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Insurance Costs Under Obamacare - Page 8

post #106 of 739
Quote:
Originally Posted by Piobaire View Post

Why not read the link I have so handily provided?

And pretty much no one in the US "have no access to any health care." That statement is pretty much without meaning.

Sorry for the Ninja edit.

I read the posts scrolling up and I didn't see your post though I replied to Chicago Rons.

I'm gonna read the link now. I get a feeling we are generally in agreement on the subject of "Insurance costs under Obamacare"
post #107 of 739
Here's a lengthy read of a discussion of surgical outcomes for nearly 1 million patients: http://thehealthcareblog.com/blog/2011/03/09/the-urgency-of-medicaid-reform/

End result? Medicaid patients 97% more likely to die in the hospital post-operatively than privately insured people. Uninsured people 74% more likely. Which odds would you rather have?

Warning: the discussion is fairly dry but demonstrates the University of Virginia study of 1 million patients was pretty well done.
post #108 of 739
Quote:
Originally Posted by harvey_birdman View Post

They are trying to exempt themselves from having to participate in these ridiculous health care exchanges the rest of us are going to be forced into by having their own taxpayer funded health insurance program. What do you not understand about this?

As I said earlier:
There's no statutory obligation from Obamacare telling any company that they must drop their employee's health care coverage and place them on the exchanges. Employers have to comply with certain new restrictions (taxes on "Cadillac Plans", no low deductible plans), but they can still offer you health insurance. You are not "forced" to go on the exchange.

Even if you don't have insurance at all, you still don't have to buy from the exchange if you want to get insurance directly from an insurer so far as I know.

The only requirement is that everyone must have insurance that meets certain standards. Employer provided insurance counts for that.
post #109 of 739
Quote:
Originally Posted by Piobaire View Post

As most anyone that has been following this policy debate knows part of the Obamacare plan is to greatly expand the state run Medicaid programs with federal dollars thus giving the poor "affordable" healthcare. Well, there's a problem with that. All data seems to show aggregate health outcomes for folks in Medicaid are equal to or worse than being uninsured. Numbers vary about how many more people will end up on Medicaid roles thanks to Obamacare but I have yet to find an estimate of lower than 10 million people. To put that number in perspective that's about 3% of the entire US population. Add that to the approximately 60 million people already on the program and we have about 23% of the entire US population on Medicaid, or put another way, 23% of the US population has billions in tax dollars buying their healthcare, healthcare that has been repeatedly demonstrated to give aggregate results equal to or worse than being uninsured.

Big win for Obama!

You bet and will be a further argument used with the low doc voters next time to convince them to vote Democrat again out of fear of losing another benefit.

This Obamaite revolution sure is getting its skates on.

Alinsky would be proud of his star acolyte.
post #110 of 739
Quote:
Originally Posted by Gibonius View Post

As I said earlier:
There's no statutory obligation from Obamacare telling any company that they must drop their employee's health care coverage and place them on the exchanges. Employers have to comply with certain new restrictions (taxes on "Cadillac Plans", no low deductible plans), but they can still offer you health insurance. You are not "forced" to go on the exchange.

Even if you don't have insurance at all, you still don't have to buy from the exchange if you want to get insurance directly from an insurer so far as I know.

The only requirement is that everyone must have insurance that meets certain standards. Employer provided insurance counts for that.

We'll see in 5 years when everyone is forced on the exchanges because their employer plans are discontinued because they don't meet the "standards" of Obamacare.
post #111 of 739
Quote:
Originally Posted by Gibonius View Post

As I said earlier:
There's no statutory obligation from Obamacare telling any company that they must drop their employee's health care coverage and place them on the exchanges. Employers have to comply with certain new restrictions (taxes on "Cadillac Plans", no low deductible plans), but they can still offer you health insurance. You are not "forced" to go on the exchange.

Even if you don't have insurance at all, you still don't have to buy from the exchange if you want to get insurance directly from an insurer so far as I know.

The only requirement is that everyone must have insurance that meets certain standards. Employer provided insurance counts for that.

While your statement if factually true we both know it does not accurately represent reality. When legislation is created to make certain behaviours costly and onerous we both know the goal is to make those behaviours stop, or greatly decrease, without actually making them illegal. Compliance with the desired behaviours is rewarded, non-compliance punished by various non-criminal means. Something does not have to be made strictly illegal for the government to stop it from happening for the most part.
post #112 of 739
Quote:
But that report is just the early breeze of the coming storm. The Obamacare employer mandate requires all employers of 50 or more full time workers to purchase the expensive insurance for those employees that Kathleen Sebelius (“The Secretary shall determine”) specifies that they must buy. But that mandate is enforced by a penalty of $2,000 per worker, which may be only 10% of the average cost of family coverage under the Sebelius requirements.
Moreover, workers who do not receive employer provided coverage are eligible to purchase their health insurance on the state Exchanges with extensive taxpayer subsidies to help cover the cost. Indeed, in the Exchanges, low and moderate income workers can even get subsidies covering their out-of-pocket expenses. Employers can terminate their employee coverage, give their workers a raise with part of the savings, and let the taxpayers bear the cost of subsidizing their coverage in the Exchanges. Former CBO Director Douglas Holtz-Eakin estimated in a study for the American Action Forum that more than 40 million workers would lose their employer coverage due to these perverse incentives. It’s going to be even worse than that, when all of the cost increasing impacts of Obamacare are realized.

http://www.forbes.com/sites/peterferrara/2013/04/07/look-out-below-the-obamacare-chaos-is-coming/
post #113 of 739
Interesting take on that thought, vis-a-vis the Grassley amendment:

http://www.bloomberg.com/news/2013-04-25/what-s-so-bad-about-grassley-s-obamacare-amendment-.html
Quote:
The regime the Grassley amendment imposes on Congress is the one that we ought to be imposing on every employer. The tax subsidy for employer-provided health insurance is hugely inefficient; it encourages overconsumption of health care and provides a benefit that becomes more valuable as an employee’s income rises -- so the biggest subsidies go to the people who need them least.

Employer-provided coverage does perform a valuable risk-pooling function, making it possible to cover people whose risky health status would otherwise make it difficult or impossible for them to buy individual insurance. But Obamacare’s exchanges also perform that function, so once they are established, in 2014, the employer subsidy becomes much less necessary.

Economics seem to make sense. Employer based system is too opaque to be efficient and the tax break rewards the wrong people. Good for us higher income folks, probably bad for the country.

Still doesn't address the provider/cost issue, but potentially insurers could drive that if they have to compete on cost.
post #114 of 739
So you're ok with losing your health insurance and getting some shitty exchange plan instead? Great. Another fucking 48%er.

I'm sorry, but some of us didn't smoke crack and blow limo drivers or impregnate the local whore while in high school and were kind of hoping that working toward a career for the better part of our lives might amount to something.
post #115 of 739
Quote:
Originally Posted by harvey_birdman View Post

So you're ok with losing your health insurance and getting some shitty exchange plan instead? Great. Another fucking 48%er.

I'm sorry, but some of us didn't smoke crack and blow limo drivers or impregnate the local whore while in high school and were kind of hoping that working toward a career for the better part of our lives might amount to something.

What I'd like to see is an exchange without the restriction on plans and a removal of the tax deduction (replace with a credit maybe, I'm not a tax wonk). If you want to buy a high deductible plan, you should be able to do that. Want to get a Cadillac Plan? You should be able to do that. You shouldn't get tax incentives for it though (as you do now).

There's nothing fundamentally wrong with exchanges. It's a marketplace, and one that's a hell of a lot more transparent than what we have right now. If we swap employer health insurance subsidies for more salary, the net result should be a positive. Just would take some time for all that to balance out. Aren't you libertarians supposed to like more transparent markets?

No reason to ban employer contributions, but without a tax incentive there wouldn't be any reason for anybody to want to do that.
post #116 of 739
Quote:
Originally Posted by Gibonius View Post

What I'd like to see is an exchange without the restriction on plans and a removal of the tax deduction (replace with a credit maybe, I'm not a tax wonk). If you want to buy a high deductible plan, you should be able to do that. Want to get a Cadillac Plan? You should be able to do that. You shouldn't get tax incentives for it though (as you do now).

There's nothing fundamentally wrong with exchanges. It's a marketplace, and one that's a hell of a lot more transparent than what we have right now. If we swap employer health insurance subsidies for more salary, the net result should be a positive. Just would take some time for all that to balance out. Aren't you libertarians supposed to like more transparent markets?

No reason to ban employer contributions, but without a tax incentive there wouldn't be any reason for anybody to want to do that.



We're going to get fucked one way or another. Our current system (pre and post-Obama) is just structurally impossible to sustain. We're going to have to go through a major shift. Giving up employer subsidized insurance in exchange for more salary, then buying your own plan of your preference (even with limitations) is not so horrible.

First, let's be clear here. The current system is not a "tax deduction" but rather preferential tax treatment of premiums paid through employer sponsored plans. Second, could you explain why removing this "deduction" is good but then doubling back and adding a credit or subsidies on one's tax return is a) different and b) good/better?

Also, yes, libertarians like more transparent markets. They however do not like highly artificial ones created by government entities, like say, exchanges. wink.gif
post #117 of 739
Quote:
Originally Posted by Piobaire View Post

First, let's be clear here. The current system is not a "tax deduction" but rather preferential tax treatment of premiums paid through employer sponsored plans. Second, could you explain why removing this "deduction" is good but then doubling back and adding a credit or subsidies on one's tax return is a) different and b) good/better?
So far as I understand the argument for a credit is that it gives a subsidy back to people who are buying insurance, but doesn't disproportionately benefit higher income earners (like a deduction does, since it comes off the top of your income). Some discussion of this and other concerns in the article I posted (perverse incentives etc).

If we did a dual-tier plan you wouldn't even need the credit I suppose, since the government would handle all the low income people, but that's a whole different discussion.

There's about a zillion articles out there talking about the tax dynamics of all this, I'm not any kind of primary authority so I'm not going to pretend and defend this at any kind of high level.
Quote:
Also, yes, libertarians like more transparent markets. They however do not like highly artificial ones created by government entities, like say, exchanges. wink.gif
What's fundamentally wrong with an exchange? It's a big listing of prices. Seems to work pretty well for stocks, futures, etc, etc. Better than having to go through a bunch of individual companies and ask them for quotes, which is what we'd have to do without something like this (as individuals).

Maybe this one isn't structured ideally, but fundamentally what's the issue?
post #118 of 739
Quote:
So far as I understand the argument for a credit is that it gives a subsidy back to people who are buying insurance, but doesn't disproportionately benefit higher income earners (like a deduction does, since it comes off the top of your income). Some discussion of this and other concerns in the article I posted (perverse incentives etc).

If we did a dual-tier plan you wouldn't even need the credit I suppose, since the government would handle all the low income people, but that's a whole different discussion.

There's about a zillion articles out there talking about the tax dynamics of all this, I'm not any kind of primary authority so I'm not going to pretend and defend this at any kind of high level.
What's fundamentally wrong with an exchange? It's a big listing of prices. Seems to work pretty well for stocks, futures, etc, etc. Better than having to go through a bunch of individual companies and ask them for quotes, which is what we'd have to do without something like this (as individuals).

Maybe this one isn't structured ideally, but fundamentally what's the issue?

Well, you're assuming here (and probably rightly) that a credit will be implemented in such a manner as to be more welfare through the tax code but it does not necessarily have to be means tested...theoretically.

As to my statement about the exchanges proposed...they're not free market which is what said libertarians would want. They are artificially bound by geographics (per state), the products are artificially mandated in structure vs. letting markets determine the structure...heck, even the consumer pool is artificial as insurers are not allowed to either pick the market they wish to serve (must serve one and all) nor the products they wish to offer (mandated). Now, within this heavily regulated and constructed exchange Obamacare hopes to garner the pricing benefits of market pressures. Given the highly twisted "market" we have here I think we can guess exactly how close to a Pareto efficiency we are likely to get.
post #119 of 739
Quote:
Originally Posted by Gibonius View Post

So far as I understand the argument for a credit is that it gives a subsidy back to people who are buying insurance, but doesn't disproportionately benefit higher income earners (like a deduction does, since it comes off the top of your income). Some discussion of this and other concerns in the article I posted (perverse incentives etc).

If we did a dual-tier plan you wouldn't even need the credit I suppose, since the government would handle all the low income people, but that's a whole different discussion.

There's about a zillion articles out there talking about the tax dynamics of all this, I'm not any kind of primary authority so I'm not going to pretend and defend this at any kind of high level.
What's fundamentally wrong with an exchange? It's a big listing of prices. Seems to work pretty well for stocks, futures, etc, etc. Better than having to go through a bunch of individual companies and ask them for quotes, which is what we'd have to do without something like this (as individuals).

Maybe this one isn't structured ideally, but fundamentally what's the issue?

OJFC, a government run "exchange" is in no way a free market. It's like buying lunch at a New Jersey rest stop. Sure, you can choose from Hardee's or Popeye's or Cinnabun, but the prices are all jacked up and you can't choose to eat at White Castle if they don't rent space there.
post #120 of 739


What's the matter? You don't like your choices? These are governmental approved eateries for you. Don't question authority.
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