Endgame – ObamaCare Will Force Employers To Drop Health Coverage

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No one saw this coming……right?

Thirty percent of employers will definitely or probably stop offering health benefits to their employees once the main provisions of President Obama’s federal health care law go into effect in 2014, a new survey finds.

The research published in the McKinsey Quarterly found that the number rises to 50 percent among employers who are highly aware of the health care law.

…The research notes among the new provisions that could spur employers to drop coverage is a requirement of all employers with more than 50 employees to offer health benefits to every full-timer or pay a penalty of $2,000 per worker. Those benefits must also be equal between highly compensated executives and hourly employees – requirements that will increase medical costs for many companies.

The findings are distinct from a Congressional Budget Office estimate that only about 7 percent of employees who currently get health coverage through their jobs would have to switch to subsidized-exchange polices in 2014.

The group said its variance is so wide because shifting away from employer-sponsored insurance “will be economically rational” given the “law’s incentives.” The law requires employers to make insurance available to low-income or part-time employees that may not otherwise be covered.

Hell, we here at FA have been saying this for years now. CBS did a segment on this very topic 9 months ago

This is the law of intended consequences unfortunately…it’s been the Obama administrations endgame all along. ObamaCare will force employers to pay the penalty and drop their healthcare, which forces people into government run healthcare, which drives insurance companies out of business and TA-DA!

Socialism in America.

Exit quote:

If Congress can impose this economic mandate on the people, what can’t it mandate the people to buy?

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Curt, I can only speak about the one company I am familiar with, AT & T.

AT & T provides health insurance for all their employees. The cost to the company for that is (2009 est.) $10,073.00 a year. That is for employee only and does not include the costs for dependents. The cost for a family can run as high as $30K/yr. All free to the employee. And I can tell you from personal experience, it is a Cadillac plan. My spouse had open heart surgery last year. Our cost? $250.00 out of a total of over $150,000.00 hospital bill.

AT & T also provides the same benefits when an employee retires and covers them until they go on Medicare, at which point the AT &T health insurance becomes secondary. This saves the retirees from not only having to buy a Medicare Advantage policy, but they are also given drug insurance. AT &T is now talking about dropping their drug plan for retirees at the beginning of 2012, and within 2 more years, dropping all retiree health insurance benefits.

Obamacare will be a boon to all companies like AT & T as they will start to refuse to give health insurance forcing employees on Obamacare. The companies will drop their health insurance and if the unions bitch about it during negotiatons, they will tell the unions to pound sand. If any employee doesn’t like it, well, there are 14 million unemployed Americans who will be happy to replace you. The fine imposed on a company like AT & T will result in AT & T saving BILLIONS of dollars because they no longer provide health insurance for the employees.
In other words, when people find out really how bad Obamacare is, and as you said, the unintended consequences of that bill, they are not going to be happy campers.

This is precisely what was predicted for RomneyCare in Massachusetts (that private companies would stop offering health insurance). The reality is that the percent of private employers actually providing health insurance increased, while the percent of Massachusetts residents covered by insurance rose to 99% and the law is overwhelmingly popular with both residents and doctors.

Many a beautiful theory is ruined by an ugly fact.

The sky is falling. ObamaCare is socialism. Death panels.

The GOP will probably be successful in killing it. But the GOP will then — finally — own the health care problem.

We live in interesting times.

– Larry Weisenthal/Huntington Beach, CA

Larry, and what has been the cost to the citizens of Massachussets for Romneycare, the very plan that much of Obamacare was designed around? And why am I not surprised that you would support federalized health care insurance?

Health care is NOT a right, contrary to what you liberals scream. It is a good, a service, and therefore subject to the free market. If health care insurance is a “right” as a criterion for sustaining life, then I should not be charged for my water as water is also required to sustain life.

There is no lack of available health care for those who need it. Even for illegal immigrants who should have no right to access free health care in this nation.

: I think that you are new on this blog. I’ve argued every nook and cranny of the health care debate with Mata and others. For the sake of the present discussion, I was restricting my comments only to the specific claim that ObamaCare is likely to lead to mass cancellation of private employer health coverage. The exact same claims were made concerning RomneyCare and these claims have proven to be entirely incorrect.

The fatal flaw with expecting private sector health care to work is that health care doesn’t follow the laws of open market economics for one simple, but deadly, reason. In health care, the sellers (doctors) make the purchase decisions for the buyers (patients). This is the fatal flaw in US health care. With the recession, many people lost health insurance, yet doctors’ incomes here in California didn’t suffer, despite the fact that they lost patients. The doctors simply provided more services for the remaining patients. Surgeons always recommend surgery, to the extent they can get away with it. Radiation therapists always recommend radiation therapy. Medical oncologists always recommend infusion chemotherapy. Family practitioners find ways to provide services. And so on. I’ve discussed these (and many other) matters relating to health care previously on this blog and it’s much too broad a topic to start debating all over again. I’m going to limit my comments only to the new issues and news which happen to arise.

– Larry Weisenthal/Huntington Beach, CA

@openid.aol.com/runnswim:

I’ll just make one point here, Larry. While I don’t agree, or disagree, that employers will drop health coverage for their employees, I do know, for a fact, that some companies within the health insurance market are dropping that aspect of their business. My own company had to look elsewhere for health insurance, as the company they used for four years, and was well liked by the employees in general, has dropped health insurance as part of their business. We expected modest increases in the monthly premiums every year as a cost of doing business, but now we are unsure just how much our coverage costs will be going up, as the health care insurance provider we are moving to is the same one we moved away from due to their hefty premium costs.

And the reason given for our current provider opting out of the health insurance market? Obamacare has, or will, force them to incur too great of costs to them, that they will have to pass on to the consumers, for them to be able to remain competitive within the market. One has to wonder how many others there will be before all is said and done.

@John: The idea that ObamaCare is the primary reason for health insurance companies raising their rates or leaving the market is unsupportable. Blue Shield of California tried to get a massive rate increase (over 50%) for small businesses (like my own), but they were careful to say that it wasn’t owing to ObamaCare; it was owing to continuing massive inflation in the health care sector. The actual costs to the companies for complying with ObamaCare are modest and are chiefly related to regulations regarding coverage of pre-existing conditions, no tossing people off policies because they get sick, and no lifetime coverage caps (to reduce medical bankruptcies). These are components of ObamaCare which various GOP politicians assert that they want to keep, although how this could be accomplished in the absence of mandates to purchase insurance is difficult to see.

The Massachusetts experience really is informative, as it’s a near perfect model for ObamaCare. It’s far from perfect and remains a work in progress, but it’s succeeded admirably in doing what it set out to do.

– Larry Weisenthal/Huntington Beach, CA

Larry, as a physician, who treats cancer patients, are you willing to accept the fees for your services that will be set by Obamacare? As an example: my PC physician charges $60. per office visit. Not an extremely high fee compared to what my brother pays in Oxnard. Out of that $60.00, he is reimbursed by Medicare 80% of $42.55, the fee determined by Medicare to be reasonable and customary. So he gets $34.04 for a $60.00 office visit. The ironic part of it is if he were located in Austin, and not some small town, he would get his entire $60.00.

Obamacare will have to maintain much of the fees and regulations now attached to Medicare. Are you willing to accept 50 cents on the dollar for your services? 58% of all Texas physicians, including specialists, have now dropped out of the Medicare system and are refusing to take Medicare patients.

Robert Reich has admitted that health care will have to be limited in order for it to pay for itself. He has also admitted that services will have to be denied to certain seniors as their value does not meet the cost. Cass Sunstein, an Obama health care guru, has advocated for “rationing”. Instead of having unknown bureaucrats at an insurance company determining what they will cover (which is outline in your policy) you will have unknown bureaucrats on some health care “panel” determining, like they do now, what benefits and services they are going to pay for.

Oh, and if think Massachussets citizens now having to wait 28 days in order to get an appointment with a physician a success story, I shutter to think what California is like.

@openid.aol.com/runnswim:

I’m not arguing anything of my own opinion, Larry. I merely pointed out that my current health care provider is dropping out of the market altogether, and that their stated reason is Obamacare and the excessive costs they will incur, pass on to consumers, and that they feel they cannot be competitive within the market due to that. I’d like to believe that they stated that opinion based on their own inherent knowledge of the market, and not “unsupported” opinion.

As I said, I neither agree, nor disagree, that companies themselves will opt out of supplying healthcare coverage for their employees. It might happen, and it might not. But when health care providers are dropping that sector of their business, it leaves less competition, and that only hurts the consumers, both the companies and their employees.

@John: The number of health insurance companies is contracting for the same reason that telecommunications companies and airlines and drug stores and hardware stores are contracting. Economies of scale and bigger companies (and more specialized companies) outcompeting smaller ones.

– Larry Weisenthal/Huntington Beach, CA

@openid.aol.com/runnswim:

Principal Financial Quits Writing Health-Care Policies

…………………
The federal health overhaul passed in March has prompted worries among regulators and industry groups that smaller insurers might have difficulty competing under rules that require insurers pay out between 80% and 85% of premiums on medical care.
…………………
Principal said its exit in part is because smaller insurers will have a hard time competing with bigger players under the overhaul.

http://online.wsj.com/article/SB10001424052748704789404575524281126700388.html

Any contraction of a market’s producers, to fewer numbers, results in less competition, and a corresponding negative impact on consumers. In this case, it seems that the larger, more specialized providers will profit from Obamacare’s rules and regulations while the smaller providers will find themselves at a disadvantage.

johngalt, on the success of Romneycare:

http://online.wsj.com/article/SB10001424052748703625304575115691871093652.html

And you noticed that Larry was not responsive to my question as to his willingness to accept lower fees for his services due to the restrictions on R & C in Obamacare.

A couple of things.
Both Mass. Universal Coverage and ObamaCare promised to bring down the numbers of people using the ER for a doctor’s office.
Mass. plan is doing the opposite:

Universal coverage fails to cut ER visits
RomneyCare Has Had Little Impact On ER Visits
Fifty-six percent of Massachusetts physicians are no longer taking new patients, pushing more people into emergency rooms. In Massachusetts, 55 percent of ER visits covered by Medicaid were considered preventable.

Both promised wait times to see your doctor would be shortened.
In Mass. under the pattern for ObamaCare plan the wait has increased:

Obamacare Spurs Doc Shortage…..
Today in Massachusetts, the wait time to see a doctor can be as long as seven weeks, and many doctors won’t accept patients in the subsidized insurance program. That does not bode well for national healthcare reform if it is fully implemented as…
The Doctor Will See You in 174 Days

But it also looks like the 11th Circuit Court of Appeals might overturn ObamaCare anyway.

Judges sharply challenge healthcare law….
A top Obama administration lawyer defending last year’s healthcare law ran into skeptical questions Wednesday from three federal judges here, who suggested they may be ready to declare all or part of the law unconstitutional…..
Los Angeles Times has whole story.

@nan: As I said, the Mass law has some growing pains. When you bring more people into the health care system, it takes awhile for the system to expand to accommodate them. The important thing is that the residents (and physicians) in Massachusetts like what they are getting, despite the growing pains.

With regard to the courts — well, they’ll do what they’ll do. In any event, I fully expect the GOP to repeal it. Then we’ll see what the GOP does, once the health care ball is squarely in their court.

: As I wrote, I’ve debated all of this extensively (including a consideration of the issues which you now raise, e.g. impact on me, personally). I truly don’t have time to rehash everything all over again. I’m confining myself to new issues, such as the topic of this thread. I’m not going to re-argue all of the many basic considerations, which we’ve covered previously, in excruciating depth and detail.

– Larry Weisenthal/Huntington Beach, CA

Larry, those are not ”growing pains.”
They are completely predictable consequences of both RomneyCare and ObamaCare.
We also saw them both here in CA several years ago when CA asked the Federal Gov’t to pay for the cost of illegal aliens in our private hospitals.
Naturally, the federal gov’t said, ”NO!”
In my city alone 27 private hospitals went under.
Same all over the state.

@nan:

Retire05 quotes a slanted op ed. Here’s an in depth study. I previously discussed the findings of this study on a different thread. I’m not going to do it again.

https://128.167.119.82/portal/binary/com.epicentric.contentmanagement.servlet.ContentDeliveryServlet/Health%2520Care%2520Reform/Overview/HealthReformAssessingtheResults.pdf

Here’s the Executive Summary:


401,000 more Massachusetts residents have health insurance coverage than did
before reform.

Massachusetts has the highest rate of insurance in the country with 98.1 percent
of residents insured.

There has been no evidence of subsidized coverage “crowding out” employer-
sponsored insurance, and employer offer rates have grown from 70 percent
to 76 percent since implementation of reform.

Public support for Massachusetts health reform has remained strong with two
out of three adults supporting reform.

Most employers believe health reform has been good for Massachusetts and
88 percent of Massachusetts physicians believe reform improved, or did not
affect, care or quality of care.

The cost of health care and the annual rate of increase in health care spending
remains a challenge. With no intervention, per capita health care spending in
Massachusetts is projected to nearly double by 2020.

– Larry Weisenthal/Huntington Beach, CA

Notice how larry either tries to discount the problems or ignores them altogether.
FYI larry, most of what you quoted above is opinion and not fact.
Then again in your quest for fuzzy unicorns and rainbows (and to make yourself feel good), who cares about facts?

@Hard: What I quoted were hard data from a comprehensive study by the Blue Cross/Blue Shield Foundation of Massachusetts. Dated April, 2011. You might look it over. – Larry W/HB

The thread is about forcing employers to drop coverage.
But Larry’s extract from Mass., also brings up another problem:
FORCING people to pay in.

REMAINING UNINSURED ADULTS MAY BE DIFFICULT TO PERSUADE TO BUY COVERAGE OR MAY NOT QUALIFY FOR SUBSIDIZED OR EMPLOYER-SPONSORED COVERAGE
43 percent are young adult (18–25 years of age).
65 percent are male.
More than half have never been married.
80 percent report they were in good, very good, or excellent health.
More than 75 percent have incomes less than 3 times the federal poverty level.

YUP.
We were not covered when we were young, healthy and thought we were going to live forever, either.

47% Uninsured with access to employer-sponsored insurance who did not take it up due to cost.
70% Uninsured who tried to purchase individual coverage but found it to be too costly.

So, affordability is a BIG problem.
And will be one under ObamaCare, too.

The 11th Circuit Court of Appeals panel has expressed unease with the requirement that virtually all Americans carry health insurance or face penalties.

Chief Judge Joel Dubina, who was tapped by President George H.W. Bush, struck early by asking the government’s attorney “if we uphold the individual mandate in this case, are there any limits on Congressional power?” Circuit Judges Frank Hull and Stanley Marcus, who were both appointed by President Bill Clinton, echoed his concerns later in the hearing.

Hull and Dubina asked the lawyers on both sides to focus on a particular outcome: What could happen to the overhaul, they asked separately, if the individual mandate were invalidated but the rest of the package were upheld?

Under ObamaCare there is a sliding fine/penalty/tax for not buying health insurance:
Some say it is as low as 1% of income or $695/year the 1st offense; others put the 1st offense at $2000/year.
Then it goes up and jail time is added.

@nan: Health care affordability is the number one economic problem facing America today. I’m self employed and my Blue Shield premiums have skyrocketed for reasons which Blue Shield asserts has nothing to do with ObamaCare.

Pawlenty agrees with Obama that the key to controlling health care costs is to change reimbursement from payment for services to payment for health care outcomes. There is something like $11 billion in ObamaCare for pilot programs to explore payment for outcomes.

The real father of ObamaCare was Romney and the real fathers of RomneyCare (including the mandate) were GOP Senators Grassley and Dole, back in the early 1990s, as an alternative to HillaryCare. Back then it was a sensible conservative alternative. Today it is a socialized government takeover.

– Larry Weisenthal/Huntington Beach, CA

Larry, your health care premiums have skyrocketed due to the regulations placed on them by your state, California. It is one of the reasons business are fleeing your state to other more business friendly states. You are also in a position to not have to personally worry about cost due the the practice of professional courtesy. I know few doctors that would charge another physician for their services.

Please, provide a link to Pawlenty’s opinion of “health care outcomes.” Actually, that is what Cass Sunstein supports, medical services provided on the quality of outcome. That leaves many seniors having doctors, and government bureaucrats, making their decisions for them.

Again I ask, are you willing to accept a payment for your services what the federal goverment determines to be R & C?

@retire: Physicians already have to accept payments which contract health insurance companies determine to be “reasonable and customary.” No, actually, it’s worst than that. “Reasonable and customary” is a quaint, old term from a bygone era. Today, prices for services are fixed/negotiated in advance. The provider agrees to accept as payment in full whatever the negotiated price is. The negotiated price is very often take it or leave it. It’s the same thing with Medicare, which is just another big insurance company. Providers can elect to be a participant or they can opt out and charge patients what they darn well wish, as long as the patient agrees to pay out of pocket. A lot of doctors and specialties have largely out of pocket practices. It’s the same way in Europe, by the way; i.e. there are parallel systems of health care.

The skyrocketing costs of health care in California as well as everywhere else have nothing to do with government regulation. The regulations haven’t changed, and yet the cost of insurance premiums is truly skyrocketing.

Pawlenty’s agreement with Obama that the solution to health care costs is shifting reimbursement to outcomes came from an interview I saw during the past week on either the PBS News Hour or ABC’s “This Week.” I’ll try to give you a link to the video.

P.S. “Professional Courtesy” is rapidly becoming as extinct as the panda. It’s the exception, rather than the norm. Typically, doctors bill the other doctors’ insurance, which, as explained, has a pre-set price for specific services. Sometimes they waive the co-pay, but, strictly speaking, this isn’t “legal,” according to both insurance contracts and Medicare law.

– Larry Weisenthal/Huntington Beach, CA

Larry, while it may seem prudent to look back at the glorious successes… in the opinion of some… of Romneycare, O’healthcare isn’t the same critter.

I actually took the time to download the 11 pg study. It does require registration, but it’s free. McKinsey & Co may complement some of your other journals and rags you also watch for the varied opinions.

This study isn’t done thru the spectrum of politics, but of business bottom line. And the final consensus is they will be opting out at considerably higher numbers than what was provided to, or determined by, the CBO because it is economically wise to do so.

This brings to fruition a uniquely odd form of truth to the Obama/Reid/Pelosi promises that the more you learn, the more you’ll love it. In the case of employers, the exodus out of ESI post 2014 grows with their awareness of the incentives, and proves to be a rational business decision for them, as well as their low income employees. Many of the 1300 companies/industries did say they may keep some ESI for a few chosen employees – to act as a Cadillac type plan incentive for attracting talent – and toss the rest to O’healthcare.

In other words, they’ll be off loading costs of employer insurance to fed expenses because of fiscal realities. And this presents a problem since the CBO numbers were only banking on about a 7% exodus.

From the study, and more indepth than the news article above:

• Overall, 30 percent of employers will definitely or probably stop offering ESI in the years after 2014.

• Among employers with a high awareness of reform, this proportion increases to more than 50 percent, and upward of 60 percent will pursue some alternative to traditional ESI.

• At least 30 percent of employers would gain economically from dropping coverage even if they completely compensated employees for the change through other benefit offerings
or higher salaries.

• Contrary to what many employers assume, more than 85 percent of employees would remain at their jobs even if their employer stopped offering ESI, although about 60 percent would expect increased compensation.

…snip…

As we have seen, a Congressional Budget Office report estimated that only 9 million to 10 million people, or about 7 percent of employees, currently covered by ESI would have to switch to subsidized exchange policies in 2014. Most surveys of employers likewise show relatively low interest in shifting employees from traditional ESI.

Our survey found, however, that 45 to 50 percent of employers say they will definitely or probably pursue alternatives to ESI in the years after 2014. Those alternatives include dropping coverage, offering it through a defined-contribution model, or in effect offering it only to certain employees. More than 30 percent of employers overall, and 28 percent of large ones, say they will definitely or probably drop coverage after 2014.

Our survey shows significantly more interest in alternatives to ESI than other sources do, for several reasons. Interest in these alternatives rises with increasing awareness of reform, and our survey educated respondents about its implications for their companies and employees before they were asked about post-2014 strategies. The propensity of employers to make big changes to ESI increases with awareness largely because shifting away will be economically rational not only for many of them but also for their lower-income employees, given the law’s incentives.

We also asked respondents questions about their philosophy and decision-making process or benefits: the current rationale for providing them, which employee group is considered most when decisions are made about them, their importance in the respondent’s industry, and geography. These questions prompted the respondents to consider all the factors that will influence their post-2014 decisions. Finally, we tested options beyond dropping overage outright. These alternatives will probably be the most effective ones for delivering reasonable return on a company’s investment in benefit programs after 2014. We would therefore expect to see a level of interest higher than that generated by surveys asking only about plans to keep or drop ESI.

…snip…

To prepare for 2014, employers should explore the economics of benefits after reform, maximize the return on investment (ROI) of benefit packages, design them for higher income employees, and satisfy the health and wellness needs of the whole workforce.

…snip…

Employers should recognize that as the ESI market changes after 2014, the system will react dynamically.If many companies drop health insurance coverage, the government could increase the employer penalty or raise taxes. Employers will need to be aware of actions by participants at any point along the health care value chain and prepare to adapt quickly.

Whether your company is poised to shift from employer-sponsored insurance or will continue to offer the same benefit package it does now, health care reform will change the economics of your workforce and benefits, as well as how your employees value coverage. Understanding these changes at a granular level will enable your company to gain or defend a competitive advantage in the increasingly dynamic market for talent.

What’s the problem? The more increased the enrollment in O’healthcare, the higher the federal outlay for the employer and employee subsidies… i.e. higher federal expenditures than planned, ergo less savings than promises. This is specifically why the report warns companies that is there is, indeed, the mass exodus, there may be increased penalties or taxes to pay for the increased federal expenditures.

oops on the numbers and planning, yes?

The Patient Protection and Affordable Care Act (PPACA)[1] offers subsidies for most individuals who purchase insurance in the newly created health insurance exchanges—a premium assistance subsidy and a cost-sharing subsidy. These subsidies are the most expensive component of the overhaul, costing over $460 billion by 2019. Perhaps even more problematic, they will cause significant and harmful disruptions far outside the health care system by discouraging work and further complicating the tax treatment of health insurance. The subsidies reinforce current tax code inequities and create new ones.

Now I realize that your focus has always been to provide some sort of coverage to all while mine has been limiting any kind of “reforms” to those that do not break the nation’s bank. Especially since our national piggy bank is nothing but a bunch of IOUs anyway.

Meanwhile, the amount of subsidies cannot remain under control because the real reason for out of control costs is not premiums, but the cost of the providers to administer health care.

In short, the problem has done nothing but transfer more health costs to the federal government via subsidies, who will then have to exercise price fixing on premiums and reduced payouts to providers in order to tighten the noose around the monster. There is no good that can come out of this save the rich will have cadillac plans, and the working class will have increasingly shaved down health care services in order to hold down the costs of the premiums.

Now, one has to wonder if providers can “opt out” of O’healthcare carriers, like they do Medicare/Medicaid. The system will then become overloaded, and quality of care will decline.

@mata: As I wrote, the same sorts of projections/predictions were offered regarding RomneyCare. The gloom and doom didn’t happen. Anyway, I think it’s a moot point. One way or the other, the best chance that we’ve ever had to develop a greatly improved health care system will have been lost. Either the GOP will kill it or the Roberts court will kill it. The enduring credit which Obama and the Dems will get is that they actually took it on and got something done. So it’s not something which can continue to be ignored. The ball will be in the court of the conservatives. Good luck hitting it in play.

– Larry Weisenthal/Huntington Beach, CA

Price fixing premiums and transferring costs to the feds in the way of subsidies isn’t “reform”, Larry. The genuine reform is to lower the cost of administering health care. We’ve been thru this, so it’s not much use in going over it.

You’re not going to believe the mass exodus until it happens, and I’m going to be kicking up my heels if it’s destroyed as unConstitutional. Then maybe we can actually beat Congress into real reform, and not nanny control over nsurance premium pricing.

The genuine reform is to lower the cost of administering health care.

I disagree entirely. Administrative costs are not at all out of line or out of control. It’s the actual costs of services and goods — physician’s fees, pharmaceutical costs, test costs, device costs, hospital costs (mostly facilities and labor). As I keep explaining, the fatal flaw in the system is that the sellers make the lion’s share of the buying decisions, in terms of total money spent. The way to reform is changing reimbursement structure to outcomes and not services. This is/was an integral part of ObamaCare.

Anyway, I’m sure that you guys will have your turn. As I said, Good Luck.

– Larry Weisenthal/Huntington Beach, CA

: Here’s a link to Pawlenty’s plan:

His ultimate proposal would base care payments on “better health care outcomes and better results”

Note that the progress to date with regard to Pawlenty’s reforms in Minnesota doesn’t necessarily compare favorably with what Romney has done in Massachusetts. Note also that his “ultimate proposal” (to shift payment from services to outcomes) is precisely the same as Obama’s long term strategy for controlling costs.

http://www.kaiserhealthnews.org/Stories/2011/May/26/California-Health-Line-Pawlenty-Health-Reformer.aspx

– Larry Weisenthal/Huntington Beach, CA

Oh, Larry, please, spare me. You reject my link to a Wall Street Journal article then give me some claptrap from Kaiser Health, a spin off of the Kaiser Family Foundation (or better known at the Kaiser Foundation) which is a far-left think tank and supports universal health care.

You also misread Mata’s statement of “administering health care” and took it to mean health care administration costs. And Tom thinks I am dumb?

Tell me, if Romneycare is so successful, why is its popularity dropping? In 2008, it had 69% approval. Now, according to a recent Suffolk University study, on 38% of Massachussets residents think the program is working, while 49% think it is not. Not to mention that Massachussets has some of the highest insurance premiums in the nation. Wait times for doctor’s office visits in getting longer (due to an increase in patients desiring services and no increase in physicians), and the plan that was supposed to reduce the number of people using emergency room services has not decreased due to long doctor office visit waits.

: I was simply giving you what you asked for — a link to prove the veracity of my statement that Pawlenty’s long term plan to contain health care costs is the same as Obama’s (shifting reimbursement from services provided to health care outcomes). This wasn’t an opinion piece (unlike the Wall Street Journal op-ed), but, no worries, here’s another link to the same thing. I know, you don’t like NPR either, but they are simply quoting the man and that’s what you asked for — a link to show that he said what I said he said:

As governor of Minnesota, Pawlenty backed a program that puts an emphasis on paying for efficient health care instead of rewarding health facilities that charge for what he calls “endless volumes of procedures.”

http://www.npr.org/2011/01/11/132815702/pawlenty-touts-minnesotas-lessons-on-health-care

Here’s a quote from a more acceptable source, possibly:

“instead of paying doctors and clinics and hospitals and providers for the volumes of procedures they perform, which is how we pay now, we want to pay them for better health care outcomes”

http://www.foxnews.com/story/0,2933,586085,00.html#ixzz1OjftcuWa

Since I am so dumb, could either you or Mata explain to me what she meant by “administering health care,” if she is not talking about health care administration?

Also, you are misinformed regarding the previous and current popularity of RomneyCare (see previous Blue Cross/Blue Shield Foundation report and see the following):

http://www.boston.com/news/politics/articles/2011/06/05/support_for_massachusetts_universal_health_care_law_rises/?rss_id=Boston.com+–+Top+political+stories

– Larry Weisenthal/Huntington Beach, CA

Larry: Since I am so dumb, could either you or Mata explain to me what she meant by “administering health care,” if she is not talking about health care administration?

“Administer” as in to bring into use or operation, to minister remedially, to furnish the benefit of, or to make application of. I used it in the sentence as a verb, not an adjective (as in “administration” department), Larry.

The cost of administering, or providing, health care as a hospital, clinic, doctor etal encompass all that comprises their base line overhead… cost of supplies, equipment, professionals, insurance, facilities, utilities, bureaucracy/accounting, etc. Some of the ways to reduce the costs have been addressed in O’healthcare, tho I find it offensive that companies need to be mandated by the federal government to go to digital records by an x date. I also find it even more offensive that, within that same mandate, is included their rights for sundry agencies to access to that privacy database. But that’s another story altogether…

When you bring down the cost of goods/service, you can bring down realistic premium prices, or the cost of paying for those goods/services, without it being detrimental to the quality of that service down line. Simple concept, really.

Don’t care about the “popularity” of RomneyCare. I care about Congress overstepping their Constitutional boundaries using the Commerce Clause, and their cheap bandaid over a problem that masks a cut well, but does nothing for disinfecting the wound. Price fixing premiums and simply making lower payouts for government adminstered/controlled healthcare – while the costs of providing/administering that service continue to skyrocket – does nothing to solve the problem. I’ve used the same analogy before to you, and evidently will have to again. If it costs me $20K to manufacture a car, and the government tells me I can only sell that car for $21K when they are paying for it out of taxpayer collected funds, I will not continue in business for long. Not unless I either cut out the government business clientele, or charge others (i.e. cost shifting) others more to make up the difference.

If I can lower my costs of production to $17K, than I may be able to subsist on that mandated high price I’m allowed to charge.

Conversely, if my costs to manufacture that car go up to $25K the next year, and the government tells me I can’t raise the price to accommodate for my increased overhead and, instead, cuts the payment to me, I’ll be out of business almost instantly. Or I will cease to have the government as a client in business self defense.

It’s the same fiscal reason that you decided not to offer your services to those on Medicare…. as have other doctors.

Price fixing is illegal except, I guess, when the government engages in that practice. But there is no instance I can think of where government should be able to mandate prices on services or goods provided by the private sector. Which is the prime reason they are trying to do a slow changeover to making it a public sector perk.

Coming from working in the Private Aircraft industry, my health insurance was taken straight out of my pre-taxed wages at about 30 bucks a week. All in all, that’s about 180 dollars a week to Insurance on my side of the balancing beam while Cessna picked up the rest of the tab. Thanks to good old Obamacare when it finally passed my COBRA rates while unemployed, went from 460 some dollars to 520 some dollars I had to pay out of pocket AFTER getting the so called COBRA “relief” program that cut my payment down 60 percent (The orginal bills were offending). My Blue Cross Blue Shield of Kansas payments whent from 146 dollars a month to 173 dollars a month due to the slow intergration of Obamacare (or The Healthcare Services Act, or whatever the offical name was on the letter Blue sent) and the company literally addressed the sections of the passed Bill where and why things are going up in price.

So yes, folks who think Obamacare will save money, keep drinking your suicide punch. It’ll taste fine till the end.

The fools, such as the Attorney who argues that for people to be exempt from the new Bill, want to encourage people into mass poverty… Here’s a question:

If the plan is to give mass coverage to all, decrease the price of “Healthcare”, not decrease the affordablity of “Healthcare”, and not wreck the economy then why is it being encouraged that people go into the deepest sections of the poverty pool to avoid the law?

The math, it doesn’t make sense if the very people you expect to take payment from doesn’t meet the quotas income wise to pay up. Fiscal suicide to be had here.

administer: 2a) be responsible for the implementation of (as in “the doctor administered an exam to determine injury). Perhaps Mata could have used the term “provide” instead, although I understood what she meant.

Really are thinskinned, aren’t you? I never said you were dumb. I said Tom thought I was dumb. Geeze, Larry, get a grip.

Mata, your points are excellent. There are a number of things that could help bring down health care costs, but the Democrats refused to do them. One is tort reform. Texas enacted tort reform, including medical tort reform, and the positive results manifested themselves almost immediately. Medical malpractice insurance rates dropped, doctor’s services also dropped in cost, rural communities that had a doctor shortage were seeing doctors, including specialists, move into their area.

Also, why not let doctors, hospitals and labs openly advertise their prices? If you have a choice between two state approved labs, and you need a blood test, one charges $125.00 and the other $100.00 which would you choose? Competition never increases cost, it lowers cost.

Also, many retirees maintain their health insurance as part of their retirement package. Due to the wisdom of a Democrat Congress, when you turn 65 Medicare becomes your primary, and they allowed the insurance companies to use the Medicare scales of payment for reimbursement. Your ESI then becomes your secondary, and you could still wind up with medical debt because your secondary is no longer covering at its original percentages. Again, the Congress tinkering with health care insurance has short changed the American public. Why not allow people to use Medicare as secondary insurance and keep their ESI as the primary? How much would that save?

Also, there is the matter of abuse of medical services, which is no small matter. I know many people with young children that rush their kids off to the doctor, or the ER, any time the kid sneezes. They don’t worry about the cost because they are covered by ESIs. Now, children are developing resistance to antibiotics because they have been perscribed antibiotics so often do to parents that doen’t know that rest, Tylenol and a little Vicks on the chest is the best medicine for the common cold.

Once again, your posts on this threat are stellar.

@retire05:

Medical malpractice insurance rates dropped, doctor’s services also dropped in cost, rural communities that had a doctor shortage were seeing doctors, including specialists, move into their area.

Your point about tort reform, and it’s effect on malpractice insurance is an important one. When I lived in Lake County, Illinois, we had five emergency neurosurgeons in the county, which is a large one, both in size and number of people and hospitals(it’s just north of Cook County, where Chicago is located). The medical malpractice insurance rates required to remain in operation in that field were enormous, hence the lack of surgeons available. At one point, there happened to be a very bad auto pileup on the interstate, and as three of the surgeons weren’t available at the time, it left only two, and there were more victims who needed their services than they could provide for. Several of the victims died, and it is unknown how many could have been helped at the time with more surgeons available. The copter trips to hospitals in neighboring counties, both in Illinois and southern WI took too long. This was an unfortunate side effect of the staggering costs of the medical malpractice insurance rates, brought on by the lack of any sort of limitations on malpractice suits. Several surgeons had moved to neighboring states in order to practice their profession due to the rates prior to this accident happening. Illinois, to my knowledge, still has not addressed the issue of tort reform, and probably won’t, considering the number of progressivist politicians in charge within the state.

@openid.aol.com/runnswim:

Several points;

One, I was initially simply making a true statement that some companies that provide health insurance coverage are dropping that portion of their business, as Obamacare makes it harder for them to do profitable business in the market. That never is a good thing, as more choices to the consumer always benefit the consumer, and vice versa. Whether or not some companies drop the benefit of health care coverage to their employees remains to be seen, however, one has to look at companies like McD’s, who requested a waiver, and wonder why they did so, if it wasn’t for the reason of continued coverage for their employees(those that rate it). My guess is that there will be some companies that drop that benefit, and the result will be an increasing burden upon everyone to provide them with coverage. Don’t you ever wonder why the progressives have stated that their end goal is a single-payer, government provided healthcare system? Tell me how that is a good thing.

Two, as Mata pointed out above, one really has to stretch the “commerce clause”, or look at it with extraordinarily wide latitude, in order to convince themselves that Obamacare falls under the purview of powers granted to Congress, and by extension, the federal government. I really hate repeating myself, as I have commented on this clause in previous topics, and the expansion of federal government power under it, in complete disregard to the original intent, as outlined within the Federalist Papers. You may choose to disregard those writings, however, it doesn’t change the fact that they were written in defense of the Constitution, as written, and supplied the original intent of nearly every questionable, or as you put it, ambiguous language, contained therein.

The continued disregard for the original intent of the clauses, phrases, sections and articles within the Constitution by politicians is responsible for the overreach of the federal government over the course of our country’s history. The Constitution is supposed to be the supreme law of the land, correct?

Article IV;

This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the Authority of the United States, shall be the supreme Law of the Land;

However, it cannot be held as a standard to which all other laws and regulations are compared to when the meanings of it’s contained clauses, phrases, paragraphs, etc., continue to be stretched to include items not meant within the original intent of them. At that point, there is no standard to compare to, and every law or regulation simply becomes the whims of men, and rule by law, which our nation was founded upon, dies.

Furthermore, the Constitution itself provides for changes to itself, and has been used over the years in a handful of cases, one even to correct the change. Why is this not done? It would be perfectly within the rights of congress, and the states, to enact an Amendment in order to expand the federal government’s powers, even to include such things as Obamacare. Why isn’t it done that way? Instead, congress, and the presidents, have continued to expand those powers by the continued disregard of the original intent of the clauses, phrases, paragraphs, etc., and argue, based on ever changing stated definitions of those clauses and such, in order to “progress” our country. UnConstitutional is unConstitutional, no matter how you look at it.

As an exercise, why don’t you explain to the readers here exactly how a mandate to engage in commerce, no matter if one wishes to or not, is allowed by the “commerce clause”. I will wait patiently for the explanation.

@John: Sorry I haven’t yet responded. I want to provide a thoughtful, well- researched reply, and I still intend to do so. Was going to do it last night, but fell asleep on the couch after dinner. It’s a real interesting topic, which does go to the core of the entire Left vs. Right debate. – Larry W/HB

@openid.aol.com/runnswim:

which does go to the core of the entire Left vs. Right debate.

It does do that, and is commonly represented as conservatives on the right seeing the document as exactly what it is, while the left tends to view it as a “living document”, to be changed and molded(the clauses and phrases) with the times, to fit the times. That they do so in disregard of the mechanism provided by it, for changing it, and instead rely on ever changing, or expanding definition of those clauses and phrases, in conflict with the original intent of them, is why many have problems with what they do. They, the left, have, in effect, changed the document from the supreme law of the land, by which all other laws and regulations are compared to, to that of a piece of paper that means relatively little as compared to when our nation was founded.

Imagine, if you will, a set of rules in a workplace. One rule, for example, disallows smoking within the enclosed building of the company. However, certain people are allowed to smoke cigars within the confines of their offices, and the company allows this, as the smoke itself is not a bother to others within the building, and is nearly completely contained within the office of the smoker. He, or she, does not have to go outside, in the heat of summer, or cold of winter, in order to get their fix of nicotine, like those who do not hold their own offices are forced to. A strict rule is broken, but is allowed to be flexible for certain people. In effect, the company has no strict workplace rules, but only guidelines that can be crossed, based on ones’ access to certain aspects of their job that allow them to be in non-compliance with the rules. This is what the left has made out of the Constitution. A set of guidelines, instead of it’s original intent of being a strict set of rules for the federal government to follow. As such, we, as a country, have devolved into the rule by the whims of men, without any standard, or limitations, placed upon them. And that being the case, the people with the most influence upon them, in many cases those with the most money to offer them, are the ones making the rules the rest of us must live by.

Without the Constitution being the standard, anything goes, and even the smallest excursion across the lines of limitations it sets takes the country further down that path. I, for one, do not wish to see it happen any more.

Not mentioned in here is the reliability (or lack thereof) of the company that made this prediction. The McKinsey Consulting firm is a hot-bed of impropriety. They produced Jeff Skilling, Enron former CEO doing Federal prison time, and their two current principals were 1) charged and 2) found culpable in the Galleon insider trading case. As management consultants, they may be recommending that their clients drop healthcare coverage, but that is not the same thing as validly predicting that it will happen in any particular percentage of companies.

@johngalt:

By this logic, it is illegal to require drivers to carry car insurance. Ah, but you say, one could choose not to drive a car, and then the government could not force you to purchase insurance. A faulty analogy – as currently constituted in the US, any health care facility cannot refuse to treat a sick person. As regards the health care system, each and every person ‘has a car’, and therefore must be insured. Congress has wide latitude to pass laws that do not infringe any provisions of the constitution. What clause would you suggest the individual mandate breaches?

@openid.aol.com/runnswim: I am so glad someone else has already said this. The ‘free market’ cannot be effective in driving down healthcare costs because consumers (i.e., patients) have no way of price comparing and evaluating the product. Buying a knee replacement is nothing like buying a car. Consumers aren’t even that good at buying cars, but at least they can compare features and prices rationally, if they choose to do so. Larry is about the only person who could intelligently decide which treatment to get, and where.

Economics folks=—-SUPPLY AND DEMAND.
There are not enough doctors.
Why not?
Because the doctors have a lock on the number of medical schools.
That’s the answer.
Nobody says it.
The AMA keeps new medical schools from being built.
The goal is to keep it an elite field.

I went to schools with doctors. They take one class in microbiology.
I was a microbiolgy major. I will never forget the fight I had with an
MD who told me to put gentamycin on my foot. I said I
would not use it. The doc asked why not. I said because I knew the
side effects and was a microbiologist. The doc seethed “I’m the doctor!:
I attended went to grad school with med students. They know a lot
about NOTHING.

That is the dirty little secret out there. There were 6 grad students in my
class and we were with about 100 med students. We even had separate
exams. We scientists had “think” questions. The docs had memorization
questions. They are glorified technicians. (sorry for the few docs that
are actual scientists, but you are the extreme minority)

I had four years of microbiology and here I was fighting with some
dufus with an MD about the side effects of a drug. The public
needs to use common sense with MDs.

I have a friend with cancer. She spoke of radiation and chemo.
I asked if she was making green drinks. She said “why?” I told
her blah blah blah from a natural health standpoint. She said why didn’t
her doctor tell her that? I said why should he….he gets paid for you to
be irratiated and chem treated. It’s common sense.

The system is set up so unless you use your common God-given sense
you are doomed. Go up against these people. They will lose their
power. Eat healthy. Eat raw food. You’ll see. Your pancreas
won’t have to work as hard either and fewer people will have diabetes.
And when did your doc tell you to eat raw that it would help control
your blood sugar? No…………………………………what’s in it for him?
Why would he tell you?

Hi Winston (#40): You are correct about one important point (I won’t comment on the rest). My graduating med school class at the U of Michigan had about 220 graduates (1975). Today, Michigan’s class size is only 170. It’s this way at many schools across the country. Why? In the late 70s, the AMA was worried about an impending “doctor glut” and lobbied to reduce med school admissions. Today we are paying the price. It takes no time at all to cut back, but it takes a huge amount of time to build back up.

– Larry Weisenthal/Huntington Beach, CA