The Sad Case of the Patient Protection and Affordable Care Act

[walrus]

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

If this tweet is to believed, more full timers going part time....

This will happen everywhere until Congress writes a law that says companies can't do that or they go single payer and it won't matter

[joecct]

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

If this tweet is to believed, more full timers going part time....

Sarah Nelson @sarahsside
Voting for 'revenge' has a price tag: @cr4z3d21 I'm working for Publix grocery, in 2013 they're cutting full timers & hiring part time only

[FreshFish]

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

So tell me again why we don't just go single-payer through an entity that inherently does not have a profit motive?

Administrative incompetence and lack of a viable alternative if they screw up.

[unofan]

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

Many self-insured risk pools are run merely to break even, which also makes them more affordable since you don't need to include a margin for profit.
...
Insurance companies are roughly like the house in Vegas: you smooth out any one individual's experience over the experience of a large number of people, pay out most of what you take in, and keep a relatively small amount as profit.

So tell me again why we don't just go single-payer through an entity that inherently does not have a profit motive?

[DrDemento]

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

Did she go to RPI? If so, I think she violated the 'tute Code of Conduct by kissing a Techer.

Back in the 60's when I was at RPI-there was nothing on campus like her. Most of what was there needed to have chromosomal testing to be sure they had 2 XX's.

[joecct]

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

Joe-Jenny sends a big kiss!

Did she go to RPI? If so, I think she violated the 'tute Code of Conduct by kissing a Techer.

[DrDemento]

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

Les & Jenny - for you (and any others I forgot)

*****https://sphotos-b.xx.fbcdn.net/hphotos-prn1/76260_10151150383841236_787146028_n.jpg******

Joe-Jenny sends a big kiss!

[FreshFish]

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

To me, self insure means that the entire risk is on the company, not palmed off to a 3rd party insurance agency.

Pretty close. Self-insure means your risk pool is limited to your own employees, and you have to pony up the excess claims cost or pocket the excess premium income (it is virtually impossible for premium income + investment income = claims outflow as rates are always set prospectively while claims are always incurred retrospetively, so to speak). Many times a "self-" insured entity will also have excess stop-loss coverage from a commercial insurer to protect against catastrophic claims experience. Many self-insured risk pools are run merely to break even, which also makes them more affordable since you don't need to include a margin for profit.

Insure with a separate insurance company means your risk pool is spread out over the insurance company's risk pool and in the short run the insurance company ponies up for excess claims or pockets excess premium income; however one year's experience (or rolling average of several years) becomes the basis for the subsequent year's premiums.

Insurance companies are roughly like the house in Vegas: you smooth out any one individual's experience over the experience of a large number of people, pay out most of what you take in, and keep a relatively small amount as profit.

In Scooby's model, he cannot forbid employers from offering insurance as that would run afoul of the First Amendment's right to free association; however we can sever the link between employer and employee generally throughout the economy while still allowing self-insured employers to offer coverage to their employees; it would merely be a slight reshuffling of paperwork under the aegis of the state insurance commissioner.

[leswp1]

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

les & jenny - for you (and any others i forgot)

*****https://sphotos-b.xx.fbcdn.net/hphotos-prn1/76260_10151150383841236_787146028_n.jpg******

stupic code won't let me smile!!

[joecct]

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

Not sure I know what self insure means. I'm saying we need to change the law so employers cannot under any circumstances provide Health Care. That way we can truly have a consumer based system. May actually drive some of the costs down.

To me, self insure means that the entire risk is on the company, not palmed off to a 3rd party insurance agency.

[joecct]

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

Les & Jenny - for you (and any others I forgot)

*****https://sphotos-b.xx.fbcdn.net/hphotos-prn1/76260_10151150383841236_787146028_n.jpg******

[FreshFish]

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

A new Obamacare requirement has just been implemented. If you run a small business, you now must submit to daily prostate exams, even if you are a woman.

[ScoobyDoo]

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

How would this affect companies that self-insure?

Not sure I know what self insure means. I'm saying we need to change the law so employers cannot under any circumstances provide Health Care. That way we can truly have a consumer based system. May actually drive some of the costs down.

[DrDemento]

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

Never treated someone who each day drank a case of pop, eh?

We did have a lady from Ireland who was an old time Irish whiskey maker. From the time she was a child she would take some profit by drinking a quarter of what she made each day and replacing it, diluting it to 100 proof, with water. We figured she averaged about 1-2 quarts per day of pure alcohol. When we treated her she was long retired from the business but still drinking about 1 quart of whiskey per day (starting at 6AM for breakfast). She often came into the office at 8AM completely toasted to the gills. I lost track of her so do not know how old she was when she died but I took the last skin cancer off her forehead when she was 98 years old!

[FlagDUDE08]

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

2050??? Holy cow-i would sell at that level and buy it back when you get her back down to the 150 range. In all seriousness in my 44 years in medicine i have not seen that level or even close to it without ketoacidosis.

Never treated someone who each day drank a case of pop, eh?