelmingly positive. Very few people said they wouldn't come back because of the increase. So, this little business man in Phoenix that has a small strip mall pizza shop can get health insurance for his employees by simply raising prices by a very modest half dollar, but the very wealthy, supposedly "in the know" business tycoon who runs Papa John's can't figure it out?

Gee, that tells me that his understanding of Obamacare is just as crappy as his pizzas.

Edit: Never mind.

Have the people opposing this never been sick and never had a sick friend or family member? Even living up here in Canada I've watched numerous American friends and acquaintances struggling to fight with their health insurance to cover things or else trapped without insurance in a realm where they have a medical issue which really should be looked at but the cost of an evaluation and possible treatment is enough to force them to delay.

Given how many conditions benefit from early diagnosis and treatment I can't help but think the freedom to go see someone about medical concerns without worrying about the bill is a good thing. Given how quickly those bills can rack up when you really need them I can't help but think better regulations on how the insurance companies treat their clients are a good thing.

I've been spoiled by having been born here and I wish people like PR had the benefits of our system to relieve him of that financial worry and the stress of fighting with insurance companies. My limited understanding of Obama Care is that it certainly won't resolve everything but it sounds like it will force things to start improving. I'm not grasping the case of the against side, you guys spend so much on your military "to protect America!" and its citizens... but won't aid those same citizens if it so happens they can't afford health insurance or get stuck with an asshole insurance company?

Right on, PR. My wife and I stopped ordering from Papa Johns and now drive to pick up our pizzas from places further away because his crazy stance off this pretty much killed our interest in supporting his bad pizzas any further. Screwing over your workers twice over (no health insurance AND fewer hours for your employees)? Classy move, bro.

To me, I keep hearing Democrats haven't explained the ACA enough... and I agree... but fighting the frothing at the mouth bull from the defunders (nice, by the way, defund it to nothing then complain it doesn't work) is so pointless. It is like trying to argue with birthers. How do you even make good points while the other side is trying to claim that it is some communist manchurian healthcare plan?

Phoenix Rev wrote:

You are overstating the case here. SOME restrictions and penalties have been kicked down the road. Many have not. The lifetime caps are gone. The pre-exisiting conditions clauses will all be gone come Jan. 1.

Both of which are effectively greatly reduced (if not basically meaningless) without an out of pocket cap.

Nothing gave the incentive to businesses to keep workers under 30 hours.

You are fined if you meet a certain full time employee threshold and don't provide healthcare. Full stop - that is a clear economic incentive to operate with part time employees. Anecdotes about pizza places don't change that fact.

NormanTheIntern wrote:
Phoenix Rev wrote:

You are overstating the case here. SOME restrictions and penalties have been kicked down the road. Many have not. The lifetime caps are gone. The pre-exisiting conditions clauses will all be gone come Jan. 1.

Both of which are effectively greatly reduced (if not basically meaningless) without an out of pocket cap.

Nothing gave the incentive to businesses to keep workers under 30 hours.

You are fined if you meet a certain full time employee threshold and don't provide healthcare. Full stop - that is a clear economic incentive to operate with part time employees. Anecdotes about pizza places don't change that fact.

Yes... and the cost to fix that, for Papa John's was $0.20 per pie. As John himself released. The horror.

That said, the idea that you are going to hurt your employees in several ways (underemploymemt, lack of health benefits, reducing business due to out of nowhere political stands...because that worked so well for Chick'Fil'a right?) for your own good... frankly, comes off as repugnant to me.

NormanTheIntern wrote:

You are fined if you meet a certain full time employee threshold and don't provide healthcare. Full stop - that is a clear economic incentive to operate with part time employees. Anecdotes about pizza places don't change that fact.

Right. So many companies are avoiding Obamacare.

Except they aren't.

Further supporting these "good guys," as my Foolish colleague Steve Heller dubbed them in December, is a study from the Minneapolis Fed released last month that showed only 4% of employers had shifted their hiring to more part-time workers in response to Obamacare. Of the remaining 96%, 7% of respondents planned to shift to more part-time hires between now and the PPACA's implementation, while a whopping 89% claimed to have no intention of changing their hiring strategies in the wake of implementation.

Again, the end must be nigh if a whopping 11% are or might be going to a part-time workforce just to skirt the Obamacare rules.

Good luck when the economy becomes robust and their part-time work force looks for greener pastures.

Assuming we accept at face value people's answers on what is essentially a good guy/bad guy poll, how can you possibly make the claim that more than 10% of employers switching to part time isn't a significant event that will have serious repercussions on the economy and the workforce? Just from an income inequality perspective alone, that's a disaster.

Demosthenes wrote:

That said, the idea that you are going to hurt your employees in several ways (underemploymemt, lack of health benefits, reducing business due to out of nowhere political stands...because that worked so well for Chick'Fil'a right?) for your own good... frankly, comes off as repugnant to me. :(

So the way we resolve these issues in the past is by creating laws, ie minimum wage. But this is the case where a law is causing the problem, not solving it. If I say to you "I'm going to poke you with a pointy stick unless you move to the right", no one can really blame you or be surprised if you step to the right - it's my fault for holding the stick and making the rules. Democrats could have forced all employers to provide healthcare to everyone. They could have passed single payer, no one could have stopped them. Instead we have a feel-good expansion of coverage that does little to nothing to address the underlying costs (the actual problem) and is being implemented in a way that penalizes average people before employers and insurance companies.

Norman- The democrats didn't have the filibuster proof numbers to pass single payer. They barely got this version through. I wish they had been able to pass it as single payer.

Can you imagine the chaos if they had managed to pass single payer? There would be rioting in the streets. OR people would have said, "hey that makes sense" and moved on with their lives. Oh wait, that would only happen in the alternate universe where the tea party group doesn't exist.

I'm confused... when were we living in a magical fantasy land of "Democrats could do whatever the hell they want without regard to anyone else" without the Tea Party there to decry everything from Democrats as Obammunism?

Having just made up that word, I can't believe they never used it before.

Demo- Obammunism.... AWESOME word. I think you're right. I don't ever recall having heard that before. Slap a copyright on that sucker QUICK!

Quick, someone tell me how to do that!

JC wrote:

Norman- The democrats didn't have the filibuster proof numbers to pass single payer. They barely got this version through. I wish they had been able to pass it as single payer.

Can you imagine the chaos if they had managed to pass single payer? There would be rioting in the streets. OR people would have said, "hey that makes sense" and moved on with their lives. Oh wait, that would only happen in the alternate universe where the tea party group doesn't exist.

Respectfully, no. Republicans at the time did not have the Senate numbers to filibuster, and the Democratic House straight up passed the Senate version and changed the budget numbers via reconciliation, both those processes were filibuster proof. They passed the whole thing without a single Republican vote, and 30+ Democratic reps broke ranks and voted no on top of that. If single payer couldn't pass, that's because it couldn't pass muster on the left - the tea party was not a legislative factor here.

obirano wrote:

Sadly about 4 years too late.

http://www.urbandictionary.com/define.php?term=obammunism

A political philosophy characterized by income and wealth redistribution, massive deficit spending, debasement of the currency and world empire. Noted for its leader's supreme arrogance and ineptitude.

Obammunism advocates transfer of wealth from the productive to the reproductive.

Question on bolded... is that... a welfare queen reference?

NormanTheIntern wrote:

They passed the whole thing without a single Republican vote, and 30+ Democratic reps broke ranks and voted no on top of that. If single payer couldn't pass, that's because it couldn't pass muster on the left - the tea party was not a legislative factor here.

Actually, the Tea Party was a factor because those 34 Democratic representatives who voted against the ACA did so because they were from extremely conservative districts that were considered vulnerable. Voting for the ACA would have cost them their next election. Heck, 17 of those reps who voted "no" still lost their seat in the 2010 election.

I think the fact that the starting point of the health care discussion (and the eventual ACA law known as "Obamacare") was nearly identical to the 1993 GOP proposal and it STILL received no Republican support pretty well demonstrates that the GOP was never going to be seriously engaged in the process to begin with.

When you start by saying "you get everything you said you wanted" and they still say "go fornicate with yourself", it is simply pointless to engage them.

DC Malleus wrote:

I just can't understand how you guys haven't worked out this universal healthcare thing by now... It is incredibly frustrating to sit on the other side of the pond listening to stories like Phoenix Rev's where citizens of almost any other developed nation would be treated like they were worth a damn :(

This. "Piss up in a brewery" comes to mind.

Paleocon wrote:

I think the fact that the starting point of the health care discussion (and the eventual ACA law known as "Obamacare") was nearly identical to the 1993 GOP proposal and it STILL received no Republican support pretty well demonstrates that the GOP was never going to be seriously engaged in the process to begin with.

It also showed how radically to the right the GOP had shifted in 15 years.

89% of companies are planning on keeping workers at >30 hours? This doesn't jive with my experience.....

Oh here:

that article wrote:

One industry where this move is readily apparent is in the fast-food industry. CKE Restaurants -- owner of Carl's Jr. and Hardee's, which was purchased by Apollo Management in 2010 -- began hiring considerably more part-time workers last year to replace any full-time turnover. Similarly, but on a smaller scale, 11 franchised Wendy's (NASDAQ: WEN ) locations in Nebraska cut back hours for about 300 non-management employees in January of this year in order to skirt the increasing costs associated with Obamacare.

That makes more sense. Food service represents most of my experience.

Oh look, fast food owners have found a new way to screw over their employees, surprise!

Demosthenes wrote:

Oh look, fast food owners have found a new way to screw over their employees, surprise!

Not terribly surprising. Fast food, as an industry, is really one that depends on feeding on the government cheese.

In principle, if your company relies on a workforce that requires government assistance to suppliment their income in order to feed their families, the one getting the handout is you.

I despair of this nation ever figuring out how to join the modern world in providing a decent universal tax-driven healthcare system.

OG_slinger wrote:
Tenebrous wrote:

Numerous delays and missed deadlines by the government, numerous corporate exemptions, a congressional exemption from the law when it was Congress that passed it. If it is such a great law then why the exemptions?

It's a law that affects tens of millions of Americans and touches on an Byzantine industry that accounts for 18% of our GDP. Did you honestly think that it would roll out smoothly and there'd be absolutely no hiccups whatsoever?

Not to this extent no (see missed deadlines below), this is a signature piece of legislation that remains controversial. It is important to get it right more times than not. Especially when it is forced (or perceived as such) the way it was.

There have been delays with Obamacare, but that's not unexpected. Remember Dodd-Frank, the financial reform law Congress passed three years ago? They haven't even finished writing that law yet.

So they passed a law that was not written yet that was meant to end too big to fail (it's still around!), and prevent the kind of financial collapse we saw in 2009. I already knew this but thanks for reminding me. Wow.

There have also been missed deadlines. But most of those have been for "bureaucratic busywork," like writing reports about the appropriate level of of education required about diabetes and not things that are essential to the ACA.

You can look at a a Forbes article on the subject which cites an internal USG memo listing the missed deadlines. The article does mention that there are some busy work and pretty significant deadlines in there. Given that most of these things will guide policy and help determine where billions of dollars would be spent, I would think even busywork would be have influence.

There have also been about 2,000 corporate exemptions. But what tends to get left out of the news reporting is that they are temporary exemptions that will give those companies a year to figure things out. That seems like a relatively prudent thing to do, especially when the health care exchanges those employees are supposed to turn to aren't mandated to be up and running until next year.

Do you have anything that is authoritative and non-partisan that says this, preferably from the USG. I have been looking for info on this.

OG_slinger wrote:

And we have absolutely no idea how the cost is going to work out. We're expanding the pool of insured by 50 million, so it's likely that there's not going to be increase in costs past the first couple of years when there's a massive backlog of health care services people will demand because they haven't had access for years.

It is simple economics. We are increasing demand for healthcare while keeping the same supply. It is not the backlog of untreated health problems that is the problem, but the net increase in demand overall caused by adding those people and the systems ability to expand appropriate skilled labor pools and increase capitol to meet that demand.

The ability to raise capitol in the healthcare sector is a problem because, as you pointed out it is uncertain how things will shake out with the law both in theory (because policy has not been written yet [see your own comments and the discussion of missing deadlines] and the outside chance of the whole thing being thrown into the trash bin or heavily modified) and in practice (because it has not really been rolled out yet). This increases the cost of capitol (really, the interest rate health care organizations can get) and reduces the ability to expand the system due to costs of that expansion.

I would also add there are probably going to be marginally less doctors and other skilled health care professionals in the next 10ish years at least due to the retirement of the baby boomers.

Paleocon wrote:
Demosthenes wrote:

Oh look, fast food owners have found a new way to screw over their employees, surprise!

Not terribly surprising. Fast food, as an industry, is really one that depends on feeding on the government cheese.

In principle, if your company relies on a workforce that requires government assistance to suppliment their income in order to feed their families, the one getting the handout is you.

Do I need a sarcasm sign?

That is an interesting point though, and one I hadn't really considered in quite that context. We complain about people needing food stamps... why don't we complain about the fact that people need food stamps because McDonald's doesn't pay them enough to AFFORD McDonald's?

Demosthenes wrote:
Paleocon wrote:
Demosthenes wrote:

Oh look, fast food owners have found a new way to screw over their employees, surprise!

Not terribly surprising. Fast food, as an industry, is really one that depends on feeding on the government cheese.

In principle, if your company relies on a workforce that requires government assistance to suppliment their income in order to feed their families, the one getting the handout is you.

Do I need a sarcasm sign?

That is an interesting point though, and one I hadn't really considered in quite that context. We complain about people needing food stamps... why don't we complain about the fact that people need food stamps because McDonald's doesn't pay them enough to AFFORD McDonald's?

I always find it hilarious that the anti-immigrant Republicans constantly talk about how they should shut down the border with landmines and ship anyone without a long form birth certificate by the traincar to refugee camps across the Rio Grande because $15/hour isn't enough to attract a white person to milk cows, but they seem perfectly okay with the MASSIVE ongoing transfer payment the middle class taxpayer makes to the likes of McDonalds and Walmart in the form of public assistance to a deliberately underpaid workforce.

In their minds, welfare is okay so long as the end recipient is a billionaire.

My complaint about food stamps, just to avoid having that poorly worded sentence of mine above misconstrued is this: I hate that we actually have people who need food stamps due to underemployment/low wages/unemployment. It is really sad to me that healthy food is not available to everyone, and that's why I always choose to end world hunger at the start of SRIV.

Tenebrous wrote:

It is simple economics. We are increasing demand for healthcare while keeping the same supply. It is not the backlog of untreated health problems that is the problem, but the net increase in demand overall caused by adding those people and the systems ability to expand appropriate skilled labor pools and increase capitol to meet that demand.

Lack of health insurance does not stop most people from seeking healthcare when they need it, it only stops them from being able to pay their bills for said healthcare. With an increase in the number of insured parties you will likely see a decrease among emergency services and an increase for GPs and preventative care. Admittedly, the US healthcare system is already feeling the shortage of GPs as all of the new med school graduates are trying to become specialists since that's where all the money's at, but they've been working on that issue for the last decade.

Demosthenes wrote:

My complaint about food stamps, just to avoid having that poorly worded sentence of mine above misconstrued is this: I hate that we actually have people who need food stamps due to underemployment/low wages/unemployment. It is really sad to me that healthy food is not available to everyone, and that's why I always choose to end world hunger at the start of SRIV.

Cheap, subsidized, corporatized food is the cause of a surprising amount of enormous western issues, from socioeconomic (as you point out) to environmental to moral (animal cruelty).

In fact almost everyone I speak to would love to see massive changes to the fast food industry, so long as those massive changes don't include "not eating there."

Kehama wrote:
Tenebrous wrote:

It is simple economics. We are increasing demand for healthcare while keeping the same supply. It is not the backlog of untreated health problems that is the problem, but the net increase in demand overall caused by adding those people and the systems ability to expand appropriate skilled labor pools and increase capitol to meet that demand.

Lack of health insurance does not stop most people from seeking healthcare when they need it, it only stops them from being able to pay their bills for said healthcare. With an increase in the number of insured parties you will likely see a decrease among emergency services and an increase for GPs and preventative care. Admittedly, the US healthcare system is already feeling the shortage of GPs as all of the new med school graduates are trying to become specialists since that's where all the money's at, but they've been working on that issue for the last decade.

Moreover, the economics isn't quite that simple.

The fact that a hip replacement or prescription for a vasodilator is anywhere between 5 and 50 times more expensive in the US than in just about any other place on the planet with enough people to justify rural mail delivery is NOT a function of normal supply and demand. It is a function of inelastic demand and zero purchasing power.

Until larger blocks of the insured start negotiating prices with health care providers (i.e.: insurance exchanges, medicare expansion, etc.), the pricing advantage will remain with the provider, not the patient.

TL:DR version: Our system is whack because everyone from doctors to medical device companies can price their services any way they want to because you have no power to say no. Until we start getting HUGE groups that prenegotiate pricing, they will continue to do so. The process of creating these blocks STARTS with "Obamacare". The present GOP "alternative" is the horrific status quo.