View Full Version : Health Insurance Rates Under the Affordable Care Act
try2bfrugal
5-27-13, 3:29pm
Here are links to the calculators so you can get an idea of what your coverage will be:
California Health Insurance Rates Under the Affordable Care Act
http://www.coveredca.com/calculating_the_cost.html
UC Berkeley Labor Center national Calculator
http://laborcenter.berkeley.edu/healthpolicy/calculator/
How will this impact you? Does it tip the balance in favor of self employment or retirement for those of you who have been on the fence?
Our COBRA / HIPAA insurance costs were crazy high. This will be great for us.
Gardenarian
5-27-13, 3:48pm
If the estimator is accurate, we would save over $1000 per month. (We currently pay for own health insurance.)
I have been wanting to retire for the past year but couldn't bring myself to it - I have some serious health concerns. This will make all the difference.
It does tip the balance for me, and not in a good way. The difference between my self-employed rate and my employed rate is approximately $14K per year.
Actually, my fear is that the $14K may become the difference between what I pay now and what it will cost me next year if my employer decides to drop coverage as so many companies are planning. Even if they upped my salary to make up the difference between their penalty and what they're currently contributing to my health insurance, it will still cost me approximately twice what it does now. In my case, the probable consequences of The Affordable Care Act are scary.
rosarugosa
5-27-13, 4:55pm
Interesting - I definitely need to keep my day job!
ApatheticNoMore
5-27-13, 5:13pm
My day job apparently provides me with no better a deal in terms of cost than the *entirely* unsubsidized rate. So why do I continually scare myself that I need to keep the job to keep health insurance again?
try2bfrugal
5-27-13, 5:23pm
My day job apparently provides me with no better a deal in terms of cost than the *entirely* unsubsidized rate. So why do I continually scare myself that I need to keep the job to keep health insurance again?
In the past it may have been because private health insurance for many people was simply not possible because of pre-existing conditions. And even if you got it the insurance companies would sometimes rescind policies over minor application issues to avoid paying for expensive treatments like cancer.
dado potato
5-27-13, 5:50pm
I was a bit anxious about DW's health insurance. She is a retiree with continuing coverage in her employer's health insurance. Over the years we've had some increases in her premium (even double digits in one year!). I was relieved to receive the notice that there would be no increase this year.
My day job apparently provides me with no better a deal in terms of cost than the *entirely* unsubsidized rate. So why do I continually scare myself that I need to keep the job to keep health insurance again?
I read somewhere that you can not get subsidies under the ACA if you voluntarily quit your job that had employer covered health insurance. Don't know if that's true but best to check it out before hoardes of people quit their jobs to play volleyball at the beach all day :-) . As for me, I am qualified to use the VA medical centers so won't have to buy health insurance - although at my voluntarily low income level I actually would qualify for Medicaid if there is no means testing of assets.
It does tip the balance for me, and not in a good way. The difference between my self-employed rate and my employed rate is approximately $14K per year.
Actually, my fear is that the $14K may become the difference between what I pay now and what it will cost me next year if my employer decides to drop coverage as so many companies are planning. Even if they upped my salary to make up the difference between their penalty and what they're currently contributing to my health insurance, it will still cost me approximately twice what it does now. In my case, the probable consequences of The Affordable Care Act are scary.
Is that because insurance companies are raising rates in anticipation of having a large number of new members who are forced to buy health insurance and so they can jack up prices?
Is that because insurance companies are raising rates in anticipation of having a large number of new members who are forced to buy health insurance and so they can jack up prices?
No, I didn't take the insurance companies themselves into the equation. I expect my health insurance to cost more because I'm one of those people who will be forced to subsidize others through legislation rather than through the market. My current benefit package is one that will almost certainly be designated as "Cadillac", which will force me to pay additional taxes for the pleasure. If my company decides to get out of the health insurance as benefit business and increases my base salary to compensate, that money will then be treated as income for local, state and federal purposes and be taxed accordingly. I also do not qualify for any of that "free" government subsidy money, but rather will be considered a source of subsidy for those who cannot pay their own way, or choose to structure their lives in such a way to qualify for subsidy.
So, if the theme of the thread is whether or not the Affordable Care Act will improve anyone's specific quality of life and make alternative life choices possible, I'd have to say no. It will have the opposite effect on me.
No, I didn't take the insurance companies themselves into the equation. I expect my health insurance to cost more because I'm one of those people who will be forced to subsidize others through legislation rather than through the market. My current benefit package is one that will almost certainly be designated as "Cadillac", which will force me to pay additional taxes for the pleasure. If my company decides to get out of the health insurance as benefit business and increases my base salary to compensate, that money will then be treated as income for local, state and federal purposes and be taxed accordingly. I also do not qualify for any of that "free" government subsidy money, but rather will be considered a source of subsidy for those who cannot pay their own way, or choose to structure their lives in such a way to qualify for subsidy.
So, if the theme of the thread is whether or not the Affordable Care Act will improve anyone's specific quality of life and make alternative life choices possible, I'd have to say no. It will have the opposite effect on me.
OK I get it. I assumed insurance companies would raise rates across the board since they now would have a captive consumer for their products - even with competetion - but hadn't really thought that employers would drop their employee coverage and make them pay their own - especially if they didn't qualify for any subsidizes. I also had a Cadillac plan at work and continued paying for that via Cobra once I quit until it expired and I we t with a low cost, high deductible plan - which I've had ever since along with the VA. - the VA bills them and I also must pay for any non-service connected care. The VA also requires a very complete means tests each year of both income andbassets . And they require every asset a you have and every source of income. Then they bill you based on that. I find it beyond ludicris that the ACA doesn't require means testing of assets and that someone like me - low income by choice but high asset and early retired - would qualify for Medicaid. Guess I'll have to decide if I should drive the Ferrari or the Porsche to my medicaid doctor appt :-). I won't sign up for it but will probably drop my Blue Cross coverage. This is one reason I'm more of an advocate for universal healthcare as the current system is too unfair to higher income earner yet doesn't consider wealth - or lack of assets - at all. At least with universal care - like public school - everyone is treated the same with equal access and care. Higher income earners can buy more or better coverage if they want.
I'm one of those people who will be forced to subsidize others through legislation rather than through the market. ...
Thank you for your service, Alan! I've reorganized my income so that you can help pay for my medical insurance, it is greatly appreciated! If you are ever in the area, I'll apply some of the $$$ to fuel for the yacht, and we can go do the Old Man And The Sea thing :-)
Alan: Aren't we already indirectly subsidizing those without coverage who show up at ERs for all their acute healthcare needs? I guess one of my big questions is whether a model that increases access to preventative care for all will truly save money in the long run. I think that is the current assumption, but I'm not sure if it's true. It might have shifted in recent years (now that MA has it's own version of healthcare for all), but in the past, I've seen people covered by medicaid or MassHealth go to the ER for head colds, which certainly isn't a cost effective use of resources.
Alan: Aren't we already indirectly subsidizing those without coverage who show up at ERs for all their acute healthcare needs?
Sure we are, through the market adjusting it's pricing schedule to accommodate. The Affordable Care Act appears to raise the cost of many people's healthcare coverage even more through additional taxes while not seeming to have any positive effect on rates. The various calculators I've seen imply that my coverage rate will increase by several thousand dollars per year on top of those tax increases.
If the theme of this thread is whether or not the ACA will improve any individual's ability to structure their life choices in a positive manner, we should also look at the negative effects imposed on others who are legislatively mandated to bear the expense.
Thank you for your service, Alan! I've reorganized my income so that you can help pay for my medical insurance, it is greatly appreciated! If you are ever in the area, I'll apply some of the $$$ to fuel for the yacht, and we can go do the Old Man And The Sea thing :-)
Well, unfortunately the system does rely on the moral honesty of the general population. The fact that some lack this honesty will hopefully be offset by plenty who do.
try2bfrugal
6-2-13, 11:57am
Well, unfortunately the system does rely on the moral honesty of the general population. The fact that some lack this honesty will hopefully be offset by plenty who do.
I always try to pay as little taxes as possible under the law. Learned Hand wrote, "Any one may so arrange his affairs that his taxes shall be as low as possible; he is not bound to choose that pattern which will best pay the Treasury; there is not even a patriotic duty to increase one's taxes."
I think he would have said the same thing about maximizing health insurance subsidies. In many other industrialized countries, health care is completely subsidized through taxes. The U.S has been unique in not having universal health care and also having the highest health care costs on the planet. Lower income and unemployed people in the U.S. have had a double whammy for a long time.
This is an interesting article with graphs of health care costs in the U.S. vs. other countries for the same procedures -
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
Well, unfortunately the system does rely on the moral honesty of the general population. The fact that some lack this honesty will hopefully be offset by plenty who do.
Really Peggy? You are really going to continue with your general pattern of vile personal attacks? At long last, have you left no sense of decency?
Living by the precepts of YMOYL, reducing your needs and designing your income to produce only a sufficient amount to cover your needs, through sources that are tax-efficient, is hardly immoral or dishonest.
Unless you think we all need to be rounded up and sent to the work camps to build your Bold New Future.
ApatheticNoMore
6-2-13, 2:19pm
I always try to pay as little taxes as possible under the law. Learned Hand wrote, "Any one may so arrange his affairs that his taxes shall be as low as possible; he is not bound to choose that pattern which will best pay the Treasury; there is not even a patriotic duty to increase one's taxes."
About as relevant to most people taking the standard deduction as telling a homeless person the rich have the same rights to sleep under bridges as them. There are often VERY FEW ways to reduce taxes (what, you'd rather rent than compete with hedge fund speculators for housing?). So it's mostly just about paying up, giving the various payroll and income taxes about a quarter of your gross income and being done with it.
Really Peggy? You are really going to continue with your general pattern of vile personal attacks? At long last, have you left no sense of decency?
Living by the precepts of YMOYL, reducing your needs and designing your income to produce only a sufficient amount to cover your needs, through sources that are tax-efficient, is hardly immoral or dishonest.
Unless you think we all need to be rounded up and sent to the work camps to build your Bold New Future.
Ordering you affairs to pay few taxes is, of course, your choice, and I applaud you for it. After all, you can delude yourself into thinking that your fewer taxes will stop wars, or wasteful spending, or what ever you tell yourself when you shut out the news of kids being tossed off food stamps or fewer meals on wheels being delivered or crumbling bridges or whatever. If it doesn't affect you then, well, it doesn't matter.... But ordering your affairs to force ME to pay for your health care, when you can WELL afford it is, IMO morally bankrupt.
Your constant bragging on your vast wealth tells us all that you CAN in fact afford your own health care. It is only arrogance in the extreme to come on a site that in part helps folks who are struggling to pay for the everyday basics of food, shelter, and transportation to boast on how you are planning to game the system to get the tax payers to pay for your health care when there are many here who wonder how they will pay for a simple dental check-up for their kids, or maybe something beyond the emergency room for the asthmatic kid. But, hey, as long as you can gas up the yacht, we'e all happy. Cause we all want to pay for that you know. We certainly find that way more important than our neighbors cancer treatment, that greedy insensitive jerk. Imagine, him wanting to survive when bae's yacht needs gassing.
You, sir, are immoral and dishonest, and something more with your nudge-nudge-wink-wink let's laugh at the idea that some may actually need health care subsidy.
You have heard of the 'ugly american'. Well, look in the mirror. There he is, in all his greedy, self centered glory.
Holy smoke, Peggy, recognize that this is a hot topic for you and step off for a breather.
People have been managing their finances for personal tax benefit forever. I do for my investments but don't skip paying taxes or pay under the table. Financial planners work to enable tax benefit options. It is not bragging but common sense.
I am amused to see that this topic is in the Frugality forum not the political realm BTW.
Peggy - you are evil and vile.
I have voluntarily donated the bulk of my net worth to philanthropic causes. Each year the bulk of my remaining income goes to such things as well. I deliberately live *well* below what my means are.
I spend the bulk of my personal time engaged in public service, from serving as an elected official in control of an entity with the same powers and responsibilities of a first class city in this state, to spending 1000+ hours a year as the head of the county planning commission, to starting and running schools, and half a dozen other such things.
I even put my own life and health on the line every day for my community, in my service as a firefighter and medical responder.
So, with all due respect...., well, strike that - I have no respect for you, you nasty, uncivil person.
https://lh6.googleusercontent.com/-XzTQF2jKyiU/UawNfYGYnhI/AAAAAAAAHuA/ULu_zwMnDsw/s640/Awesomized.jpg
Peggy, you have stepped over the line. Time to back off and think about how you are coming across.
This liberal agrees Obamacare is not good. Universal health care is the only plan that would reduce health care cost. Health care takes up about 18% of GDP. That is almost 2 times more than the rest of the advanced country. If health care cost continue to increase like it has in the past it will not be too many years before it takes the majority of GDP.
Medicare for all. The government sets the cost for procedures. That is what other countries do and doctors are still some of the highest paid individuals in those countries who set their fees.
Alan: Aren't we already indirectly subsidizing those without coverage who show up at ERs for all their acute healthcare needs? I guess one of my big questions is whether a model that increases access to preventative care for all will truly save money in the long run.
My observation, based on going on *lots* of emergency medical calls the last year, is that many of the patients I've seen who required the response of an ambulance, a paramedic, an EMT, a firefighter or two, boat or helicopter evacuation, and all that fun expensive stuff, could have had a cheaper, simpler time of it if they'd had regular medical care in the years leading up to the incident that prompted them to call 911.
This may be more of a lifestyle thing though - a significant number of these folks could have afforded to see a doctor earlier in their process, or could have gone to any of the several doctors here who *do not charge* people who can't afford to pay, but they for whatever reason didn't elect to seek medical care earlier, nor did they modify their lifestyle to reduce their chance of troubles.
I suspect the payoff for education would be huge.
Peggy, you have stepped over the line. Time to back off and think about how you are coming across.
Oh really? And I suppose him calling me evil, vile, nasty and uncivil isn't?
If you would read his self centered posts, you would see that he is not merely bragging about lowering his taxes. He is bragging about gaming the system so the government, as in we the people, will PAY for his health care. Subsidies set up for low income folks who otherwise could not afford health care. Oh I'm sure he feels he DESERVES it, even as he mocks the governments efforts to get health care to folks who actually NEED it.
Yes, this is a hot button for me, because of this very attitude I've seen over and over. Maybe he is an exception in his philanthropy, (which has nothing to do with this debate) but it just irks me when people mock and belittle the efforts to make life just a little bit better for others, while grabbing all they can with both hands. Even if he lets the government pay for his health care, even if he gives all his wealth to his community, the total arrogance of his attitude is what gets me. 'Ha ha, you suckers will pay for my health care while I gas up the yacht' is just beyond the pale. Makes me wonder if, while he is handing out his hundred dollar bills on the street corner he makes the bag lady do a little jig to 'get it'.
Some people just don't get it. How lovely for his community that he has all this excess to spread around. But the world is larger than his tiny island, and there are folks out there who are not the beneficiaries of his largess, who very desperately need basic health care and can not pay for it. At all. They don't have a can of gas, much less a yacht to put it in. Maybe Obamacare isn't perfect, but it's at least an attempt at a solution. And it has, in fact, already helped thousands of people, even though it hasn't even been fully implemented.
I recognize the attitude/ideology behind his mocking, and it is ugly.
And this testy personal negative interchange is all about helping the SLForums how?
Supporting the forums is not just about money, is it?
Hey Peggy: I totally took Bae to be kidding. I don't think he was seriously talking about gaming the system himself. I think it was a sardonic way of illustrating what some people will probably do, not anything he personally intends to do. There is always the legitimate concern with this type of program that some will take advantage. Of course, that's just my interpretation.
Bae: Please correct me if I'm wrong.
I do actually know a couple who owns a home on the water and a boat (not a yacht by any means, but still more of a boat than I’ve ever owned) and they do not have health insurance because they "cannot afford it." And these are decent, hardworking middle-class people who truly believe they cannot afford health insurance (neither is offered employer-sponsored coverage, so would have to buy on the private market). It only became a major issue when one of them developed a serious health problem. Oddly enough, they are vocal opponents of Obamacare, but also express outrage over not having coverage when needed. So I don’t even know what they would favor; perhaps some plan administered by fairies and unicorns.
When I looked at the calculator on what one might expect to pay under the ACA, my first thought was that I could never afford that. My second thought was that I actually could, but I would have to cut back in almost every other area of my life. My takeaway is that people don't always make reasonable choices, and they don’t value access to healthcare appropriately until they are in a healthcare crisis. Food and housing seem to be more realistically valued in terms of where they belong in setting priorities. When you aren’t sick, it is much more gratifying to choose the boat.
I don’t favor basing our system on the idea that people are too dumb to make their own choices so the government or society must choose for them, but if we’re not going to let our more knuckleheaded fellows die in the gutter as a result of their poor choices, we’ve got a bit of a dilemma.
I was always very much opposed to universal health care, but it’s not nearly so black & white for me anymore.
ApatheticNoMore
6-3-13, 9:06pm
There is always the legitimate concern with this type of program that some will take advantage.
A problem that universal healthcare wouldn't have. There is no "taking advantage" when a program is intended for all and not just the disadvantaged.
When I looked at the calculator on what one might expect to pay under the ACA, my first thought was that I could never afford that.
my first thought was wow, the prices of non-employer provided non-subsidized healthcare are fairly reasonable - who would have known? Of course if I was older maybe they'd be a lot more?
My takeaway is that people don't always make reasonable choices, and they don’t value access to healthcare appropriately until they are in a healthcare crisis.
Oh I don't necessarily think they are irrational even if they try to pay most of their own non-healthcare bills in principle rather than go on welfare and even *IF* they become sick. To really be sure you are covered in terms of healthcare if things should go wrong in the U.S:
1) you need to of course be able to pay the premiums - but it hardly stops there
2) you also need to be able to meet the deductables up to the amount of the out of pocket maximum (because hospitalization will take you to the maximum - and remember that maximum renews EVERY year - don't end up hospitalized in the last week of Dec!) - so you need a decent chunk of healthcare emergency fund savings either that or a really good healthcare plan that covers pretty much everything
3) you need to be able to do this even if you lost your job. But your job is secure? Very well .... but we're imagining here that you get SICK - some diseases render people unable to work for months at a time even in some cases permanently.
So in order to really have healthcare you need to make sure all 3 are covered. And the last quite frankly might require you to have disability insurance on top of health insurance - that *might* be enough. But Medicaid will kick in if you are sick and destititute anyway? Yea, but if that is actually your *plan*, why pay the heavy insurance premiums all these years for more premium plans in the first place? Just for better preventive care? And better care until the money all runs out?
But ordering your affairs to force ME to pay for your health care, when you can WELL afford it is, IMO morally bankrupt.
. Actually Obamacare laws ordered a way for people like Bae and myself to "game the system" by not requirering means testing for assets. Change the requirements and people like us wll be bumped from being eligible for subsidized (or free medicaid in my case) health insurance coverage. Call your legislators to affect a change requirering a means test for all.
ETA: I also took Baes comments as kidding - just as mine were when I said I'd have to decide between the Ferrari or the Porshce when driving to my medicaid dr. I actually have a 12 year old pick up truck. Although I will be one of the "morally bankrupt" individuals because I full intend to drop my Blue Cross policy and will use the VA hosipital exclusivily. While I would be happy to continue paying for my private coverage - as well as any fees I incur when I use the VA for non-serivice connect medical stuff - I do not qualify for a subizidy - only medicaid - because I am TOO low income. And I find it offensive that people with incomes up to $92K and potentoially unlimited financial assets can get subisidies.
flowerseverywhere
6-4-13, 4:51am
Here is the saddest thing. Our children will have yet another burden on their shoulders. People like me (paid for house,non means tested assets) will get subsidized. Our kids, who are working, if they are doing well will pay for the whole shot. Plus they are funding a social security system they will not benefit nearly as much from as current retirees, most will never see a company funded pension, and many are saddled with huge student loans. Like others here, I happily pay my health insurance premiums each month. But under the new law mine will go down by hundreds a month, and I doubt the retiree benefits that allow us to be in the group plan will continue under the new laws so there you are. I won't take the money and buy another made by slave labor piece of clothing for example, but will continue my frugal ways and be able to save more for my children and grandchildren's future or do more good for my favorite causes. I'll make good use of the money, but I don't think that is what the subsidies are intended for. I am certainly not morally bankrupt, in fact we give a large amount to charity each year by living way below our means, and spend less than your average middle class no yacht (just a canoe) family by living simply.
try2bfrugal
6-4-13, 10:58am
I am surprised that more people here are not thrilled. Most industrialized countries have universal health care that is tax payer funded, not even income tested, as shown on this map -
http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/
"Nearly the entire developed world is colored, from Europe to the Asian powerhouses to South America's southern cone to the Anglophone states of Australia, New Zealand, and Canada. The only developed outliers are a few still-troubled Balkan states, the Soviet-style autocracy of Belarus, and the U.S. of A., the richest nation in the world."
Most of the funding will be from taxes that will impact the wealthy -
http://www.huffingtonpost.com/2012/12/04/obamacare-investment-income-tax_n_2236687.html
Plenty of people either have, or think they have, a vested interest in being vehemently opposed to ACA. For some, it's gone past any tie-back to what's factual, and has entered the realm of the religious. There's a lot of "pissing in the pool" now, and that seems to pollute any discussion of healthcare. However, as yet, no opponent has presented any cogent defense for claims of doom and gloom. What is known is that ACA translates what was once paid as human costs into financial costs (i.e., coverage for preexisting conditions, elimination of lifetime caps, etc.), so that's a wash unless one insists on acknowledging only the human costs that that one has personally experienced (past tense). Beyond that, no other sources of new financial cost have been identified. Generally, the folks most supportive of ACA would be among the first to raise objections if the healthcare industry started adding costs beyond those associated with the aforementioned translation of human costs into financial costs. It simply not what's going on. Rates will go up for some, will go down for some, and folks who weren't paying before [either through choice (relying on EMTALA and other opportunistic exploits of the system), through lack of eligibility (as mentioned above), or through lack of affordability] will be paying. However, there isn't anything about ACA that causes significant new sources of cost to be introduced into the system. If anything, the health exchanges offer the opportunity to pit insurance companies against each other more directly, and competition is, of course, good for the consumer. I cannot help but wonder how much of the chest-beating against ACA can be tracked back to some misinformation or other propaganda device fostered by the industry, fearful that such direct competition will cause profits to be trimmed out.
try2bfrugal
6-4-13, 11:28am
And even in countries without universal health care, it is still at least much more affordable. We pay many times over what patient in other countries pay for the same procedures -
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
My concerns are why don't we have universal coverage and why do we pay many times over for health care as people in other countries with better quality of care?
"Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday."
http://www.commonwealthfund.org/Publications/Fund-Reports/2011/Oct/Why-Not-the-Best-2011.aspx
try2bfrugal
6-4-13, 11:33am
cannot help but wonder how much of the chest-beating against ACA can be tracked back to some misinformation or other propaganda device fostered by the industry, fearful that such direct competition will cause profits to be trimmed out.
That and the wealthy who want to keep the wealth inequality situation in the U.S worse than it is -
http://en.wikipedia.org/wiki/List_of_countries_by_income_equality
flowerseverywhere
6-4-13, 11:44am
well at least some of our insurance rates are so high because the plans, like Blue Cross/Blue Shield have big shiny buildings full of people that need to be paid while working on expensive equipment and software. That money comes from somewhere. add to that the CEO and executives compensations and packages, and it really adds up. They have an army of people to review and pay (or reject) claims, another army to work with providers for network purposes, another army to answer phones and make glossy brochures and presentations to sell their product. as an example I found this article written in 2011 when California made Blue Cross reveal salary info. "In its report to the state, Blue Shield said that its 10 highest-paid executives earned more than $14 million total last year. The insurer identified the executives only by number, saying each earned $749,643 to $4,601,226. The top earner was listed as "chief executive officer," Bodaken's title" http://articles.latimes.com/2011/may/26/business/la-fi-insurer-executive-pay-20110526 I am not picking on BC/BS, just pointing out one of the problems our current medical system has.
Since 2011, ACA's "medical loss ratio" provision has held that most general health insurers have been required to spend either 80 percent or 85 percent of their revenue on medical expenses, depending on their size. That should help curb some of the excesses (especially in light of the December 2011 Forbes article that speculated that insurers would even have trouble operating on just 15%-20% of receipts - much less operating extravagantly). Last August (2012), insurers started issuing refund checks associated with this provision.
ApatheticNoMore
6-4-13, 12:03pm
And even in countries without universal health care, it is still at least much more affordable. We pay many times over what patient in other countries pay for the same procedures -
http://www.washingtonpost.com/blogs/...are-ludicrous/
My concerns are why don't we have universal coverage and why do we pay many times over for health care as people in other countries with better quality of care?
+1
I've heard that for the amount we pay for Medicare alone, many countries have universal healthcare for all ages :\
Not the Mod here.
Peggy & Bae, please do drop this long enough to do what you need to stop name calling & the general nastiness being exchanged. As I told my kids, it doesn't matter who started it, it's time to stop. I appreciate you both for your passion, and cannot hear you when you're shouting. Thanks.
well at least some of our insurance rates are so high because the plans, like Blue Cross/Blue Shield have big shiny buildings full of people that need to be paid while working on expensive equipment and software. That money comes from somewhere. add to that the CEO and executives compensations and packages, and it really adds up. They have an army of people to review and pay (or reject) claims, another army to work with providers for network purposes, another army to answer phones and make glossy brochures and presentations to sell their product. as an example I found this article written in 2011 when California made Blue Cross reveal salary info. "In its report to the state, Blue Shield said that its 10 highest-paid executives earned more than $14 million total last year. The insurer identified the executives only by number, saying each earned $749,643 to $4,601,226. The top earner was listed as "chief executive officer," Bodaken's title" http://articles.latimes.com/2011/may/26/business/la-fi-insurer-executive-pay-20110526 I am not picking on BC/BS, just pointing out one of the problems our current medical system has.
Insurance is a business, whether its health, auto, accident, marine or whatever. As a business, what makes its compensation scheme different from other industries such as technology, entertainment, etc.? Is there a moral perogative which should prevent them from employing as many people as it takes to oversee their business, own tangible assets such as real estate or pay their executives in a manner which recognizes the value they bring to the business?
I am surprised that more people here are not thrilled. Most industrialized countries have universal health care that is tax payer funded, not even income tested I think many more people would be thrilled if Obamacare were true universal healthcare similair to our public education system where everyone, irregardless of income or assets, had access to it. Or if it did means testing of assets to weed out those wealtier individuals who could fund their own health insurance. That is what most people dislike about Obamacare - that a middle income family with few financial assets may not get subsidized while a person who has a seemingly low income yet vast wealth via assets can get it. Most people aren't too happy about their taxes going to pay for someone like Mitt Romney's family's subidized health insurance who - if you remember from the whole income tax issue during the election - was fairly low income on paper yet a gazzillionaire IRL.
So, unlike public education, the wealthier (as welll as the middle income earner) are being asked to bear the financial burden for the program yet may not be able to take advantage of low cost or free medical care themselfs - and as Alan pointed out, they may even incur much higher costs as well as higher income taxes to provide their own insurance coverage if their companies drop coverage and require them to buy their own unsubidized coverage. This would be equivilant of us banning the children of higher or even middle income parents from going to free public schools and making them HAVE to pay for expensive private schools all the while still requiring them to pay property taxes and income taxes to fund those children in public schools - who may have parents with very high financial assets but lower incomes.
I think many more people would be thrilled if Obamacare were true universal healthcareI'd like to think that's true, but I fear that there's really no basis for such an assumption. Those who objected to ACA were even more vehemently opposed to universal healthcare. ACA was most definitely a compromise between the progress some wanted, universal healthcare, and the reactionary perspective, which seemed to extol the current system where those less fortunate literally suffer the consequences. What will be interesting to see is whether ACA perhaps has softened the objections to universal healthcare - or whether the objectors will double-down on their insistence on the "everyone out for themselves" approach to the matter.
try2bfrugal
6-4-13, 2:04pm
That is what most people dislike about Obamacare - that a middle income family with few financial assets may not get subsidized while a person who has a seemingly low income yet vast wealth via assets can get it. Most people aren't too happy about their taxes going to pay for someone like Mitt Romney's family's subidized health insurance who - if you remember from the whole income tax issue during the election - was fairly low income on paper yet a gazzillionaire IRL.
One of the main funding sources for the ACA is additional taxes on households making over 250K.
According to an article on CNBC.com (http://www.cnbc.com/id/49807529), "By most measures, a $250,000 household income is substantial. It is five times the national average, and just 2.9 percent of couples earn that much or more. "For the average person in this country, a $250,000 household income is an unattainably high annual sum — they'll never see it," says Roberton Williams, an analyst at the Tax Policy Center, a nonpartisan think tank in Washington, D.C."
Subsidies exist up to 400% of the poverty level. For a family of 4 that is 92K. The median household income is the U.S. is around 50K. So household earning about 2X the median income will still get subsidies. I think the rules make it pretty clear that any family that earns in the middle class range will get significant subsidies.
Mitt Romney made $13.7 million in 2011. Four hundred percent of the federal poverty level for a two person family is 62K. Mitt Romney would not qualify for subsidized health care. I do not understand why you think he would. His income doesn't make him anywhere even in the ballpark of getting subsidized health care. He will have to pay more in taxes for midldle class households to obtain subsidized care.
There is currently no asset test on Social Security. The Romney's actually could get Social Security.
I was just joking when using Mitt for comparisions. My point is that single childless person #1 who earns $25K in income can get the subsidy even if that person owns several million dollar homes, a couple of yachts, 20 luxury vehicles, a plane, and has a few million in tax deferred accounts. Where as single childless person #2 who earns over $50K yet has no other financial assets at all cannot get subidies. I consider that unfair. I'd much rather see my taxes go to funding the truelly poor - both in income as well as assets - rather then fund a welfare program for a wealthy,non working person who lives on interest income from their trust-fund assets.
As for social security. that is an earned benefit - not really an entitlement due to being low income. You have to have worked (or had a working spouse you were married to longer than 10 years) a large number of years and contributed to SS all those years in order to get it.
try2bfrugal
6-4-13, 2:28pm
I was just joking when using Mitt for comparisions. My point is that single childless person #1 who earns $25K in income can get the subsidy even if that person owns several million dollar homes, a couple of yachts, 20 luxury vehicles, a plane, and has a few million in tax deferred accounts. Where as single childless person #2 who earns over $50K yet has no other financial assets at all cannot get subidies. I consider that unfair.
I am guessing that is not a huge percent of the population has millions in assets and taxable income low enough to qualify for subsidies Houses and yachts need money for upkeep, so anyone that wealthy would either need after tax money, which would generate taxable income on the interest, dividends and capital gains, or would have to withdraw from retirement accounts to cover expenses, which would also generate taxable income.
A 2001 study done by the Kaiser Commission on Medicaid and the Uninsured found that states that dropped the [asset] tests said they were costly and time-consuming to administer and rarely resulted in someone being disqualified from Medicaid.
"You don't find a lot of low-income families with assets," Pennsylvania officials said in the Kaiser study.
"The cost the eligibility agency was incurring exceeded the cost of benefits that might have been denied," said officials in Oklahoma, which reported saving $1 million a year in administrative costs after dumping asset tests.
Read more: Colorado Republicans want asset test for Medicaid - The Denver Post (http://www.denverpost.com/legislature/ci_19654608#ixzz2VH1UezQu) http://www.denverpost.com/legislature/ci_19654608#ixzz2VH1UezQu
One thing that bothers me about this whole issue is that we continue to focus on insurance instead of getting the costs down. Why is a colonoscopy in another country only $300 and triple that in the US?
The whole thing is just one huge mess.
One thing that bothers me about this whole issue is that we continue to focus on insurance instead of getting the costs down. Why is a colonoscopy in another country only $300 and triple that in the US?
Rent-seeking.
The national average cost for a 12-lead EKG is about $1500. I've had about 20 EKGs in the past 6 months, and administered about 50 of them. The disposable electrode set costs about $1, and maybe 10 cents for the paper.... If it is a normal rhythm, the supervising physician spends mere moments looking at the trace.
One thing that bothers me about this whole issue is that we continue to focus on insurance instead of getting the costs down.Until ACA, much of the cost was hidden - human costs paid by the least fortunate, which the vast majority of Americans either didn't know about or didn't care about. Now, at least, thanks to ACA, practically all the costs are financial, countable in dollars, and visible to the majority of people. ACA is a good first step, but you're correct that it is just the first step.
flowerseverywhere
6-4-13, 4:22pm
Insurance is a business, whether its health, auto, accident, marine or whatever. As a business, what makes its compensation scheme different from other industries such as technology, entertainment, etc.? Is there a moral perogative which should prevent them from employing as many people as it takes to oversee their business, own tangible assets such as real estate or pay their executives in a manner which recognizes the value they bring to the business?
I make no judgements as to what is moral. It simply is part of the equation of what adds up to make our health care costs so high. There are many other examples. A friend of mine's husband of 70 years has pancreatic cancer and was told he has less than a 10% chance at a one year survival rate. He has had several surgeries and is undergoing chemo. Again, not judging, just pointing out why our costs are so high. The prescription drug industry, that has many convinced there is a pill for everything, and many physicians that will throw a pill at anything. The companies that advertise on TV "we can get a scooter for you at no cost from your insurance company" never mind that the physician should be the one that ultimately decides that a chair is necessary, not having a company that stands to profit try to get the MD to order one. And on and on. If I had the solution I would certainly state it, all I know is there are multiple factors that make our costs so high.
I just had an EKG it took about a total of 15 min for the EKG and the doctor to look at it. I don't know what it cost yet because Medicare is paying for it but I bet it is around $ 1,500. I had to have the EKG prior to back surgery I had and I am afraid to look how much the back surgery cost Medicare.
try2bfrugal
6-4-13, 4:50pm
The companies that advertise on TV "we can get a scooter for you at no cost from your insurance company" never mind that the physician should be the one that ultimately decides that a chair is necessary, not having a company that stands to profit try to get the MD to order one. And on and on. If I had the solution I would certainly state it, all I know is there are multiple factors that make our costs so high.
The Scooter Store is under investigation and bankrupt now.
http://www.washingtontimes.com/news/2013/apr/17/the-scooter-store-files-for-bankruptcy-while-under/
They spent millions on lobbying and political contributions, including lobbying against laws to prevent waste and fraud in Medicare and Medicaid.
flowerseverywhere
6-4-13, 5:05pm
The Scooter Store is under investigation and bankrupt now.
http://www.washingtontimes.com/news/2013/apr/17/the-scooter-store-files-for-bankruptcy-while-under/
They spent millions on lobbying and political contributions, including lobbying against laws to prevent waste and fraud in Medicare and Medicaid.Exactly. It is always very interesting to look at elected officials contributors. No wonder we are in such a mess.
I am guessing that is not a huge percent of the population has millions in assets and taxable income low enough to qualify for subsidies Houses and yachts need money for upkeep, so anyone that wealthy would either need after tax money, which would generate taxable income on the interest, dividends and capital gains, or would have to withdraw from retirement accounts to cover expenses, which would also generate taxable income.
A 2001 study done by the Kaiser Commission on Medicaid and the Uninsured found that states that dropped the [asset] tests said they were costly and time-consuming to administer and rarely resulted in someone being disqualified from Medicaid.
"You don't find a lot of low-income families with assets," Pennsylvania officials said in the Kaiser study.
"The cost the eligibility agency was incurring exceeded the cost of benefits that might have been denied," said officials in Oklahoma, which reported saving $1 million a year in administrative costs after dumping asset tests.
Read more: Colorado Republicans want asset test for Medicaid - The Denver Post (http://www.denverpost.com/legislature/ci_19654608#ixzz2VH1UezQu) http://www.denverpost.com/legislature/ci_19654608#ixzz2VH1UezQu
That's true most with millions in assets probably have higher income levels - I was using hyperbole to make a point :-) . However there are many people in my situation - especially in the frugal, simple living, "Millionaire Next Door" crowd. My income is under $18k per year - much of that non-taxable. That is enough for my expenses with a paid off house, no debt and a large amount of tax deferred savings. I choose to quit work when I was 42 with no plans to ever go back. So is it fair to the tax payers that they should subsidize someone like me so I can go on medicaid or get health insurance coverage paid for so I can spend my days playing beach volleyball? I don't think so. Which is the reason I think means testing is important since - unless we have universal coverage for all - I believe that the current ACA is unfair although better than nothing. In Calif they will eliminate means testing for assets to qualify for medicaid in Jan.
However there are many people in my situation - especially in the frugal, simple living, "Millionaire Next Door" crowd.
Exactly. I "retired" when I was 36, and don't work for a salary. I do have a lot of assets. However, everything I own is paid for already, I have very low expenses, I do most maintenance/work myself, and as a result, I chose to realize very little income each year, just enough to pay the bills. My biggest two expenses are property taxes and medical insurance, which I pay out-of-pocket. I could chose to take *no* income for many years if I wanted to completely avoid paying anything, or qualify for various free-stuff programs.
I know quite a few people in my neighborhood in similar circumstances.
flowerseverywhere
6-5-13, 2:28pm
Well, I'm in between bae and spartana, a lot more in spartana's direction, and have many friends who are in the same boat. I think the millionaire next door was perhaps the biggest inspiration to me, as well as your money or your life. Not focusing on things, but rather people, doing good and charitable work, and emphasizing frugality has gotten me to where I am. I never tried to game the system, and have through the years paid a lot in taxes of all kinds. We also have never taken unemployment, or food stamps or other entitlement benefits that tend to make people angry and accusatory, Who would have thought I could have qualified for a gbmt subsidy just through simple living.
That's true most with millions in assets probably have higher income levels - I was using hyperbole to make a point :-) . However there are many people in my situation - especially in the frugal, simple living, "Millionaire Next Door" crowd. My income is under $18k per year - much of that non-taxable. That is enough for my expenses with a paid off house, no debt and a large amount of tax deferred savings. I choose to quit work when I was 42 with no plans to ever go back. So is it fair to the tax payers that they should subsidize someone like me so I can go on medicaid or get health insurance coverage paid for so I can spend my days playing beach volleyball? I don't think so. Which is the reason I think means testing is important since - unless we have universal coverage for all - I believe that the current ACA is unfair although better than nothing. In Calif they will eliminate means testing for assets to qualify for medicaid in Jan.
I was reading an article, it's more complicated than working or not working. It was on the costs for subsidizing low wage workers - they were estimating one Walmart in Wisconsin employing 330 workers was costing taxpayers over $900k in foodstamps, etc.
gimmethesimplelife
6-5-13, 9:57pm
One thing that I think is wonderful about the ACA is that (IMHO anyway) it is going to make more people aware of the extreme social class divisions in America.....who this works for and who this doesnt work so well for is going to be based somewhat on income and social class. Honestly, I don't have a problem with that. I can remember back to my Junior year in high school and in American History the teacher made the statement that what was so great about America was that there were no social classes and anyone can achieve upward mobility. I was 16 at the time and already had learned differently and had a real hard time keeping my mouth shut on that one.....but I realized opening my mouth would not change anything or serve me well.
Many times when I have crossed the border to afford health care, I think back to Mr. Malinsky and his comment. I wonder if he is still alive and if he ever would understand that part of the reason I am forced to cross the border is that too many people buy into his comment. But I digress.....I think it is going to be interesting when the exchanges first appear in October as there will be all kinds of commentary and opinion flying around out there based on social class and/or economic standing. And here we are talking about a life and death issue, access to health care, and yet there will be all this commentary against, once again, based on social class/economic standing/hits to the wallet. Rob
try2bfrugal
6-5-13, 11:23pm
And here we are talking about a life and death issue, access to health care, and yet there will be all this commentary against, once again, based on social class/economic standing/hits to the wallet. Rob
I don't get all of the bitter opposition, either, especially when it comes from people who will benefit from the ACA. Many Americans who aren't on Medicare or Medicaid are one job layoff away from losing their health insurance without the ACA. It makes no more sense to lose health insurance when you lose your job than it does to lose your car insurance. Most of the other industrialized countries seem to have universal care. Why has the U.S. been so different in terms of accessible care and the extremely high costs not found in countries with higher quality health care?
We have relatives bitterly opposed to the ACA yet they happily cash their Social Security checks and let Medicare pick up most of their health care costs.
The bitter opposition is something that is very deliberately cultivated by those who are looking for any way to get ACA overturned or otherwise scuttled. They lost on the legal side. They lost on the logic side. So all they have left is to wage a propaganda campaign to make people join their campaign bent on destruction by popular opinion, and a big part of that is to refuse to acknowledge the positive changes that ACA is bringing about (coverage of preexisting conditions, removal of lifetime caps, elimination of that "dying in the streets" aspect of the way things have been, etc.)
gimmethesimplelife
6-6-13, 1:49pm
I don't get all of the bitter opposition, either, especially when it comes from people who will benefit from the ACA. Many Americans who aren't on Medicare or Medicaid are one job layoff away from losing their health insurance without the ACA. It makes no more sense to lose health insurance when you lose your job than it does to lose your car insurance. Most of the other industrialized countries seem to have universal care. Why has the U.S. been so different in terms of accessible care and the extremely high costs not found in countries with higher quality health care?
We have relatives bitterly opposed to the ACA yet they happily cash their Social Security checks and let Medicare pick up most of their health care costs.+1
I don't get all of the bitter opposition, either, especially when it comes from people who will benefit from the ACA. Many Americans who aren't on Medicare or Medicaid are one job layoff away from losing their health insurance without the ACA. It makes no more sense to lose health insurance when you lose your job than it does to lose your car insurance. Most of the other industrialized countries seem to have universal care. Why has the U.S. been so different in terms of accessible care and the extremely high costs not found in countries with higher quality health care?
We have relatives bitterly opposed to the ACA yet they happily cash their Social Security checks and let Medicare pick up most of their health care costs. Don't get me wrong - I completely support the ACA and see it as something that is needed to protect all people. Especially low income people who can't afford medical coverage at all, as well as middle income who may be unable to afford it because of pre-existing conditions and as a way to keep them from desending into poverty due to a medical catastrophe while uninsured that financially wipes them out and leaves them unable to work. I just don't think the WAY that it's set up is fair or even productive. I feel that structuring it differently so that more money is funneled towards truelly low income or low middle income people would be a much better use of taxpayer money then funding health insurance premiums for higher earning people (I think a $92K income ceiling is way too high for a familiy of 4 especially without means testing of assets) or higher asset people (like my retired neighbor who has $6 million in the bank in tax deferred stuff but lives on little income) who could cover those premiums themselfs from their income or their assets. I don't really want to fund people like Bae and myself (unless it's universal coverage for all), I want to fund those people who can't work, or are low income due to lifes circumstances not because they want to play rather then work. So just because some of us dislike the technical aspects of the ACA, it doesn't mean we are bitterly opposed to the whole thing.
gimmethesimplelife
6-6-13, 11:17pm
Don't get me wrong - I completely support the ACA and see it as something that is needed to protect all people. Especially low income people who can't afford medical coverage at all, as well as middle income who may be unable to afford it because of pre-existing conditions and as a way to keep them from desending into poverty due to a medical catastrophe while uninsured that financially wipes them out and leaves them unable to work. I just don't think the WAY that it's set up is fair or even productive. I feel that structuring it differently so that more money is funneled towards truelly low income or low middle income people would be a much better use of taxpayer money then funding health insurance premiums for higher earning people (I think a $92K income ceiling is way too high for a familiy of 4 especially without means testing of assets) or higher asset people (like my retired neighbor who has $6 million in the bank in tax deferred stuff but lives on little income) who could cover those premiums themselfs from their income or their assets. I don't really want to fund people like Bae and myself (unless it's universal coverage for all), I want to fund those people who can't work, or are low income due to lifes circumstances not because they want to play rather then work. So just because some of us dislike the technical aspects of the ACA, it doesn't mean we are bitterly opposed to the whole thing.Spartana, I see your points and agree with you. Thank you for this well thought out post and logical reasoning. I myself believe the ACA should be means tested - as you put it, your neighbor with the 6 million dollars in tax deferred investments with small income to show - this person should not be getting a subsidy, I couldn't agree with you more. Rob
flowerseverywhere
6-6-13, 11:29pm
We have relatives bitterly opposed to the ACA yet they happily cash their Social Security checks and let Medicare pick up most of their health care costs.
Selfishness and greed. I got mine so I don't care. There is a mistaken notion that illegal immigrants are getting tons of welfare benefits, that women deliberately have more children to get more welfare, that people game the system and are lazy cheaters and liars. The 47 or49% freeloaders who pay no taxes, Anyone who has worked with or has been poor knows most of us are not far away from losing it all under the wrong circumstances.
gimmethesimplelife
6-6-13, 11:35pm
Selfishness and greed. I got mine so I don't care. There is a mistaken notion that illegal immigrants are getting tons of welfare benefits, that women deliberately have more children to get more welfare, that people game the system and are lazy cheaters and liars. The 47 or49% freeloaders who pay no taxes, Anyone who has worked with or has been poor knows most of us are not far away from losing it all under the wrong circumstances.You speak the truth that so many Americans now face.....not just a small disenfranchised minority, but unfortunately, more and more and more of us. I wonder if poverty statistics continue to rise, when will human nature take over and take to the streets? I can see it coming - maybe not tomorrow, maybe not next year, but within my lifetime (I'm 46, as a basis of reference) third world type instability coming to pay a call. Rob
The number I've seen bandied about is 30% unemployment. I think, though, that that misses the point: Unemployment can be managed - is being managed - by allowing employers to exploit unbalanced power in the interest of paying people less than fair and living wages, which in turn acts (over time) to reduce the expected standard of living. We spent the last century with an expectation of the standard of living increasing. I think if you could take the psychological temperature of young Americans today you'd find few who aren't expecting their own generation's standard of living to be more spartan than what they grew up in. So not only has the tide turned in the reality, it has turned in the perception - the latter paving the way to accomplish the former without causing that "instability" you referred to.
So I don't think we're going to see an unemployment-driven revolution. I think business will carefully craft the environment of their cash cow (the US) and ensure adequate employment, affording it (while still making their profitability targets) by aggressive action to reduce the expectations of workers. They need a certain sized middle class for optimal profitability, but it doesn't matter where those middle class people live. You'd think that the opportunity presented by the middle class developing in other nations would bring about new competitors (thereby requiring a larger middle class) but what we're seeing is that that can be kept under control, through aggressive merger and acquisition. So as the middle class of other nations grow, a larger lower class in the United States is in business' best interest (cheaper labor).
So if there is going to be "instability", it's going to have a foundation other than unemployment. The most likely vector is economic inequality, something that has doubled in a generation. However, it's not as powerful a motivator as unemployment. Besides the obvious (unemployed people have lots of extra time on their hands; underemployed and underpaid people not only don't, but actually their time is rather stretched), it isn't the kind of issue that strikes as strong of an emotional chord with those only marginally affected by it. They can be easily duped into thinking, "I'm doing okay - not great - but okay. I have to care about myself. I can't care about people who are 10% less fortunate than I am." That kind of antisocial self-centeredness can be very easily fostered with political propaganda.
so true, bUU. I'm sure there are plenty of people in Detroit, for example, who have nice houses and decent-paying jobs but they're watching the place crumble around them.
We don't live in a vacuum - what happens to others happens to us too.
Selfishness and greed. I got mine so I don't care. s.
I don't think it's fair to label elderly people over 65 who have contributed a percentage of their working income into SS and medicare each and every pay period for 20, 30, 40, even 50 years as greedy and selfish. They earned that benefit thru years of labor and income deductions - all the while paying other income taxes to fed and state to fund our welfare programs.
I don't think it's fair to label elderly people over 65 who have contributed a percentage of their working income into SS and medicare each and every pay period for 20, 30, 40, even 50 years as greedy and selfish. They earned that benefit thru years of labor and income deductions - all the while paying other income taxes to fed and state to fund our welfare programs.I've never understood that mindset. I've been contributing to those mandatory programs, along with my employers who have been forced to contribute as part of the overall expense of maintaining an employee, for over 40 years and consider any future return on those contributions to deserved.
Now it would appear, based upon the various exchange calculators I've seen, I'll pay extra for my health insurance and other related taxes in order to subsidize others and be considered selfish and greedy for not appreciating the privilege. I'm thinking folks don't understand the real definition of selfish and greedy.
flowerseverywhere
6-9-13, 10:12pm
I don't think it's fair to label elderly people over 65 who have contributed a percentage of their working income into SS and medicare each and every pay period for 20, 30, 40, even 50 years as greedy and selfish. They earned that benefit thru years of labor and income deductions - all the while paying other income taxes to fed and state to fund our welfare programs.
An online forum captures a tiny fraction of what people are really thinking. Of course if you qualify for social security and Medicare you paid into the system, you had no choice. Collecting the benefits is right and deserved. Medicare is not cheap and you pay a lot for the privilege.
What I think is selfish and greedy is not caring if anyone got what you got no matter how hard you work. Our lawmakers have taken our contributions they forced us to give and spent them. It is selfish and greedy not to care that in our great country working people go without adequate basic healthcare.
I can't not care about people. Some really good people have been laid off, have gotten sick or have a sick child or spouse. Not having good healthcare is a shame for a country as wealthy as ours.
I don't think it's fair to label elderly people over 65 who have contributed a percentage of their working income into SS and medicare each and every pay period for 20, 30, 40, even 50 years as greedy and selfish.It actually is, if they are as try2bfrugal described: Bitter about ACA. It is possible, and reasonable to expect, people over 65 who receive SS and Medicare to still care about others.
I'm thinking folks don't understand the real definition of selfish and greedy.And I'm thinking they think those who bitterly oppose the socially conscious perspectives that try2bfrugal outlined "don't understand the real definition of selfish and greedy".
It is selfish and greedy not to care that in our great country working people go without adequate basic healthcare. Precisely.
And I mostly think that those who are "bitterly opposed" and over 65 probably don't understand the whole issue. At least those seniors I talk to around my mother in law (who is 80) are mostly just afraid of the future. They want their kids and grandkids and great grandkids to be safe and have health care. They "fall" for the media stories in a greater percentage. My Mominlaw still thinks that if it is on TV, it must be right.
try2bfrugal
6-10-13, 11:17am
I don't think it's fair to label elderly people over 65 who have contributed a percentage of their working income into SS and medicare each and every pay period for 20, 30, 40, even 50 years as greedy and selfish. They earned that benefit thru years of labor and income deductions - all the while paying other income taxes to fed and state to fund our welfare programs.
People do not necessarily get back into Social Security and Medicare what they put into it (http://www.nytimes.com/interactive/2013/04/03/us/politics/getting-more-or-less-than-you-paid-for.html?_r=0). One of my relatives against the ACA has had 7 figure Medicare bills even though her life span is nearing the upper end of the mortality tables anyway. She never put that much money into Medicare even over her life time.
Yet her household doesn't want tax dollars, and remember a lot of these dollars are coming from households making over $250K a year which isn't her household, to subsidize health care for a single mom with 3 kids making $25K a year.
Most of the industrialized world has universal care. Even in the ones that don't the costs for health care for the poor are not as astronomical as they are in the U.S.
France has top rated health care, universal care and the doctors there still make house calls (http://prescriptions.blogs.nytimes.com/2009/09/11/health-care-abroad-france/). If you want to get angry about tax dollars being squandered I think a better place to vent anger is why are U.S. health care costs so high anyway compared to countries like France, England and Canada? Hint: look at the lobbyists and follow the money. Its the AMA limiting the supply of doctors, the drug companies wanting huge profits, the executives at "non-profit" hospitals (http://healthland.time.com/2013/02/20/bitter-pill-inside-times-cover-story-on-medical-bills/), etc.
If you want to get angry about tax dollars being squandered I think a better place to vent anger is why are U.S. health care costs so high anyway compared to countries like France, England and Canada?
I think there are several reasons, such as our propensity to lead unhealthy lifestyles and doctors being forced to practice defensive medicine, although the major reason is that we're rich. Richer countries can afford to spend more on health care, and they do.
ApatheticNoMore
6-10-13, 11:51am
If you want to get angry about tax dollars being squandered I think a better place to vent anger is why are U.S. health care costs so high anyway compared to countries like France, England and Canada?
I think there are several reasons, such as our propensity to lead unhealthy lifestyles and doctors being forced to practice defensive medicine
England has a healthier lifestyle than we do?!? Canada maybe slightly and France maybe more so but .... if France is more so it's because they eat real food fresh from farms and animals that are humanely raised etc.. Their food system isn't as big a disaster as ours in other words - it's ALL about the food system. That and the vino I guess :) Maybe the stress. Still I'm not sure any of those countries have super low rates of disease. Maybe it improves more as you get to the Mediterranian, I'm not sure. I get the feeling the really low rates of disease are outside the western world altogether. Of course lifestyle does seem to have a major impact on disease, but I really don't think it's why our medical care is so much more expensive. If one was really convinced of that then .. we should change the food system already Actually, do that anyway.
although the major reason is that we're rich. Richer countries can afford to spend more on health care, and they do
that may be, but since it doesn't produce better results it just becomes kind of unproductive as it were - more and more money chasing less and less ROI at least in terms of healthcare outcomes. So at a certain point more money becomes unproductive I guess.
...
France has top rated health care, universal care and the doctors there still make house calls (http://prescriptions.blogs.nytimes.com/2009/09/11/health-care-abroad-france/). If you want to get angry about tax dollars being squandered I think a better place to vent anger is why are U.S. health care costs so high anyway compared to countries like France, England and Canada? Hint: look at the lobbyists and follow the money. Its the AMA limiting the supply of doctors, the drug companies wanting huge profits, the executives at "non-profit" hospitals (http://healthland.time.com/2013/02/20/bitter-pill-inside-times-cover-story-on-medical-bills/), etc.
We have a for-profit health "care" system--layers of people getting rich off drugs and treatments. Period. If there are other developed countries allowing such medical grifting, I'm not aware of it. It's a national disgrace, IMO.
try2bfrugal
6-10-13, 12:37pm
I think there are several reasons, such as our propensity to lead unhealthy lifestyles and doctors being forced to practice defensive medicine, although the major reason is that we're rich. Richer countries can afford to spend more on health care, and they do.
It is not because we are rich we spend more on health care. It is because of the health care lobbyists in the U.S. In the U.S. health care prices are ludicrous compared to other industrialized countries with universal care.
Check out the graphs on U.S. costs versus other rich countries -
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
A routine office visit is $30 in France. In the U.S. is it $178. An angioplasty in Switzerland is 5K compared to 61K in the U.S.
If you want to get angry over health care costs, get angry over lobbyists, not subsidized care for single moms with 3 kids.
Read the Time article called Bitter Pill where the reporter follows the money on health costs in the U.S.
Most of the negative articles over the ACA are disinformation campaigns by the power that be in health care designed to lather up the general population against changes in health care laws that would actually greatly benefit the vast majority of voters. They are terrified that if we move to universal care their profit margins will be reduced to more reasonable amounts like those in other industrialized countries.
The CEO of a non-profit Catholic Charities Hospital group on the west coast annual pay is 3 million dollars a year. No one running a hospital is worth that kind of money.
The CEO of a non-profit Catholic Charities Hospital group on the west coast annual pay is 3 million dollars a year. No one running a hospital is worth that kind of money.
Just out of curiosity, what is the CEO of a non-profit Catholic Charities Hospital group on the west coast worth?
try2bfrugal
6-10-13, 1:52pm
Just out of curiosity, what is the CEO of a non-profit Catholic Charities Hospital group on the west coast worth?
According to this blog, hospital CEO compensation averages $500K -
High CEO Salaries at Nonprofit Hospitals Under Scrutiny…Once Again
http://www.healthbeatblog.com/2011/03/high-ceo-salaries-at-nonprofit-hospitals-under-scrutinyonce-again/
"In fact, Joanne Doroshow, executive director of the Center for Justice and Democracy, writes in the Huffington Post, (http://www.huffingtonpost.com/joanne-doroshow/rich-new-york-hospital-ex_b_826371.html) “the 21 top-earning New York hospital executives collectively earned $64.3 million in 2008. If New York simply capped annual hospital executive salaries to the level of the ‘cap’ to which they want to condemn the sick and injured for a lifetime ($250,000), we'd have $63 million for the Medicaid budget, right there.”
"The survey also identified 17 hospitals in California where the total compensation to CEOs exceeded the cost of charity care. “It would be outrageous if hospitals are paying more to their (entire) executive teams than in indigent care in their community,” Anthony Wright of Health Access California told the Ventura County Star (http://www.vcstar.com/news/2010/jul/24/lofty-pay-for-hospital-ceos-area-administrators/): “For some hospitals to provide more to one individual just seems wrong.” "
According to this blog, hospital CEO compensation averages $500K -
I'm not sure we're comparing apples to apples here. My question pertained to the CEO of a non-profit hospital group. I would assume that means more than one, although the poster did not specify so I can only assume.
The point I wanted to eventually make is that arbitrary numbers and our individual opinions of those numbers have little to do with reality. Let's say that this particular CEO runs a group of 10 hospitals. Does that equal the average compensation of a hospital CEO that you presented? Not if your numbers are based on one hospital per CEO as s/he would be underpaid according to your figure. You see, throwing around arbitrary numbers doesn't tell us anything about scale or responsibility or value to the organization. Is this particular CEO an effective fundraiser? Does he/she add value on a scale that makes him/her cheap at twice the price?
I think my point is that throwing out numbers and taking offense at how many zero's are attached to it doesn't tell the story. Well, it does but not necessarily one that I'd be comfortable repeating.
try2bfrugal
6-10-13, 2:52pm
I think the point of the CEO health care articles in general is that non-profits shouldn't be spending more on executive compensation than the are on charitable care. And that there aren't any safe guards in place to make sure that "non-profit" hospitals, ones not paying any taxes, aren't just in reality tax dodges for wealthy executives.
In Bitter Pill, high CEO compensation is one of the reason U.S. health care costs are so high compared to other industrialized countries. It certainly isn't because we have better care. We're first in cost many times over, 37th in quality according to WHO. So where is all this extra money that we spend on health care over other countries going to? What entities are reaping the benefits? CEO pay is a biggie.
U.S. Healthcare Rates 37th
http://www.cbsnews.com/2100-202_162-207853.html
flowerseverywhere
6-10-13, 6:37pm
Alan in my post 35 I mentioned the high cost of corporate health care, and you answered it was a business and all the reasons businesses are worth the pay. Many others have mentioned these costs as being factors in the current sad state of affairs. What do you think is the solution? You have stated you will pay more under the new act. I could be wrong, but if we got the healthcare companies (insurance for instance) out of the equation we would all pay less. Like Medicare, some stuff is covered at x percent, some is not. Period. No lobbying to include more chiropractic visits, or transplants to people outside the selection criteria, or coverage of brand name drugs when a generic will do. You would be able to access good care and many others would be able to as well and you would not have to subsidize others. You know you are paying more under the new act and money will continue to flow, perhaps a lot more of it to these companies as they expand to meet the new rolls of paying customers. Kind of a double whammy for you. Am I missing the point you are making? What is your solution to have more people be covered so we all aren't paying for Er visits, chronic health conditions that people neglect due to not having the money to have health insurance, because it is now not very affordable to many many born in the USA working Americans.
gimmethesimplelife
6-10-13, 11:38pm
It is not because we are rich we spend more on health care. It is because of the health care lobbyists in the U.S. In the U.S. health care prices are ludicrous compared to other industrialized countries with universal care.
Check out the graphs on U.S. costs versus other rich countries -
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
A routine office visit is $30 in France. In the U.S. is it $178. An angioplasty in Switzerland is 5K compared to 61K in the U.S.
If you want to get angry over health care costs, get angry over lobbyists, not subsidized care for single moms with 3 kids.
Read the Time article called Bitter Pill where the reporter follows the money on health costs in the U.S.
Most of the negative articles over the ACA are disinformation campaigns by the power that be in health care designed to lather up the general population against changes in health care laws that would actually greatly benefit the vast majority of voters. They are terrified that if we move to universal care their profit margins will be reduced to more reasonable amounts like those in other industrialized countries.+1
gimmethesimplelife
6-10-13, 11:40pm
People do not necessarily get back into Social Security and Medicare what they put into it (http://www.nytimes.com/interactive/2013/04/03/us/politics/getting-more-or-less-than-you-paid-for.html?_r=0). One of my relatives against the ACA has had 7 figure Medicare bills even though her life span is nearing the upper end of the mortality tables anyway. She never put that much money into Medicare even over her life time.
Yet her household doesn't want tax dollars, and remember a lot of these dollars are coming from households making over $250K a year which isn't her household, to subsidize health care for a single mom with 3 kids making $25K a year.
Most of the industrialized world has universal care. Even in the ones that don't the costs for health care for the poor are not as astronomical as they are in the U.S.
France has top rated health care, universal care and the doctors there still make house calls (http://prescriptions.blogs.nytimes.com/2009/09/11/health-care-abroad-france/). If you want to get angry about tax dollars being squandered I think a better place to vent anger is why are U.S. health care costs so high anyway compared to countries like France, England and Canada? Hint: look at the lobbyists and follow the money. Its the AMA limiting the supply of doctors, the drug companies wanting huge profits, the executives at "non-profit" hospitals (http://healthland.time.com/2013/02/20/bitter-pill-inside-times-cover-story-on-medical-bills/), etc.+1
Personal Finance Tip: Don’t Get Sick, Injured, or Hurt in AmericaWhy are common medical procedures so expensive in the United States?
http://www.psmag.com/health/personal-finance-tip-dont-get-sick-injured-or-hurt-in-america-59831/
People do not necessarily get back into Social Security and Medicare what they put into it (http://www.nytimes.com/interactive/2013/04/03/us/politics/getting-more-or-less-than-you-paid-for.html?_r=0). One of my relatives against the ACA has had 7 figure Medicare bills even though her life span is nearing the upper end of the mortality tables anyway. She never put that much money into Medicare even over her life time.
Yet her household doesn't want tax dollars, and remember a lot of these dollars are coming from households making over $250K a year which isn't her household, to subsidize health care for a single mom with 3 kids making $25,000. .
Probably because they see that it isn't going to subsidize just the impoverished but to the higher income earners as well. My mom was that single impoverished parent working 2 full time minimum wage jobs to support her three kids. Who every week for decades funded both SS and medicare. And when she retired she got less than $500 a month from SS - and had approx $65 a month of that or more taken out to pay her monthly medicare premium. Not a person I would label greedy or selfish. She completely supported the idea of universal healthcare, and would also support the ACA for truelly low income and low asset people who were unable to work or fund their own insurance. However, like many people who have worked for little pay and were unable to save for anything like retirement or early retirement, a car, a house, the kids college, or a trip to Tahati let alone any etras, who had no retirement benefits other than minimal SS, she would be completely against the funding of the higher earning people that the ACA will fund. Especially if those people are not means tested and are using government welfare funds to achieve early retirement, etc... - the topic of this thread ("how will getting subsidized medical insurance under the ACA change your life. Will you be able to retire early, become self employed....?" ). Why should a family of 4 who's self employment income is close to $90k receive extra money from taxpayers to fund their expenses when that single Mom of 3 who makes under $15k and has employer health insurance she has to pay for partially (think Walmart minimum wage employee) get to continue living in poverty. I think that's the problem many people,e have with that ACA. It does too much for the higher earners who don't need financial hep and may have much much more than granny on SS ever did, yet does very little for the low income earners in poverty who are actually in need.
try2bfrugal
6-12-13, 3:44pm
It does too much for the higher earners who don't need financial hep and may have much much more than granny on SS ever did, yet does very little for the low income earners in poverty who are actually in need.
I wouldn't call free health care very little for people who are in need.
The 92K is the high end and that is only for families of 4, and even then the amounts are not free, merely subsidized. Families at that level may still be paying $700+ a month for premiums alone.
I wouldn't call free health care very little for people who are in need.
The 92K is the high end and that is only for families of 4, and even then the amounts are not free, merely subsidized. Families at that level may still be paying $700+ a month for premiums alone.
True - every bit helps but I was adressing why some people don't like the ACA. It's not so much that they don't want to help impoverished, disabled or ill people who are unemployed or under employed due to no fault of their own, or haven't the skills to earn much money, or the assets to live on. I believed many people want to help those folks. But there is a large segment of the population who do not want to see subsidies go to people who may earn higher salaries and have many financial assets and don't need that subsidy to help pay for their insurance. Those aren't the people who have to make the choice between medical insurance or the need to feed, cloth and shelter themselves or their family like poorer people do. So many people dislike fundng them when that money can go to lower income people where it is needed. And don't forget that even a low wage earner who has employer covered health insurance which they may have to pay towards can not get free or subsidized health insurance under the ACA. They have to continue paying their portion of the premiums like always. So that minimum wage working person with employer health insurance who may ride the bus from their tiny ghetto apt may end up paying much more to cover their family than that $80k self employed person with a couple of Mercedes and a Beemer they use to drive the kids to private school with in the 3 car MacMansion garage.
But there is a large segment of the population who do not want to see subsidies go to people who may earn higher salaries and have many financial assets and don't need that subsidy to help pay for their insurance. Those aren't the people who have to make the choice between medical insurance or the need to feed, cloth and shelter themselves or their family like poorer people do. Those are people who are making choices between private s books or a new RV. So ma y people dislike fu ding them when that money can go to lower income people where it is needed. And don't forget that even a low wage earner who has employer covered health insurance which they may have to pay towards can not get free or subsidized health insurance under the ACA.I don't believe that it is a "large" segment of the population. Rather, I believe the subsidies are designed to mostly help people who actually do need assistance affording the high cost of healthcare in our society, and those who are actually surreptitiously more wealthy but still eligible for the subsidies are only a small number.
I don't believe that it is a "large" segment of the population. Rather, I believe the subsidies are designed to mostly help people who actually do need assistance affording the high cost of healthcare in our society, and those who are actually surreptitiously more wealthy but still eligible for the subsidies are only a small number.
You may be right. It would be iterestng to see the actual statistics eventually. And of course "wealth and middle income" means different things to each of us. I may think someone with an income of $50k or so with a spouse and 2 kids is middle income, to another person that would be poor and to another that would be high income. So defining what amount of income is middle or low (and I'd probably be OK with $50k as lower middle but not with it as poor) and what amount of financial assets besides income is middle too would make a difference. I have no idea what that amount would be - but certainly much much higher than the current medicaid amount of $2k. Probably something g closer to $100k or above. And that would just be to qualify for subsidies, no one under any circumstances should be denied insurance ever - and it should be affordable too. Now how to solve that with private Insurers is the big question.
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