Hey there, My Righties...

Whatzzzzz up!? How's it hangin'?

It has been while, I know. My bad. Sorry we haven't been hanging out.

It's just that some stuff has been going on. Not bad stuff, but stuff. You know...and I'm thinking that we just can't hang any more.

But hey, you guys are still my peeps - always will be. We had some good time, chillin', and I wish you the best. I know you're going to kick it on your own.

Best of luck with the OB-man. I think you guys are going to rule it with the ROmminator. Really. Good times ahead. For sure.

So take care.

Always your Bro,

Justice Roberts

A tax by any other name is still.... a tax
Now we will have to see how it plays out in the fall.

Yup, kind of interesting. I thought the governments primary argument was that it was not a tax. Seems he went out of his way to justify his call.

All the dem victory laps today have been about the "free" to this point rules changes, and none of them want to mention a peep about the biggest coming tax hike in our history. Without a little help in November, it may be a very expensive New Year.

I made a New Year’s resolution not to aggravate people on internet forums so I will try to say this delicately. Things usually do not end the way they begin.

When the dust settles the progressives will realize they fought tooth and nail for a mandate/tax that is exceptionally regressive. Not that I care either way. I just find it ironic.

This may actually help me out because I’m trying to figure out how to work less. When the insurance exchanges kick in I can go to independent contractor or part time status without having to worry about healthcare. If I keep my adjusted gross income below the cutoff I can even get federal assistance. Maybe I will only work a few months a year and have more fun.

I’m pretty sure I wasn’t the target demographic for healthcare reform...Or maybe I was. One never can tell.

Ryan, yep, you can probably do that. You could do it even before Obamacare. I know guys who did.

Someone will always want to game the system.

But there will be a lot of people with good ideas and a decent work ethic who will be able to start businesses, some of which may grow and employ significant numbers of people.

I guess it's all in the way people perceive opportunity.

Interesting Gnomon. This is a valid concept under any circumstance. What would make you believe it would be easier or better to start a business with the burden of higher overhead. Might perceived opportunity be a no bid contract servicing the new entitlement. Chances are the opportunities would more likely be an increase in government work force?

craig, I may be wrong on this but I think the number of gov't employees (not counting military) has retained about the same proportion of the total US population for a long time and probably won't change significantly.

I also suspect that there won't be a "burden of higher overhead" but rather a lowering of cost - if everyone is insured then the risk is distributed and individual premiums go down - this is why I had long hoped for a single-payer method. That's the ideal thing to promote small business - even Mom & Pop stores could afford to hire someone if they were all covered by some basic insurance. I know anecdotes cut both ways but a young guy around here has a thriving lawn-mowing/gardening business. He works dawn to dusk and is a very decent guy. He's killing himself because he cannot afford to hire full-time help. The labor market has gotten very tight and he's competing with other employers and he just can't manage to pay the salary and offer insurance.

Ryan made a very important point - when Obamacare cuts in he can afford to go "independent contractor" route. Many people will be able to do that, not necessarily to rip off the system but to do work they like better, to learn new skills and maybe spend time raising their kids. Some will have the goal of keeping their AGI way down; most people will still want to increase their incomes. Only rarely do people turn down the opportunity to earn more money.

I think the word "entitlement" carries different baggage for different folks. I don't think of being able to buy health insurance as an entitlement but I suppose others might. The two big beneficiaries of this cumbersome Obamacare are the private insurance companies and the public. I'm not sure where your "no-bid" comes in here - what will be no-bid?

Sorry- I rambled.

Gnomon,
Obamacare will not induce Ma and Pa stores to hire employees or help your start-up landscaper hire full time help.
Take your gardening specialist, in order to hire someone and be fully legal he will need a workers compensation policy and be charging enough and have a volume of work to pay his employer contributions all in all about 25% over the projected salary. He also needs and may not have liability insurance for his business and depending exactly where you reside may need state licensing and bonding and a City license for the areas he intends to work in. Also once employees are in play the house in which he resides is probably not zoned for contracting operations and he will have to rent a yard or office and increase his liability insurance to cover those premises. If in addition to just providing labor he also provides materials he will need to start collecting any sales tax if that is applicable. He will also need to be able to cover these costs even in a slow month. Oh and then there is the Obamacare.

PM - my age is showing! By "young" I meant in his 40s.

Everything you say about his business is true, except that you assume he's done none of it. He has been in biz some 20 years and isn't the kid next door with a borrowed lawn mower. In short, he's been running a real business for a long time. Why assume he's operating out of his house? The guy has several trucks and trailers for his equipment and operates out of a commercial building. He used to have 2 guys working for him but the labor market got very tight and they got poached.

And the guy's rates are not for the faint of heart! By the way, he's fully insured - his mower once threw a stone through a picture window and it was fully covered by his insurance company.

Obamacare may, as Ryan pointed out, may make it possible for some people to go the independent contractor route and my "young" landscape guy might get workers that way.

you are certainly wrong re the # of govt employees being the same over many years. There are far more state and fed workers now than 30 years ago. Just the enforcement of Obama care will add even more.

You're right - the TOTAL number of all gov't employees is higher now than it was 30 years ago.

My point was that I thought the percent relative to the total US population was not much different. I do not think the number of employees per million population has changed much. Admittedly I am relying on memory and haven't looked it up. Am I wrong about that?

Where to start. No big deal G. It's a very simple matter to look up self employment taxes, medicare taxes and scheduled rate increases for 2013. It will be more expensive for an employer to hire someone, and if you check, an individual will be required to pay both the employee and employer portion. Just one small part of coming 'taxes'.

Your blanket spread the risk theory doesn't mention the track record of the entity that is administering the health plan. There are specific dollar amount 'taxes' that increase over the next four years on the entire 'middle class', who ever that has yet to be determined may be. If you have some sort of health plan you would know that premiums are increasing and under the new law projected to mushroom.

No one said your personal purchase decisions are an entitlement. You may be disappointed to discover that you 'cadillac' health plan, meaning private, is scheduled for a forty percent tax. Drop in the bucket because you're rich, or are you prepared to stand in line with the peasants on principal. So, how again does private insurance benefit by your hoped for single payer method.

Your original example was of a hard working responsible go getter. Wouldn't that person factor in healthcare for themselves and their families, or just assume it'll be cover by the government. Isn't that the entitlement mentality.

It will be just another bureaucracy and about as worthless as the existing ones. Hopefully we'll get rid of the Kenyan and regain control of the Senate in November. If that happens the whole Obamacare fiasco can be repealed.
Jim

Just wondering how many in this discussion are eligible for and turned down medicare?

Anybody who is working on a W-2 basis is paying for MediCare out of every pay check. Many of those who work for companies with group health benefits will find that they are precluded from simply continuing on the group plan if they continue working beyond age 65. Why? Because the group plans often have provisions that require participants to elect MediCare as their primary coverage once they become eligible for MediCare. Some are forced into MediCare because of these provisions, even if they can elect the group plan as secondary. In addition, it is virtually impossible for any individual who is age 65 to purchase an individual policy (except for a HIPAA policy) because of the medical underwriting requirements of the insurance companies. Most companies have tightened their underwriting criteria since ObamaCare came on the scene, because they don't want to take on any risks now that they don't absolutely have to. So, once you turn 65, you probably don't have any choice other than to sign up for MediCare.

MediCare is not an entitlement program. It is a plan that you pay for while you are working (1.45% of your gross income, plus another 1.45% contributed by your employer), and that you continue to pay for once you begin active participation, through monthly premiums. Obama's plan will double your Medicare participant premiums by 2014. May not look like a tax, but is has the same net effect.

Isn't five hundred billion dollars being cut from medicare under the obamacare plan.

The numbers are squishy, but premiums are going up and benefits are going down. Double whammy for those over 65. OMG.

The actuaries will tell you that the gov't will probably still need to raise the age for future MediCare participation, just as they did for Social Security participation. Both programs are not sustainable under the current formulae and demographic trends.

Something about your landscaper story does not make sense. Why isn't he competitive in the labor market after 20 years in business? If he had two employees he must have had at least 120 man hours of work per week to keep them and himself busy. How is he completing that work by himself? and if not how is he carrying his overhead? With unemployment at 9% has he advertised for help? No one will work because they don't like his healthcare plan? How much does he charge?

You don't need Government intrusive healthcare to become an independent contractor, never have. Healthcare can be bought now on your dime and your dime only. Ryan pointed out he was going to game the system and feed at the trough at others expense.

craig all your comments are interesting and certainly discussable. I only take issue with:

"So, how again does private insurance benefit by your hoped for single payer method. "

A single payer method is the most efficient way to buy medical care. We are unlikely ever to get it and our national per-capita health expenditures are likely to remain among the highest int he world. Under Obamacare private insurance companies will benefit (by "Private" I mean non-gov't corporations that sell insurance, not the insurance that they sell). Under single-payer they would not make as much money even tough they would be able to sell any supplemental plans they want, as they can do in Britain, for example.

Also, Medicare is run very efficiently. Social Security is very efficient also. The overheads are actually very low.

Thanks for you input- gotta run - got a meeting.

P.S. Glad to know I'm rich!

Let's not confuse "healthcare" with "health insurance." Sure, anyone with the money can go to the doc or the hospital as a private pay patient, and the providers absolutely love those folks. But if you actually try to purchase an individual health insurance policy, you are likely to be very disappointed. The insurance companies are not accepting any risks, and the only way you can get underwritten is to be young and in PERFECT health. Underwriting has gotten much tighter since Obama got his plan passed, because the insurers will be forced to take all risks come 2014. So, they are now taking no risks, to maximize their short term profitability between now and 2014.

And, going the independent contractor route may sound easy. It's only easy if you don't get caught. The IRS has pretty specific guidelines about who qualifies as an IC rather than as a statutory employee. Most people working as IC's do not meet the IRS guidelines, and the penalties if you get caught fall on both the IC/employee and the employer. You can expect the IRS to step up enforcement come 2014, because they want as much of your money as they can get, and they know violations will become more common as Obamacare phases in and as the economy improves.

I am self employed and have been providing for my own healthcare/insurance for years. I am an independent contractor and have a St Lic.
Ryan was speaking about going from employee to IC doing the same work and would need to take care for sure to meet the requirements.
Gnomon was speaking about a true IC with employees.

As pointed out, inability to buy medical insurance or exorbitant premiums with limited coverage is the same problem faced by many who are not in perfect health and certainly those with preexisting conditions. Also, medicare is not paid for by the small medicare tax nor by the monthly premiums for Part B. It is an entitlement whether you want to recognize it or not. It seems to me (and I am on Medicare) that it's a bit disengenous to try to treat Medicare as if it is somehow different. It sort of reminds me of the teaparty signs to "keep the gov't out of our social security and medicare." Personal expediency trumps conservative political views almost every time, although many conjure up rationalizations for that expediency.

Ugh, I should have kept my mouth zipped.

I’m not hoping to game the system (if one even can). I just want to take a few steps back.

My work ethic is needs rehabilitation. For the last few years, working has been like fishing in the wrong tide. You catch a few but it is too damn hard to be worthwhile. I’m ready to take an easier path.

Health insurance happens to be the biggest obstacle to walking away. Maybe that will change, maybe not.

Ryan - I apologize if I sounded as though I was accusing you of trying to game the system. The scenario you painted is entirely legal - just as legal as someone paying zero percent Fed income tax on "qualified" dividends from stocks.

cpa- thank you for that insight - I have never worked thru the Medicare numbers and don't know how much of Medicare is actually paid for by the Medicare tax and premiums.

re my lawn guy - he bought the business a long time ago and works like a demon. He charges by the area and complexity of the mowing (basically an hourly rate that I never understood but I pay about 5K/annum for his services) He is good and would like to expand. He thinks there are a lot of guys who are employed who dislike their jobs but don't dare quit because of health insurance that they can't get on their own.

Unemployment around us is nowhere near 9%. It's more like 3-4% and those 3-4% are slobs. Lawn man told me that he's tried hiring a few of those and they don't pitch in and work but stand there and watch him do the heavy lifting. The unemployed around here are those who don't want to work and you won't find local liberals disagreeing.

But Lawn Man's story is anecdotal and I'm sure there are many anecdotes that disagree with his! But thanks for the comments.

So let me get this right, single payer is better for private insurance companies because they would not make as much money. How about this, the company chooses to make a lower profit to compete in the market place. Do we need obamacare for them to sell supplemental plans.

I like your consistency G. Lots of assumption, but little meat n taters. So, you believe obamacare will be run just like social security and medicare. I do take one issue with your last comments though, prove you're not rich. Instead of giving away sidelocks, why don't you donate a couple of boxlocks to Dave for a support raffle.

Made me smile G. If the time is wasted it may as well be pleasantly. Ones mans slobs are another mans victim in need of healthcare. Shame on you.

I also believe cpa was trying to pass along to you that the IC senario may not be 'entirely legal', ifin you don't want surprise fines, back taxes and penalties. Just isn't that easy, particularly if it's the same job for the same 'boss'.

Because Dave isn't my nephew and I don't have any boxlocks!

Actually I do have boxlocks but I do not have to prove that I'm "not rich" - that is ridiculous.

And you're right again! But it is not the responsibility of the American consumer to provide great profit to any industry whatsoever. They gotta earn it.

And some industries and companies die in the process.

Think RIMM

See you tomorrow- I'm off to my usual Friday white-tie dinner with my fat-cat liberal corporate buddies.

But you pay your gardener $5K per year to mow your lawn. "That is ridiculous."

I just can't follow the thought process whereby his labor problems are going to be solved via Federally run healthcare. Increasing his labor costs will cause him to increase his fees. You now pay 420.00 per month for your lawn service. If he needs to give a health insurance policy inorder to secure labor would you be willing to pay 600.00 for your same service?

Gnomon's lawn guy will be exempt from the employer mandate to provide health insurance to his employees. Business is too small.

That is true but Gnomon stated that Ma and Pa businesses and his lawn guy could now hire employees based on the presumption that health insurance was going to become more affordable. Insinuating the law was going to spur new hirings. I am just trying to work through that.

Don't even try to work through that logic. Gnomon is confused. Health insurance will become more available, but that does not mean it will be any less expensive. Administrative costs will go up for employers and insurers, and enforcement costs will go up for the government (that means more, higher taxes). The lawn guy will still be the lawn guy, and he will still have difficulty finding new employees who actually want to work.

Cpa, MediCare was passed in 1965 and implemented in 1966. The maximum MediCare withholding tracked with the SS max until around 1993, at which point the MC max was uncapped and the MC rate went to 1.45% of gross wages (plus the matching amount from the employer). For someone earning the SS max of $135K in 1993, the MC deduction was almost $2K, plus the employer's $2K. Over the years the net MC tax has increased at more than three times the rate of inflation, because of changes in the posted rate and in the amounts on which it is assessed, plus the overall growth in wages. You might want to run an NPV calc on the total withholding paid by a hypothetical employee and his employer's matching contributions for someone who entered the workforce around 1970 and is turning 65 about now. You will need to make some assumptions about contribution levels and discount rates, but the NPV will be astoundingly high (the corpus will be all tax-free money, of course). I think it's reasonable to use a long term pension rate discount assumption of 7.75% for a 45-year career, and a life expectancy of about 18 years after achieving MC eligibility. Then use the NPV and the discount and life expectancy assumptions to set up a sinking fund for that employee and see what kind of premium can be supported for the actuarial lifespan. Include the new Part B premium which will be around $214/month (this from memory) in 2014, with annual increases after that. Most of us have paid and will pay plenty for the privilege of being in MediCare. I know that for me, it's not an entitlement program, because I have paid in a ton of money over the years, and will continue to pay when I become eligible for benefits. It is an entitlement for low-wage workers, because they can never pay in what it will cost to care for them, and the higher wage earners will continue to subsidize them.

The main reason that withholdings and Part B premiums can't support the aggregated program is that the government pisses away so much of the money and is fairly inefficient in its overall administration. This is compounded by the same increasing life expectancies that are dogging Social Security. Re Obamacare, I am coming to the conclusion that we need a mandatory national plan (similar to Medicare) with involvement of for-profit insurers, but with strict regulation as a public utility.

Whew, seems like taking the long way home. In a nutshell, the program is not solvent and it'll be up to our grandkids to decide what we're entitled to.

It's insolvent because of governmental malfeasance on a grand scale over many years. You have to separate the MediCare issues from the Obamacare issues, even though Obama is financing Obamacare partially on the wallets of the MediCare recipients who have already paid into the system for their entire working lives. Much of the financing approach fits nicely with his apparent desire to redistribute wealth in this country. There are no nutshells for this problem. It is massive and complicated (and expensive).

In part, Replacement wrote:
" Re Obamacare, I am coming to the conclusion that we need a mandatory national plan (similar to Medicare) with involvement of for-profit insurers, but with strict regulation as a public utility."

Well said!! This is close to the Swiss model and it works well.

re someone else's comment on my lawn guy - yes, health care insurance will be available but it will also be mandatory and that takes it off the table as a hiring chip. Yes, he will still be the lawn guy but that's the nature of his business. It is the nature of any one-man business that depends upon the guy's manual labor - if he breaks a leg in late June he's screwed; if he needs a liver transplant he's screwed. The guy he bought the lawn business from runs an excavating company with a partner. If one of them gets laid up the biz will survive. Lawn man badly needs to become at least a 2-man operation.

By the way, Replacement, thank you for your analysis of Medicare pay-ins.

Yep, the employer mandate won't kick in but the hirees will have their own insurance.

[/quote]

Yep, the employer mandate won't kick in but the hirees will have their own insurance.

[/quote]
Or they will pay the tax < 300.00 per year.

He, the lawn guy, is not competitive (he doesn't offer enough compensation) in the labor market now and Obamacare won't change that.

He could still run his business with broken bones but someone needing a liver transplant probably doesn't need the stress of self employment. Partnerships rarely work.

Or they will pay the tax < 300.00 per year.
[/quote]

Yep, a loophole in Obamacare as currently constituted is that it is cheaper to pay the penalty (i.e., tax) than to buy the mandated coverage. For anyone willing to go without coverage for the nickel and dime ills of everyday life, it will make economic sense to just pay the penalty/tax, and defer the insurance purchase until something serious happens. If you are young and healthy, you could go for a lot of years before you need to pony up for a full premium. Economically, the concept is similar to the idea of a catastrophic coverage policy in which you self-insure for minor ills and then can fall back on the catastrophic coverage if something bad happens. With the elimination of the pre-existing condition exclusion, this will become a reasonable strategy for some people. It also works against the long term success of the plan design (such as it is) and creates an adverse selection bubble down the road.

Some of the best minds in the country are working on this problem. Unfortunately, those minds are not in the government.

Are you sure your lawn guy is a good example. I believe it shows that you sit back with comfortable means and refuse to acknowledge what joe average has to contend with.

The reason for taking on a partner over an employee is to have someone with 'skin in the game' or an incentive to create billable services. Your reason for having a partner is to make a nonproducer entitled to the others production. Wouldn't most legal partnership agreements limit the liability, or is your legal perspective one of a taker not creator.

Your lawn business may survive forever on paper, but are you going to be satisfied with their service if no one stopped by for the last six months. With your new revelation of medicare taxes and scheduled increases, does that make it easier for a start up company to do business. Remember this wink and a nod didn't even get to the taxes or penalties that'll fall under obamacare.

Gnomon, we have single payer in Canada. It is a disaster. Single payer (government only) means inefficient, bureaucratic bloat. No getting around it.

Yes, I know, it doesn't HAVE to be that way. But human nature being what it is, government being what it is and bureaucracies being what they are, costs will spiral out of control so fast your head will spin.

Why is it a disaster?

What percentage of revenue goes toward medicine and what per percent goes to overhead?

I do not know about your country and will not comment upon it, but here in the USA Medicare and Social Security are well-run, low-overhead agencies that undercut private suppliers. Since I don't know the Canadian situation I don't think it appropriate to comment upon your government.

However "inefficient" you may think your program is, you guys are getting a far better medical outcome per buck than we are.

I disagree. Aside from that, there are no private suppliers for Social Security, unless you are referring to defined benefit pension plans. Many, if not most, DB pension plans are currently severely underfunded.

Regarding private suppliers for MediCare, there are plenty of health insurance companies in this country that could be said to be alternatives to MediCare. If MediCare is undercutting those companies, how is it that virtually every big health insurer offers a Medicare risk contract that beneficiaries can select as an alternative to government Medicare? These companies offer these "senior plans" because the plans are profitable for them and because subscribers like them. No undercutting here, either.

Actually, they are probably not getting better medical outcomes per buck of medical expenditure. It may look that way because of differences in the way the medical expenses are counted, and because the U.S. legal system forces huge incremental costs onto our system that are not actual medical expenditures. Some of my best friends (and my son) are lawyers, but I still think tort reform is part of the solution to the health care conundrum in the U.S.

Can you explain these risk contracts? Are you referring to Medicare Advantage Plans? If so, they are subsidized by the govt. at an avg. cost 14% greater than traditional medicare.

I realize you'll tend to selective pot stir, but could you elaborate on your comments. Is it simply a matter of repetition to convince yourself of validity. Are you just smarter than regular folks. Do these topics come up over cocktails and lunch at the upscale country clubs.

Since you don't know and you volunteer that it's inappropriate to comment, how might you conclude about medical outcome. Do you subscribe to the end justifies any means. I can appreciate that you draw your own conclusions, but do you prefer if folks ignore questions about your support comments.

Yes to Advantage plans. The insurers, providers, or integrated health networks agree to take over total responsibility for care for their subscribers. The feds like this because it relieves Medicare of the risk associated with these beneficiaries (hence the reference to "risk contracts," as they are known in the trade). The feds are happy to subsidize the Advantage plans because then they no longer have to deal with the beneficiaries and their ills. If the Advantage plans could not run their plans at a profit, they would not offer the plans. I mentioned these plans to refute Gnomon's suggestion that MediCare is somehow undercutting the private plans. In fact, MediCare is aiding and abetting the private plans.

I also mentioned governmental waste. An example of this in the MediCare context would be the PACE programs (Program of All-inclusive Care for the Elderly). PACE programs are notoriously lucrative cash cows for the providers, because the providers are paid per member per day. In 2007, the national average provider payment was $3000 per member per month (PMPM), with a high of $4300 in NYC and a low of $1700 in Miami, with PACE programs operating in about 28 states. Five years later, allowing for the rapid, compound inflation in health care costs, the national average is probably approaching $5000 PMPM. In the Los Angeles market area in 2008, the payment for a full-time PACE participant was about $4700. Full-time means the participant is in the PACE center five days per week, but not all are. Reimbursement in L.A. was a bit over $200 PMPDay, as I recall. Why does this matter in this discussion? Because nationally, about 40% of PACE funding was coming from MediCare and MedicAid, all administered by the Centers for MediCare Services (CMS), using your tax money. In CA, MedicAid is called MediCal and is administered a bit differently than the federal programs. In CA, there is no requirement for PACE participants at Federally Qualified Health Centers (FQHCs) to pay any premiums, MediCare or otherwise, because the MediCal guidelines set a sliding fee scale based upon ability to pay. The fee scale slides all the way to zero for a lot of the local participants. That means that 100% of the cost of PACE is paid with our tax dollars, and the FQHC PACE operators even get a higher payment rate than do for-profit operators. PACE programs are a wonderful idea and provide a range of necessary services, but waste and abuse are rampant, increasing the overall cost of health care in this country.

What it boils down to is this--->How many dollars does it cost the federal government to spend one dollar?

Without looking it up, I seem to remember that the administrative costs of SS are about 3%. No private insurance company can match that - it is indeed a well-run entity. Whether or not SS should be doing all it's doing is another issue, but it is efficient.

There's a hell of a lot of money in SS which is why the industry wants to privatize it. That would be a real scam. Millions of tiny retirement accounts, expensive to manage, getting fleeced by Wall St.

Replacement wrote (in part) " I mentioned these plans to refute Gnomon's suggestion that MediCare is somehow undercutting the private plans. In fact, MediCare is aiding and abetting the private plans."

I had thought that the Advantage Medicare plans were given to the private providers to manage because of intense lobbying by the industry. The Advantage plans are much more expensive, administratively, thann Medicare. A larger percentage of Medicare dollars goes to health care if paid directly by Medicare than if paid via the private contractors.

The same thing with student loans - there is no reason why banks should administer student loans and take a fee if the gov't can do it for less. Obama cut the banks out of the chain and now the money that goes into student loans has a lower administrative cost.

Stop spreading lies Gnomoron. There would not be such a problem with ultra high medical costs or ultra high college tuition if the government had not intervened by instituting subsidies for both without any measure of control. No one is asking why these two parts of the economy have exceeded the rate of inflation so much for so long. Sometimes government intervention is the answer. More often, it is the problem.

When oil is flowing out of the ground faster than you can handle it, you build more storage tanks and accept it. You don't burn it or try to stuff it back into the well. Universities, Hospitals, Doctors, and Insurance Companies have been more than happy to accept the overflow.

Now go back to the "Re: Fast and Furious Executive Privilege" thread and answer the two simple questions I asked in my last post. Stop telling lies. Stop trying to cover your previous lies with more lies.

keith wrote (in part):
" No one is asking why these two parts of the economy have exceeded the rate of inflation so much for so long."

This issue is being discussed and argued over incessantly. Nobody is ignoring it and people most certainly are asking "why"?

Why are you ignoring my request to go back to the "Re: Fast and Furious Executive Privilege" thread and explain your filthy lies.

Grow a pair. Man up and put up... or shut up. Filthy liar!

At the end of last year on the 23 of December, the administration quietly released an unaudited report that federal unfunded liabilities were sixty-five Trillion dollars. Not only has actual debt ballooned, but so have liabilities and money printing in the last few years.

Knowing your administration and its fondness for sunshine, the actual numbers will 'change'. Six hundred plus thousand dollars liability per household does not spin well into efficiency, but thanks for the partial list of superficial diversions.

Yep the debt has ballooned. And it's gonna get worse.

Efficiency and spending are 2 separate things and are independent of each other. I could run up a monstrous household debt by spending all my money very efficiently (maximum amount of stuff per dollar) but that would be unwise.

Gnomoron, this was directed at you, filthy liar. TTT

The medical loss ratio (MLR) on some (not all) of the Advantage plans may not be higher than that of govt Medicare, but the subscribers prefer the service and outcomes of the Advantage plans. That's why they subscribe to the Advantage plans in the first place, and that's why they generally stay in them.

Re the lobbying issue, the insurers and providers saw a market opportunity that they thought they could make money on. The market has spoken, and the plans are generally profitable. That is capitalism at work.

I brought this up in response to your contention that MediCare is undercutting other insurers and provider organizations. MediCare is not undercutting anyone.

From one of your earlier posts:

Thanks Replacement - I was wrong about the Advantage plans. I had thought they were simply a part of Medicare run by private insurance companies.

Time to face the music Gnomoron. Answer the questions I posed in post #283333. You falsely accused me of some things. Prove it you filthy liar.

I received this e-mail today from my insurance provider:


NEWS ABOUT HEALTH CARE CHANGES!

US Supreme Court Upholds Affordable Care Act

On June 28, 2012, the US Supreme Court upheld the Affordable Care Act (ACA), ruling that the law's individual mandate is a constitutional exercise of Congress's power to impose taxes

With the exception of the limitation on the federal government's authority to withhold Medicaid funding, all provisions of the ACA stand and compliance efforts likely will move ahead at full speed. In preparation for the major coverage expansion to occur under the ACA in 2014, the Administration is expected to release a host of regulations dealing with the definition of minimum essential coverage, employer coverage and reporting requirements, and an array of new taxes and fees. Clients should be aware of provisions of the law set to take effect in 2013 and 2014, including those listed in the table below.

Provisions of the Affordable Care Act That Take Effect in 2012, 2013 and 2014

2012

• Medicare hospital value-based purchasing program
• Increase in physician quality reporting requirements in Medicare
• Additional Medicare pilot programs on alternative payment methodologies, e.g., accountable care organizations
• Increased requirements for hospitals to maintain not-for-profit status
• Fees from insured (including self-insured) plans transferred to the Patient-Centered Outcomes Research Trust Fund

2013

• Increase Medicare payroll tax by 0.9% on high-income earners
• Impose a 3.8% tax on net investment income of high-income individuals
• $500,000 cap on health insurers' deduction for executive compensation
• Eliminate employer deduction for Medicare Part D subsidy
• FSA limitations
• Excise tax on medical device manufacturers and importers
• Medical expense deduction floor increases to 10%
• Nationwide bundled payment pilot begins in Medicare
• Increased Medicaid reimbursement for primary care
• Medicare physician comparison data available to the public
• Reductions in Medicare payments for select hospital readmissions
• Expanded coverage of preventive services by Medicaid

2014

• Employer mandate and individual mandate
• Employer and insurer reporting requirements
• New health insurance market reforms take effect
• State health insurance Exchanges established
• Premium tax credits and cost-sharing subsidies available to certain individuals in Exchange insurance products
• Medicaid expansion to new populations (100% federal match to states for newly- eligible populations through 2016)
• Annual fee on health insurers
• Medicare/Medicaid DSH payment cuts begin
• Independent Payment Advisory Board (IPAB) issues first report to Congress if Medicare spending exceeds growth target

Post-2014

• Excise tax on high-cost employer-sponsored coverage

It is going to get very ugly, very quickly. Health insurance coverage will be more accessible but less affordable, and we will all have less money to spend on other things.

The various mechanisms and layers of bureaucracy to implement this plan boggles the mind. How can anyone think this is good for the country or good for business. I am worried for our next generations.

I'll give the Democrats credit for one thing... if a Republican President had promised not to raise taxes on folks earning less than $250,000.00 per year as Obama did, they would be howling non-stop about the broken campaign pledge.

Strangely, Democrats are being pretty quiet about this broken promise. Go figure.

Thieves, whores, and liars, all of them.

gnomon,if obamma care is such a great plan why all the exemption for the union etc.replacement is correct "thieves whores and liars"

They're on to you Gnomoron.

I'm referring specifically to the politicians. Dirt bags.

That's OK because he's ignoring me anyway. But I don't believe that either because he's such a pathological liar that he doesn't even know that he's telling lies.

If Obamacare is allowed to stand it will create another federal bureaucracy of thousands of worthless employees and billions of dollars in unecessary expense, That's the bottom line of this commiecrat boondoggle.
Jim

every one else is playing checkers Roberts is playing chess.the politicians are thieves whores and liars.

Sadly this is true on both sides of the aisle. If Obamacare is repealed it will be replaced by some equally useless, unfair and ineffective program. Or replaced by nothing, which is just as bad.

Well if the dems aren't gonna repeal it them it must be the republicans who're unfair. It would be a very short list of 'bad' things if it was replaced by nothing, but I believe the right had the Ryan plan. What's your plan and how many nonexistent tax dollars will need to be printed or borrowed.

It's pretty clear that doing nothing is not the answer. I guess you see something or someone you're willing to trust; good for you. I haven't seen it on either side.

They are almost all crooked morons. I'll give Obama credit for trying to do something, but I just don't like what he has done, nor do I care for the way he rammed it through the legislative process without adequate review or disclosure. If Obamacare gets repealed, we still need to fix a lot of things related to our health insurance and health care systems. Those are two separate but related systems. The solutions go way beyond those two systems, and include factors such as tort reform, border control, state insurance restrictions and regulation, allowable scope of services for medical and dental professionals, the federal and state tax codes, the orientation of the NLRB, and the list goes on. We need an integrated approach to solving this problem and the legislators seem incapable of thinking rationally or on a macro scale. There is way too much ass covering and posturing at the federal level for the problem to be solved any time soon. Obamacare is not the solution, but we may be stuck with it anyway. Suboptimized more because of politics than because of economics. Crap. A pox on both houses.

Right you are. And both sides are so locked into their ideology that neither is willing to step back and do what's necessary to move things forward.

Most if not all of the 'factors' can be fixed for free through legislation not taxation. I do not blindly subscribe that it's broken. We have the best healthcare in the world. If given a stack of stats on how great things are somewhere else, I know where I'd prefer to get sick or more importantly where I'd want my wife to get medical attention.

There's an underlying implication that we need more money, and a panel of smart folks who decide how to spend it. 'Allowable scope of services', are you sure if that's legislated, things would be better.

If you don't realize that the system is broken, then you are not paying enough attention. I never said nor implied that it needs to be fixed through (additional) taxation, but the current tax code is an impediment to reforming the health care system. They are already collecting plenty of our tax money, but they are not spending it efficiently. We have some of the best health care in the world, but it is not THE best (see comparative data on infant mortality, for example). The fact that not all of our outcomes are at the top of the heap is not necessarily the fault of the system. Many of the problems, especially re chronic disease patterns, are directly related to lifestyle choices by the population, whether conscious or unconscious. Health education is part of the solution, just like controlling the borders is part of the solution. No single factor will fix the system. I'm not talking about "how great things are somewhere else," but rather how much better things could be here if the government got its head out of its ass and screwed it on straight. If the government were a patient, the diagnosis would be acute cranial-anal impaction. There is no "underlying implication that we need more money, and a panel of smart folks who decide how to spend it," at least not coming from me. We need to do a better job of allocating the financial and other resources that we already have, and "smart people" are probably best equipped to do that. Re "allowable scope of services," I am absolutely sure that if scope of service and related payment issues were refined, that we would have a more efficient delivery system. Just as you don't need an electrical engineer to replace a blown circuit breaker, you don't need a board certified surgeon to diagnose and treat a common cold.

Re your comment "Most if not all of the 'factors' can be fixed for free through legislation not taxation." I agree, but a large component of the problem is that the politicians who could fix much of this through legislation are neither smart enough nor honest enough to get it done.

Oh, I think they're smart enough. Smart enough to do what's best for themselves. Now, honest enough? That's another matter.

With very few exceptions, they are not smart (i.e., informed) enough to grasp the nuances of the systems, because they have never worked within the health care or health insurance systems, and have not taken the time to immerse themselves in the details. Even if they did that, many don't have the innate intelligence to synthesize the data into useful information and action plans. This is compounded by the myriad of personal and political agendas that they are pursuing. Few, if any, actually have the best interests of the country and the electorate in mind. Some of the most intelligent people I have ever worked with have been in health care, but their intelligence did not give them the ability to fix the parts of the system that they had no experience in. The clinicians often do not understand the business and the business guys do not understand the clinical aspects. And the government relations people only understand politics.

Your point is well taken. They're smart enough if they would apply it correctly; I agree that most don't or won't. You are spot on that politics, personal agendas, and pleasing their special interests take precedence over what's best for the people and the country.

The last couple of posts I have been told* consist of "Obamaspeak". If you read them be prepared to be immersed in a whole new level of liberal B.S.
*These posters are on my "Ignore" list with good reason.
Jim