The PPACA Implementation Phase II - Love it or Lose it!

[Foxton]

Re: The PPACA Implementation Phase II - Love it or Lose it!

ah son, this is america.

if you want to measure in millimeters, go to france!

Or pretty much any company that isn't the USA.

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

There is always rationing, for everything.

The typical method is to ration by price. Some people don't like that. and so they force us all to endure rationing by time instead.

Rationing by time might be okay for some things, but in healthcare? Seriously? I have a minor skin rash that starts to appear, I see the dermatologist in a week, he gives me a cream, and it goes away. I have a minor skin rash, I see the dermatologist in two months, and by then it has spread over half my body. that is not a good way to operate a healthcare system, IMHO

 

[Priceless]

There is always rationing, for everything.

The typical method is to ration by price. Some people don't like that. and so they force us all to endure rationing by time instead.

Rationing by time might be okay for some things, but in healthcare? Seriously? I have a minor skin rash that starts to appear, I see the dermatologist in a week, he gives me a cream, and it goes away. I have a minor skin rash, I see the dermatologist in two months, and by then it has spread over half my body. that is not a good way to operate a healthcare system, IMHO

No, it's much better to ration by price so you can't even afford to go to the dermatologist at all and show up at the ER when the rash spreads all over your body.

 

[mookie1995]

No, it's much better to ration by price so you can't even afford to go to the dermatologist at all and show up at the ER when the rash spreads all over your body.

I can afford it

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

No, it's much better to ration by price so you can't even afford to go to the dermatologist at all and show up at the ER when the rash spreads all over your body.

says the person whose own life was saved by timely medical intervention.

Somehow I seriously doubt that in your own life you'd have been fine waiting for months rather than weeks for treatment....or just have shrugged meekly when you found out that the specialists who had been providing your care suddenly were no longer part of your provider network.....

 

[DrDemento]

Re: The PPACA Implementation Phase II - Love it or Lose it!

says the person whose own life was saved by timely medical intervention.

Somehow I seriously doubt that in your own life you'd have been fine waiting for months rather than weeks for treatment....or just have shrugged meekly when you found out that the specialists who had been providing your care suddenly were no longer part of your provider network.....

Or the provider that finally did see him was not a trained physician who attended and studied in a medical school for four years, did a one year internship, spent 3 years in training at a teaching hospital as a resident and had 5-20 years experience. But there are wsome who want us to beleive that all medical care-any medical care-it is all the same.

 

[Priceless]

says the person whose own life was saved by timely medical intervention.

Somehow I seriously doubt that in your own life you'd have been fine waiting for months rather than weeks for treatment....or just have shrugged meekly when you found out that the specialists who had been providing your care suddenly were no longer part of your provider network.....

When it comes to urgent medical assistance, like say a massive tumor growing inside your skull, the system works. Fortunately I had insurance when it happened so I didn't get handed a bill for $160K+ when all was said and done.

However, if it had happened 54 weeks earlier, I would have had no insurance. I might not have been willing to go to the hospital in the first place, knowing it would cost me $500+ out of pocket (which I didn't have) just to walk in the door, and I might very well have died that afternoon - still thinking it was just food poisoning.

 

[mookie1995]

When it comes to urgent medical assistance, like say a massive tumor growing inside your skull, the system works. Fortunately I had insurance when it happened so I didn't get handed a bill for $160K+ when all was said and done.

However, if it had happened 54 weeks earlier, I would have had no insurance. I might not have been willing to go to the hospital in the first place, knowing it would cost me $500+ out of pocket (which I didn't have) just to walk in the door, and I might very well have died that afternoon - still thinking it was just food poisoning.

could have been like every uninsured now and just show up at mass general (which is where you were taken care of!! much ado about nuttin' )

 

[SJHovey]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I was reading the Las Vegas R-J (because candidly, if you're going to read a daily newspaper for entertainment purposes, it's hard to go wrong with Las Vegas'), and I saw this article. http://www.reviewjournal.com/politics/own-small-business-brace-obamacare-pain

It struck me because that is exactly what happened to my business.

My business is apparently one of the small percentage that doesn't renew in November or December. Our renewal comes up now, in May. We've been working with our broker. We got our quotes last week.

Now, I should disclose that my company is probably one of the few still around that pays the entire premium for the employee coverage. We've done that primarily to keep good employees with us, and it's worked. If they want their families covered, they have to pick up the premium for the additional coverage.

Our quote this year is for a premium increase of 49%.

I'll be blunt with you, we're debating whether to continue. Right now we've got the broker working with the employees. I'd say there is probably an 80-90% chance we just drop the coverage for the employees entirely. First, we can't take that hit. Second, that will be a big hit for the employees who have elected family coverage. Maybe we throw a little extra pay at them to help with their coverage. The broker tells us that a number of the employees will likely qualify for subsidies on the exchange, and in some cases, significant subsidies.

I'll be interested to gauge the reaction of our employees when we do this. My guess is they will initially be unhappy with us, as opposed to the President or anyone else. Whether that translates at the voting booth or not is questionable to me.

But I thought I would pass along at least one piece of anecdotal evidence from a small business owner. If my experience is the norm for similarly situated businesses, it seems pretty clear there's going to be a shifting in the small business area from employer covered insurance to insurance (and subsidies) on the exchange.

 

[unofan]

I was reading the Las Vegas R-J (because candidly, if you're going to read a daily newspaper for entertainment purposes, it's hard to go wrong with Las Vegas'), and I saw this article. http://www.reviewjournal.com/politics/own-small-business-brace-obamacare-pain

It struck me because that is exactly what happened to my business.

My business is apparently one of the small percentage that doesn't renew in November or December. Our renewal comes up now, in May. We've been working with our broker. We got our quotes last week.

Now, I should disclose that my company is probably one of the few still around that pays the entire premium for the employee coverage. We've done that primarily to keep good employees with us, and it's worked. If they want their families covered, they have to pick up the premium for the additional coverage.

Our quote this year is for a premium increase of 49%.

I'll be blunt with you, we're debating whether to continue. Right now we've got the broker working with the employees. I'd say there is probably an 80-90% chance we just drop the coverage for the employees entirely. First, we can't take that hit. Second, that will be a big hit for the employees who have elected family coverage. Maybe we throw a little extra pay at them to help with their coverage. The broker tells us that a number of the employees will likely qualify for subsidies on the exchange, and in some cases, significant subsidies.

I'll be interested to gauge the reaction of our employees when we do this. My guess is they will initially be unhappy with us, as opposed to the President or anyone else. Whether that translates at the voting booth or not is questionable to me.

But I thought I would pass along at least one piece of anecdotal evidence from a small business owner. If my experience is the norm for similarly situated businesses, it seems pretty clear there's going to be a shifting in the small business area from employer covered insurance to insurance (and subsidies) on the exchange.

I'm curious if your broker told you why it was going up that amount.

 

[SJHovey]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I'm curious if your broker told you why it was going up that amount.

He didn't have a real good explanation for it. Basically his comment was, "it's happening to everyone." He also pointed out, correctly, that we do have an older workforce. Candidly, my opinion was that he didn't know.

 

[Handyman]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Not to make light of your situation, but dont we all agree things would be better if people didnt use work as a source of their health care coverage anyways? Havent most of us on both sides been saying that for years? If your employees can get a better rate by joining the exchanges I guess I dont see the problem. (for them not you obviously)

Also please remember I hate the ACA and have since it was first announced.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I'm more concerned about the broker's possible lack of knowledge. In that I mean is he aware of the subsidies, etc that are offered? Given the comments Hovey has relayed here, I'm not convinced that he is and that was pretty much the #1 reason ACA horror stories ended up getting debunked after they went public. People were looking at how much they're premiums would go up but weren't considering what subsidies they qualified for. Not sure how this works for businesses however.

 

[SJHovey]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I'm more concerned about the broker's possible lack of knowledge. In that I mean is he aware of the subsidies, etc that are offered? Given the comments Hovey has relayed here, I'm not convinced that he is and that was pretty much the #1 reason ACA horror stories ended up getting debunked after they went public. People were looking at how much they're premiums would go up but weren't considering what subsidies they qualified for. Not sure how this works for businesses however.

He's well aware of the subsidies. He understands how the system works. In fact, he is telling us we should just cut the employees loose in terms of group health insurance, even though it will cost him business. He's even offered to sit down with our employees and help them try to get enrolled through the exchange. Basically, what he has told us, and will tell them, is that most of them will likely be entitled to some sort of subsidy. That means that when the total cost of their individual coverages are added together, after subsidies, he expects it to be significantly lower than what our collective group cost will be.

One of the things we have talked about is basically giving the employees a bump in pay to help them cover this extra cost. But, of course, each employee's cost may be slightly different. And going forward we won't really have any knowledge of what each employee sees for increases, and candidly, don't want to undertake the time and hassle of keeping track of that.

And we get to the issues of subsidies. That money has to come from somewhere. I'm sure some small, incremental slice of it is ultimately paid by me and others paying taxes.

I'm just reporting our personal experience. We can debate whether it's good or bad to shift our relatively small business from one where the employer picked up 100% of health insurance, to one where the employees each buy their own, possibly with a subsidy, and possibly with a subsidy from us the employer.


Edit: I do agree with Handy. If we could go back in time and prevent the connection between employment and health insurance I think this country would be a vastly better place. Unfortunately, I have to do business in the circumstances that we live in, and that has meant offering health insurance as a carrot to come work for me.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

He's well aware of the subsidies. He understands how the system works. In fact, he is telling us we should just cut the employees loose in terms of group health insurance, even though it will cost him business. He's even offered to sit down with our employees and help them try to get enrolled through the exchange. Basically, what he has told us, and will tell them, is that most of them will likely be entitled to some sort of subsidy. That means that when the total cost of their individual coverages are added together, after subsidies, he expects it to be significantly lower than what our collective group cost will be.

One of the things we have talked about is basically giving the employees a bump in pay to help them cover this extra cost. But, of course, each employee's cost may be slightly different. And going forward we won't really have any knowledge of what each employee sees for increases, and candidly, don't want to undertake the time and hassle of keeping track of that.

And we get to the issues of subsidies. That money has to come from somewhere. I'm sure some small, incremental slice of it is ultimately paid by me and others paying taxes.

I'm just reporting our personal experience. We can debate whether it's good or bad to shift our relatively small business from one where the employer picked up 100% of health insurance, to one where the employees each buy their own, possibly with a subsidy, and possibly with a subsidy from us the employer.


Edit: I do agree with Handy. If we could go back in time and prevent the connection between employment and health insurance I think this country would be a vastly better place. Unfortunately, I have to do business in the circumstances that we live in, and that has meant offering health insurance as a carrot to come work for me.

Not trying to blast the guy. Just asking after you wrote that he wasn't sure why everything was going up. Subsides are paid for. From either higher taxes, givebacks from the insurers and hospitals, etc - the cost of the program, unlike the unfunded prescription benefit law of a decade ago, is paid for according to the CBO.

 

[SJHovey]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Not trying to blast the guy. Just asking after you wrote that he wasn't sure why everything was going up. Subsides are paid for. From either higher taxes, givebacks from the insurers and hospitals, etc - the cost of the program, unlike the unfunded prescription benefit law of a decade ago, is paid for according to the CBO.

I understand. Honestly, I didn't expect him to know why the costs to us made such a big jump.

I only offered the story because I was struck by how similar our situation was to the Las Vegas R-J story that I linked to.

 

[LynahFan]

Re: The PPACA Implementation Phase II - Love it or Lose it!

That means that when the total cost of their individual coverages are added together, after subsidies, he expects it to be significantly lower than what our collective group cost will be.

Meaning that it will still increase, just less than 49%? Or do you mean that it will actually decrease relative to last year's actual cost?

 

[SJHovey]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Meaning that it will still increase, just less than 49%? Or do you mean that it will actually decrease relative to last year's actual cost?

We actually talked about that. He said that certainly it will be lower than the quote (which as I posted earlier was 49% greater than last year's cost). He said that it might even turn out that it's lower than our current, soon to expire, cost. But he thought that was pretty unlikely. I guess it will depend on family income information for each of the employees, something the broker did not have available to him. But knowing what we paid, and apparently making some guesses based upon the known jobs of spouses, he was pretty confident many of the employees would be eligible for subsidies.

My take was that the total of the individual employee's costs, after subsidies, would fall somewhere between our current year's cost and this new quote.

 

[LynahFan]

Re: The PPACA Implementation Phase II - Love it or Lose it!

We actually talked about that. He said that certainly it will be lower than the quote (which as I posted earlier was 49% greater than last year's cost). He said that it might even turn out that it's lower than our current, soon to expire, cost. But he thought that was pretty unlikely. I guess it will depend on family income information for each of the employees, something the broker did not have available to him. But knowing what we paid, and apparently making some guesses based upon the known jobs of spouses, he was pretty confident many of the employees would be eligible for subsidies.

My take was that the total of the individual employee's costs, after subsidies, would fall somewhere between our current year's cost and this new quote.

Gotcha - thanks for the clarification.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

This article is pretty amusing about the GOP's "hearing" with insurance execs! What's that old saying about never asking a witness a question in court that you don't already know the answer too?

http://thehill.com/policy/healthcare/205471-gop-struggles-to-land-o-care-punches

I'm not sure why the Republicans would call a public hearing just to get humiliated over their easily dubunked ACA rumors by their own witnesses, but there it was. Anybody else still wondering why suddenly Ben Gazi (which is in Cuba according to most conservatives polled recently) is getting so much publicity???