The Sad Case of the Patient Protection and Affordable Care Act

[WeWantMore]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Not only that but Obamacare is exactly that, collaboration between government and business.

Yes, exactly. For all the discussion about the evils of Big Pharma in the SCOTUS thread, Obamacare doesn't exactly bring them to heel.

In fact, quite the opposite:

"Pharma came out of this better than anyone else," said Ramsey Baghdadi, a Washington health policy analyst who projects a $30 billion, 10-year net gain for the industry. "I don't see how they could have done much better."

Costly brand-name biotech drugs won 12 years of protection against cheaper generic competitors, a boon for products that comprise 15 percent of pharmaceutical sales. The industry will have to provide 50 percent discounts beginning next year to Medicare beneficiaries in the "doughnut hole" gap in pharmaceutical coverage, but those price cuts plus gradually rising federal subsidies will mean more elderly people will purchase more drugs.

Lobbyists beat back proposals to allow importation of low-cost medicines and to have Medicare negotiate drug prices with companies. They also defeated efforts to require more industry rebates for the 9 million beneficiaries of both Medicare and Medicaid, and to bar brand-name drugmakers' payments to generic companies to delay the marketing of competitor products.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Let me introduce you to the concept of supply and demand. Supply and demand, Rover. Rover, supply and demand. I think you two will get along well. Cocktail, anyone?

And in today's workforce, (by and large) Supply >>>>> Demand. So if you eliminate employer sponsored coverage, employers now have a lot more money lying around. The concept it seems out of some people is that they'll altruistically kick that back to their employees. I'm saying based on what? Corporations' long standing track record of doing things solely for the benefit of mankind? Maybe in Fantasyland, where borrowing money for tax cuts for wealthy campaign contributors decreases the deficit and divorce is eliminated because gays aren't allowed to marry, but not in reality.

[MinnFan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Why do you think it would drive up wages? Why wouldn't employers just keep people at the same wages they're used to getting, and then keep the rest for themselves?

How about I amend it to say, it would more likely than not drive up wages. If company A wanted to just keep the money and be taxed on it and company B wanted to improve their workforce so they raised wages how many employees leaving do you think it would take before company A raised their wages.

It goes along the lines of why doesn't every compnay just pay everyone the minimum wage. Not saying it would be a complete 1 for 1 tradeoff, but it would get rid of the 3rd party payor system which I believe is the biggest driver of cost increases in health care and over time be a net benefit to everyone.

[LynahFan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

And in today's workforce, (by and large) Supply >>>>> Demand. So if you eliminate employer sponsored coverage, employers now have a lot more money lying around. The concept it seems out of some people is that they'll altruistically kick that back to their employees. I'm saying based on what? Corporations' long standing track record of doing things solely for the benefit of mankind? Maybe in Fantasyland, where borrowing money for tax cuts for wealthy campaign contributors decreases the deficit and divorce is eliminated because gays aren't allowed to marry, but not in reality.

MinnFan has it right - in order for wages to stay the same in your scenario, every single company out there would have to independently decide that the best thing to do with that money is to pay higher dividends or to invest in their infrastructure or to buy other companies (which are also now sitting on "piles of cash" which would still need to be invested somewhere). But if even a few companies said to themselves, "you know, another thing that we could do with this extra money is to upgrade the quality of our workforce by raising wages," that would kick off a wave of salary increases across the board. In order for your scenario to come true, 99% of companies would have to decide not to raise wages - the probability that all companies are going to act in this same way is zero.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

How about I amend it to say, it would more likely than not drive up wages. If company A wanted to just keep the money and be taxed on it and company B wanted to improve their workforce so they raised wages how many employees leaving do you think it would take before company A raised their wages.

It goes along the lines of why doesn't every compnay just pay everyone the minimum wage. Not saying it would be a complete 1 for 1 tradeoff, but it would get rid of the 3rd party payor system which I believe is the biggest driver of cost increases in health care and over time be a net benefit to everyone.

Much like tax cuts for the rich, your scenario only makes sense if there's two choices. 1) Pay employees more, or 2) keep the cash and pay higher taxes on earnings as there's less expense.

What it completely ignores is that there's other thing to do with those proceeds. Namely increasing shareholder value (you know, the people who actually own the company). They tend to like higher returns, and will want either a share buyback or higher dividends. Might I suggest they'll demand it. While this isn't a bad thing, and it benefits the shareholders tremendously, the avg worker ain't seeing a big raise. I'm not sure what about that you and Lynah are having trouble comprehending. Company management exists to benefit ownership first and foremosts, not employees.

Next to Lynah's assertion, you don't need collusion amongst 99% of companies to hold down wages. All you need is to be dictated by the same forces you always are when deciding what to pay the staff, which is availability of workers. Apple right now is sitting on $1Bn in cash reserves. Did they decide to A) kick that to the employees in the form of higher salaries, or B) pay a dividend? (I'll save you a search, the answer is B). So, while I tend to disagree with many of your postings, I never considered you to be an idiot. That's why I'm confused about your stance here. Companies will act in the interests of ownership instead of employees if they receive a windfall from not having to pay health insurance. For that reason, little of these profits will funnel back to their workers.

[MinnFan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Good read on a doctor's perspective of Obamacare

Insurance doesn't equal care

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Good read on a doctor's perspective of Obamacare

Insurance doesn't equal care

Thanks for posting that. Very interesting read. and some real solutions too, not just kvetching!

There wouldn’t even be a case before the Supreme Court if Congress and the president had stayed within their roles and expanded the National Health Services Corp and federal clinics expressly designed to care for the underserved. If there is a public health care need then let's get our government to provide for it directly.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Good read on a doctor's perspective of Obamacare

Insurance doesn't equal care

Oh, but that's Fox Snooze! It can't be credible!

That link has made the most sense of just about everything in here.

[MinnFan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Much like tax cuts for the rich, your scenario only makes sense if there's two choices. 1) Pay employees more, or 2) keep the cash and pay higher taxes on earnings as there's less expense.

What it completely ignores is that there's other thing to do with those proceeds. Namely increasing shareholder value (you know, the people who actually own the company). They tend to like higher returns, and will want either a share buyback or higher dividends. Might I suggest they'll demand it. While this isn't a bad thing, and it benefits the shareholders tremendously, the avg worker ain't seeing a big raise. I'm not sure what about that you and Lynah are having trouble comprehending. Company management exists to benefit ownership first and foremosts, not employees.

Next to Lynah's assertion, you don't need collusion amongst 99% of companies to hold down wages. All you need is to be dictated by the same forces you always are when deciding what to pay the staff, which is availability of workers. Apple right now is sitting on $1Bn in cash reserves. Did they decide to A) kick that to the employees in the form of higher salaries, or B) pay a dividend? (I'll save you a search, the answer is B). So, while I tend to disagree with many of your postings, I never considered you to be an idiot. That's why I'm confused about your stance here. Companies will act in the interests of ownership instead of employees if they receive a windfall from not having to pay health insurance. For that reason, little of these profits will funnel back to their workers.

Then why don't they just cut everyones' salary in half right now?

The money where the wage increase would come from is already there. It just goes to two different places right now. Salary and Benefits. I'm not saying that it all absolutely will go to the employee. I'm sure there would be companies who spend it on something else. My bigger point is that the system needs to change and this is best way I can see going forward. Perfect is the enemy of good.

I'm open to any suggestions you may have.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

And in today's workforce, (by and large) Supply >>>>> Demand.

Sorry, the work force is far more fragmented than that. There are a substantial number of good-paying jobs that are going unfilled because they require specialized skill sets (I've seen these stories so many times in so many places that I'm not going to post a link; there are plenty of them around).

Also, you write as if the only employers out there are large, publicly-traded companies. Many of us work for smaller, closely-held businesses in which the owners and the employees work together all day every day. We have a formula-based bonus pool that aligns employee incentives with corporate profitability: if our company makes more money, all of us participate too.

You seem to think too much in abstractions sometimes, it appears. The economy is more diverse and more fragmented than there appears to be room for in your black-white good-evil world view (at least as you present it here).

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Sorry, the work force is far more fragmented than that. There are a substantial number of good-paying jobs that are going unfilled because they require specialized skill sets (I've seen these stories so many times in so many places that I'm not going to post a link; there are plenty of them around).

Also, you write as if the only employers out there are large, publicly-traded companies. Many of us work for smaller, closely-held businesses in which the owners and the employees work together all day every day. We have a formula-based bonus pool that aligns employee incentives with corporate profitability: if our company makes more money, all of us participate too.

You seem to think too much in abstractions sometimes, it appears. The economy is more diverse and more fragmented than there appears to be room for in your black-white good-evil world view (at least as you present it here).

Your first point is an irrelavent tangent. Try to stay on topic please if that's within your abilities.

Your next point is very simplistic. Publicly held or privately held, company management operates for the benefit of ownership. That's fundamental capitalism. If you want all benefits to flow to the workers, that's communism. Whether your small, private company is run by the owners or they hired someone to run it, bottom line is the majority of proceeds in most companies are either 1) going to the owners, or 2) invested in the business. Profit sharing is real, but ask yourself how much of the profit does your share come out to be? Probably not alot. The people who own the company expect the biggest benefits from its success.

Minn, don't you think a lot of companies have already figured out what the going wage is for the line of work they do, and are paying workers accordingly? So, they can't cut wages in half because that's lower than "market value". What you're suggesting is companies with money will willingly pay way more than market value if they make more money. Suggest that as a manager to the board of directors and you will be fired. Apple could start paying its people that extra billion they have in reserve. Instead its being distributed via dividends? Why? Management doesn't work for the employees. It works for the owners.

PS - What I'm addressing here is the fantasy that all, most, or even half of these savings will go to employees. I'll be happy to discuss the broader health care market with you, but my comments thus far are strictly to debunk the notion of a huge worker payday.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Your first point is an irrelavent tangent. Try to stay on topic please if that's within your abilities.

gratuitious insults are not conducive to constructive dialog. also, who made you arbiter of what topics we "must" remain limited to?

I'd like to close by saying "typical progressive" but that would lower me to your level of pettiness....

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Your first point is an irrelavent tangent. Try to stay on topic please if that's within your abilities.

First off, I hate people that preach about their education and type with spelling and grammatical errors. Granted, I've been known to use British spelling on here, but it's still acceptable in Scrabble.

You don't want to acknowledge that as a point because it doesn't fit your argument. What's wrong with someone going through appropriate college or vocational training to earn the necessary requirements to fill a job in demand?

Also, you seem to have an issue with the stock market. Why can't you invest? It's a lot easier with the advent of technology. There are plenty of discount brokers out there, some willing to allow you a trade at as low as a $3 commission!

[LynahFan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Minn, don't you think a lot of companies have already figured out what the going wage is for the line of work they do, and are paying workers accordingly? So, they can't cut wages in half because that's lower than "market value". What you're suggesting is companies with money will willingly pay way more than market value if they make more money. Suggest that as a manager to the board of directors and you will be fired. Apple could start paying its people that extra billion they have in reserve. Instead its being distributed via dividends? Why? Management doesn't work for the employees. It works for the owners.

The part you're ignoring is that under the proposed scenario, the "market value" of an employee would drastically change. Nobody is suggesting that companies would willingly pay more than market value. We're suggesting that the market value of employees (measured in dollars) would increase.

Believe me - I absolutely know first hand that companies will only pay as much as they have to in order to keep their turnover rate to an acceptable level. But if every company were suddenly handed 20% of their payroll in extra cash, it's pretty naive to think that no company would increase wages. As soon as the first company does it, then their competitors will find their tunover rate to be unacceptable and have to respond accordingly. No, they wont "want" to do it (as your example of Apple shows), but they would be forced to do it due to the changing market. Your Apple example is non-informative, because you're comparing Apple's actions to the current market, not what Apple would do in the revised market.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

The part you're ignoring is that under the proposed scenario, the "market value" of an employee would drastically change. Nobody is suggesting that companies would willingly pay more than market value. We're suggesting that the market value of employees (measured in dollars) would increase.

Believe me - I absolutely know first hand that companies will only pay as much as they have to in order to keep their turnover rate to an acceptable level. But if every company were suddenly handed 20% of their payroll in extra cash, it's pretty naive to think that no company would increase wages. As soon as the first company does it, then their competitors will find their tunover rate to be unacceptable and have to respond accordingly. No, they wont "want" to do it (as your example of Apple shows), but they would be forced to do it due to the changing market. Your Apple example is non-informative, because you're comparing Apple's actions to the current market, not what Apple would do in the revised market.

I think I agree with you, if you meant to say that "while the 'market value' of an employee would not change, the way that companies express that market value would change: less of that unchanged market value would be paid in the form of fringe benefits and more of that unchanged market value would be paid in cash compensation."

Which is the exact same process in reverse that got us into this whole mess to begin with!!

During WWII, there were wage - price controls, while fringe benefits were not subject to the wage cap. and so employers used increased fringe benefits as a way to offer higher 'market value' when the federal government made it illegal to offer that market value in wages.