The PPACA - Implementation Phase I

[LynahFan]

Re: The PPACA - Implementation Phase I

It sounds like you are shifting the question, or perhaps there are just two different ways that the question was framed. One person framed the question as saying that if healthcare costs grow faster than the rate of inflation, there "must be" a problem. I responded to that question by saying "not necessarily."

You are raising a different question, which is healthcare costs as a percentage of GNP. You omit the impact of technological change and of productivity improvements: if we can perform basic services more efficiently (using tractors and harvesters instead of hoes and scythes), we can feed more people more cheaply than before. A portion of those savings can then be used to finance greater discretionary healthcare spending.

In this example, healthcare spending is growing faster than the economy as a whole because gains in one part are financing spending in another part. We don't necessarily need the entire economy to be growing faster in aggregate, we merely need continued innovation and productivity improvements. A certain part of the growth in the economy comes from population growth. What we REALLY need is for the growth of the economy to exceed the growth in the population. THAT is the single key metric that drives the rest.

You're right - should be framing this on a per capita basis to normalize for population growth, and you're right that I'm assuming that the Fed roughly does its job so that the rate of inflation is not terribly different from GDP growth rate.

I'm definitely not sold on your technology/productivity point, though. I think there are currently ~9 milllion people (3% out of 300M) involved in agriculture (don't quote me on that, but let's go with it for now). What if our farming became so efficient that only 1M people were needed to supply food for the entire country? If food prices (initially) remained the same, then those 1M people would be raking in all of the profits that used to be distributed among 9M people, and the total size of the economy would not change. However, there are now 8M people out of work, who have less purchasing power. They'll scrimp and save - and buy less food than before - so the demand for food will fall and the 1M remaining producers will have to lower their prices. All else being equal, then, the net size of the economy will shrink, not grow.

[FreshFish]

Re: The PPACA - Implementation Phase I

I'm definitely not sold on your technology/productivity point, though. I think there are currently ~9 milllion people (3% out of 300M) involved in agriculture (don't quote me on that, but let's go with it for now). What if our farming became so efficient that only 1M people were needed to supply food for the entire country? If food prices (initially) remained the same, then those 1M people would be raking in all of the profits that used to be distributed among 9M people, and the total size of the economy would not change. However, there are now 8M people out of work, who have less purchasing power. They'll scrimp and save - and buy less food than before - so the demand for food will fall and the 1M remaining producers will have to lower their prices. All else being equal, then, the net size of the economy will shrink, not grow.

Reminds me of a famous story, I wish I could remember which economist told it. I think his last name starts with a Z. Maybe we should shift to the Business & Economics thread for it? I'll post it later.

[Rover]

but that's NOT how health insurance worked, pre-PPACA. ALL new employees at a company can enroll in the health insurance plan when they are first hired, regardless of pre-existing conditions. For the Federal government insurance program, ALL existing employees, during an open enrollment window, can switch health insurance companies if they want, regardless of pre-existing conditions.

You stated something that is demonstrably not true.

One of the biggest problems has been that employer-sponsored insurance, association-sponsored insurance, and insurance offered to individuals have all operated under different sets of rules. We certainly did NOT need PPACA to rectify that situation.

Fishy you're missing the point. Lets say you have a pre-existing condition (you beat cancer in the past or have high blood pressure, etc). Yes, there's a chance if you get hired at a company you can get coverage when you enroll for next year's coverage. The problem which you're either being disingenous or stupid about is if you aren't fortunate enough to get a new job. What is your solution to that little issue, especially when you consider how many people 1) go through periods of unemployment, 2) work for themselves, or 3) work for companies that don't offer coverage. Many people have to leave the workforce to deal with an injury. What would you do with them?

[Rover]

Re: The PPACA - Implementation Phase I

Hey remember when knuckledraggers were trying to tell us that doctors were all ditching Medicare patients? Turns out that was BS. Yet another example of why conservatives have the credibility and popularity of a steaming pile of turds....

http://www.thefiscaltimes.com/Column...ching-Medicare

[FreshFish]

Re: The PPACA - Implementation Phase I

Fishy you're missing the point. Lets say you have a pre-existing condition (you beat cancer in the past or have high blood pressure, etc). Yes, there's a chance if you get hired at a company you can get coverage when you enroll for next year's coverage. The problem which you're either being disingenous or stupid about is if you aren't fortunate enough to get a new job. What is your solution to that little issue, especially when you consider how many people 1) go through periods of unemployment, 2) work for themselves, or 3) work for companies that don't offer coverage. Many people have to leave the workforce to deal with an injury. What would you do with them?

I've already answered this question more than once. You just choose not to listen because you have your preferred narrative and no amount of data or evidence to the contrary will be allowed to threaten your zealous belief that you've found your Savior. There's no point in responding to you any further since you refuse to listen to a reasonable alternative.

If anyone else, new to the discussion, wants a practical, workable answer to Over's question, and doesn't feel like scrolling backwards to find it, just let me know and I'll answer you. I've had it with him. His disconnect from reality has finally worn out my patience.

[joecct]

Re: The PPACA - Implementation Phase I

Going to cross post this on the GWOT part IV thread

If you gave the administration a choice between PPACA and Syria, which one would they choose?

[unofan]

Re: The PPACA - Implementation Phase I

Going to cross post this on the GWOT part IV thread

If you gave the administration a choice between PPACA and Syria, which one would they choose?

Is that a serious question? Because that's like asking, "If you had a choice between sex with a supermodel or dying a slow, painful death, which would you choose?"

[FreshFish]

Re: The PPACA - Implementation Phase I

Because that's like asking, "If you had a choice between sex with a supermodel or dying a slow, painful death, which would you choose?"

Given some of his speeches lately, it sounds like Obama might choose "death by having sex with the supermodel so frequently that he'd expire from exhaustion."

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

Oh, but nothing will change with employment.

http://news.investors.com/politics-o...hours-jobs.htm

[Rover]

Re: The PPACA - Implementation Phase I

Apparently not Flaggy!

http://economix.blogs.nytimes.com/20...s&emc=rss&_r=1

[joecct]

Re: The PPACA - Implementation Phase I

Trader Joe's explanation of why they are dropping health insurance for part time employees

Thank you for writing to us. It's possible you have been misled, at least to some degree, by the headlines in some articles regarding our reasons for implementing the [Affordable Care Act] in January. We'd like to take this opportunity to clarify some facts.

For over 77% of our Crew Members there is absolutely no change to their healthcare coverage provided by Trader Joe's.

The ACA brings a new potential player into the arena for the acquisition of health care. Stated quite simply, the law is centered on providing low cost options to people who do not make a lot of money. Somewhat by definition, the law provides those people a pretty good deal for insurance ... a deal that can't be matched by us -- or any company. However, an individual employee (we call them Crew Member) is only able to receive the tax credit from the exchanges under the act if we do not offer them insurance under our company plan.

Perhaps an example will help. A Crew Member called in the other day and was quite unhappy that she was being dropped from our coverage unless she worked more hours. She is a single mom with one child who makes $18 per hour and works about 25 hours per week. We ran the numbers for her. She currently pays $166.50 per month for her coverage with Trader Joe's. Because of the tax credits under the ACA she can go to an exchange and purchase insurance that is almost identical to our plan for $69.59 per month. Accordingly, by going to the exchange she will save $1,175 each year ... and that is before counting the $500 we will give her in January.

While we understand her fear of change, at her income level this is a big benefit that we will help her achieve.

Clearly, there are others who will go to the exchanges and will be required to pay more. That is usually because they have other income and typically a spouse who had a job with no benefits and they do not qualify for the subsidies under the ACA.

One example of that we had yesterday was the male Crew Member who worked an average of 20 hours per week but had a spouse who is a contract consultant who makes more than $200,000 per year. The Crew Member worked for the medical benefits and unfortunately for them they are likely to have to pay more because of their real income. We understand how important healthcare coverage is to our Crew Members and we are pleased to be able to provide and support this program.

We do hope this information helps, and we appreciate your interest in Trader Joe's.

[Rover]

Re: The PPACA - Implementation Phase I

Yeah I don't think Trader Joe's is being a bad guy in all of this. They seem to actually be working with the people to make sure they have health insurance. Its a far cry from the pathetic Papa John's excuse that he'd have to charge 10 more cents for every pizza.

[joecct]

Re: The PPACA - Implementation Phase I

Yeah I don't think Trader Joe's is being a bad guy in all of this. They seem to actually be working with the people to make sure they have health insurance. Its a far cry from the pathetic Papa John's excuse that he'd have to charge 10 more cents for every pizza.

Except for the part timer who's spouse (can't say wife these days) makes $200K. They're going to pay through the nose.

[LynahFan]

Re: The PPACA - Implementation Phase I

Just heard a piece on NPR where someone (missed who) suggested that the Republicans were going to set "delay of the PPACA" as the price of the debt ceiling increase. I can't even begin to count the ways that this is monumentally stupid, but it's not even consistent. If you really believe that:

1. The PPACA is horrible and will lead to all kinds of bad things
2. It's the Democrats' fault and they'll be punished at the polls once people see all the bad things happening

then why on earth would you want to let the Democrats off the hook by delaying the law and giving Obama more time to get things implemented? Logically (I know, I know, we're talking about House Republicans, here), they should want the entire PPACA implemented ASAP so voters can get good and ferverous over it by the time the 2014 (and especially 2016) elections roll around.

[Rover]

Just heard a piece on NPR where someone (missed who) suggested that the Republicans were going to set "delay of the PPACA" as the price of the debt ceiling increase. I can't even begin to count the ways that this is monumentally stupid, but it's not even consistent. If you really believe that:

1. The PPACA is horrible and will lead to all kinds of bad things
2. It's the Democrats' fault and they'll be punished at the polls once people see all the bad things happening

then why on earth would you want to let the Democrats off the hook by delaying the law and giving Obama more time to get things implemented? Logically (I know, I know, we're talking about House Republicans, here), they should want the entire PPACA implemented ASAP so voters can get good and ferverous over it by the time the 2014 (and especially 2016) elections roll around.

Stop being a traitor to the cause !

Opposition to the PPACA kinda reminds me of opposition to gay marriage, which also was supposed to lead to the end of civilization as we know it, or at least to people marrying their pets. When it actually started being legalized, and not only did the world continue to exist but it changed very little for most people, the doomsayers looked pretty dumb. If you want a non-political example, Y2K certainly qualifies.

So, if Obamacare gets up and running and cannibalism doesn't result, I'm not sure what the right is going to do for an encore.