Health Care Reform and the Appliance Industry
Submitted by advisor on Mon, 03/22/2010 - 9:02am.
You can discuss anything you like......have at it....but we're particularly interested to hear about your immediate problems with health care as an employee, employer, dealer, distributor, manufacturer.
Do you expect the Health Care Reform Bill, as you understand it, to SOLVE, EXACERBATE or LEAVE UNCHANGED these problems?
As Many of You Might Recall ...
... I had a Liver transplant this past July ... my wife postulates that she is glad I had it before this "plan" went into effect ...
Our biggest concern is that our present coverage will be watered down because they are no longer in need to be competitive but can accept the mediocrity of the government plan ...
I certainly hope I do not have the necessity to test the "pre-existing condition" guarantee supposedly in the government plan ...
Health care
Ed SmithKitchen Appliance Sales/Customer Service ProfessionalAllentown PA While I would be the last one to advocate mediocrity nonetheless a mediocre plan outweighs none. That being said I certainly don't want to use this forum to get into a political discussion. Democrats need appliances just as much as Republicans :)
SPAM "replay"
The initiative taken for the concern is very serious and need an attention of every one. This is the concern which exists in the society and needs to be eliminated from the society as soon as possible. I like this particular article. It gives me an additional input on the information around the world Thanks a lot and keep going with posting such information.============================================ ADVISOR: LINK REMOVED, USER BLOCKED. SORRY, WE SHOULD BE FASTER ON OUR TOES
Uncertainty
I did speak to an owner of a Ventilation distributor today. He was upset by the $2,500 cap on Healthcare Savings Plans. His primary concern is with all of the unknowns. His business has been fairly stable over the last 2 years. Because of the uncertainty they have no intentions of adding to their payrolls until they have more information.
One company, $100,000,000.00
Caterpillar (I know it's not our industry) weighed in. They believe that the health care overhaul could cost them $100,000,000.00. That should be great for them! And us! and unemployment! If I remember, this is the same company that stood by President Obama as he played handout with the "stimulus" package. To him I say, "Thanks, jerk I hope you learned a lesson in all this". www.marketwatch.com/story/caterpillar-health-bill-would-cost-100-million-2010-03-20
excuse me
Excuse me… But Caterpillar stands to gain a whole bunch from the stimulus program…They are in the earth moving business. They’ll make billions just from what road work related sales they get. The dinky hundred million will be chump change compared to the profits they're sure to realize. They didn’t stand by and let Obama "do his thing"because they’re passive. They’re smart business people and made the right move. As for concern about health care costs, it would be out of character for a business not to bring up the "customary loss" any government program bring on...
We need an accountant here
Your story calls the expense, "non-cash", which I assume to mean not so much a cost, as an accounting issue. What is a cost is actually a federal subsidy. Doesn't the federal government get to change what it chooses to subsidize?
Wouldn't a non-cash acccounting issue of $100,000,000 really reduce the companies tax liabilities, while having no (or little) effect on the bank balance? Or is this simply the recognition today of all combined future tax expenses? A one time recognition, with no tax offsetting benefits?
Yes, the Federal Government
Yes, the Federal Government can change it's mind on what it chooses to subsidize. That is the dangerous game that is played. So if this bill adds $100,000,000.00 to their tax liability, or removes $100,000,000.00 from Caterpillars earnings what effect do you think that has on hiring? Why would Caterpillar continue to offer the benefit if they did not have to as part of a union contract? There is no doubt that this legislation is designed to move to single payer. That is bad for America. Our country is on the verge of having our AAA credit rating reduced due to our unfunded debt before this bloated bill was passed. Anybody who believes that this actually helps with the deficit is insane. Let me ask you, what does an all out collapse of the US economy look like for the appliance industry and the American Appliance manufacturer?
Facts Not in Evidence
How does the economy look in the future if you don't enact health care reform? Do you have any idea what the year over year health care cost growth was this year? What the trend has been? The growth since Hillary-Care failed to launch? The trends and forecast going forward without the bill? Seems like the collapse of the economy was cemented into the current system. The CBO, says that whatever was going to be, that this is better, and one hope better-enough. Are your numbers better than the CBO?
There's been this demand from the right that health care reform be taken in smaller bites, phased in. I think that the Right was right, but not the way they thought. The current massive, plan, we hope IS the first phase, to be followed with addditonal cost control tweaks.
Things this difficult are never possible unless our backs to the wall. One would expect difficult decisions in Social Security, to extend working years, or means testing, or increasing payment ceiling so that the program can meet the needs of the baby boom.
I can speak to that ...
... from intimate knowledge !!! During my over five (5) week stay post-transplant, I had the unique opportunity to ask some very learned and highly trained professionals what their impression of the government's intervention might mean into their world ...
First and foremost, everyone to a person, agreed with me that there is no "health care crisis" to reform ... it is properly put, a "health coverage crisis" ... the term is/was developed by politicians for "scare" tactics ...
The second aspect they all agreed on was that when government got involved, a massive amount of $$$ was wasted on senseless paperwork and duplication of effort ... I was reminded time and again that government could not manage Social Security, so they wondered how government could think to manage something so highly technical as medicine !?!?!?
I agree and worry why medical professionals are not making these representations in favour of politicians, none of whom have written the entire bill !!!
We are a Representative Republic and something as sweeping as this type of "reform" should have been handled via "Issue and Referendum" because our present Congress is incapable of truly representing their constituencies ... proof of this is that @ least thirteen (13) states are lining up to sue the Federal Government over this bill !!!
... and if that doesn't stir your cocktail, then how about this ... The bill requires the hiring of 16,500 new IRS agents to handle the enforcement of the bill ... that's not anything but sheer and utter liberal fascism !!! Instead of simplifying government, we just saw government grow and prove that Orwell was certainly right !!!
Few Questions
1) There is a small possibility that the learned professionals you spoke to, who have a much to lose in any cost cutting measure, have some slight bias. They should be highly paid, just less so.
2) At the risk of really not knowing your full story. Was your transplant problem discovered in the Emergency Room, or by a doctor who saw you by appointment? That appointment would not be one an uninsured person would be able to get.
3) I do not receive Social Security, but I'm curious why you saw the government can't run it. Except for a few corrections for changing demographics, and another change that is forthcoming, what are referring to? I have never heard a complaint.
4) A paperwork reduction bill, and a full cost reduction bill would have eliminated the middle man, the insurance companies......which would have been great......if our Canadian, Taiwanese, UK, Singapore, Continental Europe friends are any guide. And with a snap, a 15 - 30% reduction in cost, elimination of pre-existing conditions, instant portability, instant information flow.
5) Congress was not designed to be driven by plebiscite, in fact quite the opposite. I wonder what the South would have said if we would have had to consult with them in advance of the Civil Rights Act, or the Emancipation Proclamation. $13 million for What!! (New Orleans and 830,000 square miles of empty space), $7 million for What! (580,000 square miles of tundra and oil).
Only 13? 13 state lawsuits is not proof of anything....except what 13 attorney generals think.
They don't represent what we want, but they should represent what we need. They are designed to be insulated from the voter, some more (Senate for 6 years), than others (House for 2 years).
6) Only 16,500!!!! They should hire more than that. The IRS was gutted in the last 2 administrations, and the rate of tax audits plummeted, sticking it mainly to the simple and low level, and avoiding the large and complex. The audit rate per 1000 for those earning less than $25K is 8%, while the rate for those over $200K is 4%. Supposedly only 30 of 180,000 individuals reporting greater than a $1 million annual income were audited. That's nuts.
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Responding to a Few Questions ...
Advisor, here are the answers for inquiring minds ...
1. I did not detect any "self-preservationalism" in their attitudes, probably because they, as a university hospital and research centre, are not interested in profit, rather attaining a certain set of accomplishments ... like successfully sending my home for a healthy balance of my life !!!
I honestly could not have asked for better treatment ... everyone from orderly to the surgeon who performed the transplant were caring, compassionate, and tremendously professional ... I am, thankfully, in weekly contact with them as I have volunteered for a study as I am now eight (8) months post-op !!!
2. I had my first symptoms April of 2008 ... I then spent until August of 2008 trying to find out what it was ... I went thru every test and scan known to modern medicine and they ruled out the obvious things for my age and ugliness ... first and foremost was cancer, then other major maladies, then, in frustration they sent me to a GI Doc, who took until December of 2008 to diagnose me as having irreparable liver damage called NASH, presumably due to a life long use of ibuprophen ... accent on the world "presumably" ... it was not alcohol related ...
I was then referred to UPenn in Philly for a transplant evaluation, which was both rigorous and eye-opening ... In May of 2009 I was accepted into the program, fortunately, because me condition began to worsen exponentially to the point where, during a procedure in the hospital my Liver quit on me, throwing me into a coma ... five (5) days later I was transported to UPenn where 3-4 days later I received my transplant ...
3. I do not qualify for SS either and it would cost me too much to have someone appeal my case ... that has made $$$ a severe issue !!! At a result I have nothing but contempt for our government who wastes $$$ on everything and everyone under the sun, but a good American like me gets crapped on !!!
4. My observation is that some Doctors are unwilling to allow patients access to their own medical records ... Just ask your Doctor for his/her file on you when you want to move on ... I had to threaten to sue on GP when I fired her !!! She tried to make me blink but I sent her a copy of a letter I was sending to the local hospital ... she came to my way of thinking ... Yes, it sounds like blackmail but she was wrong and I was going to do anything to "out" this archaic practice !!!
Now, I go for blood tests every week to gauge how the anti-rejection drugs are working ... it takes more time to do the paperwork than it takes to take the blood test !!! I asked them why they didn't give me a credit card type of ID which I could swipe in a kiosk each week ... they told me that ... " ... honestly, no one had thought of it ..." Honest, but pathetic and costly ... and not "green" either !!!
5. I was not talking about a plebiscite ... I was trying to make the point that our politicians are so corrupted by the way business is done in Washington that they no longer vote the will of their constituencies, favouring the "party position" ... It's not "DemoCrap" or "RepubLeakin" ... it's both !!!I think that if that many States are willing to fight the Federal Fascists it means that there are plenty of people willing to break with the party line in favour of their voters !!!
Instead of Federalizing Health Coverage, they ought to allow any insurance company to sell insurance in any state of the union ... Competition is always good for the consumer, but Obama and his lock-step minions don't think that way !!!
6. I am an unabashed advocate of the Flat Tax as a way of "equillibrating" our country ...
A. By causing everyone to be paying a faire %%% of their income ... Period !!!
B. By causing Congress to only be able to spend what they bring in, so if they want more to spend (aka waste) they need to grow the economy !!!
C. By controlling the ridiculous corporate taxes which they only pass on to their consumers in their "marked up" price !!!
D. By eliminating the ridiculous amount of exemptions which are often contrived for imaginary charities, etc. ...
E. By eliminating the feel-good programs by the Kum-Byah crowd ... One look @ ACORN explains my point !!!
Whew, is that enough for now ???
Hope so ... your turn !!!
Responding to a Few Questions II
1) University medicinals are the best. I'd guess you got an honest opinion.
2) Without insurance, it sounds like someone without insurance would have only participated in the final organ failure cycle. 5-6 hours per visit to the Emergency Room can persuade one to hold off the vital exploratory work you got.
3) You don't qualify for SS!! Would be nice if you did. I feel you should, like handicapped and damaged folks do....I thought. Most parts of the SS are black and white. Disability I guess is not. Though I sympathize with you, the black and white parts, and the permanent disability parts seem to work. I wonder if you don't qualify based the expected length of your disability.
4) Better information management would be great. Every insurance company has a different form, different code for each procedure. Be nice, but if they haven't figured it out in the 50 years of the computer age, they aren't ever going to.....unless you have a single payer system.
5) I really will try to be fair here, but the bill seems to be a Kamikaze move for the Democrats, with little political upside, and certainly not enough to be worth the risk. Reform, of some kind is necessary or we are screwed. The Democrats may play games in their own areas, but this doesn't seem to be it. The Right started the debate by inventing Death Panels, and the debate declined from there. They did not demonstrate an interest in participating except for a mere handful. I know that the Right is against current the plan, but they never offered (or I missed it) any other plan to solve pre-existing conditions, lifetime caps, portability, etc, etc. I would have been interested, honestly interested in what they proposed.
6) Flat Tax. Discussed earlier.
Costs
Do you ever ask yourself or investigate why insurance costs have risen so much? Do you know how insurance works or is supposed to work? The whole idea is that insurance is supposed to cover risks. If insurance were allowed to just cover risks it would remain far more affordable. But insurance is not allowed to just cover risks. It is mandated to cover things that are completley predictable, like annual check ups. This would be like my care insurance covering oil changes. If my car insurance covered oil changes it would become more expensive. Some states mandate totally elective procedures. Let me ask you:
Now, what do you think will happen when some of the remaining cost controls are removed, like pre existing conditions and caps? Would a home owner insurance company extend me a policy if my pre existing condition was that my house was on fire? There is not one damn thing in here that will reduce costs. If there are than prove me wrong and show me where the costs are reduced. Shifting who pays for it or refusing to pay the costs do not reduce costs. If the government was concerned about the economy and controlling costs they would have gone in the opposite direction. The CBO uses the numbers that the politicians give them. Their track record is laughable. There are a whole host of other reasons why the costs have increased going back to the early 20th century. The problems started with government intervention.
Oil Changes and Lube Jobs
If your car insurance covered wear and tear, then it should cover oil changes as well. To do otherwise would be penny wise......etc, etc.
Coverage of pre-existing conditions is a requirement of a functional health care system. Seems that a boss shouldn't have the power of life and death over an employee, just by firing an employee with a chronic but treatable condition.
It costs more to treat people with pre-existing conditions as it costs more NOT to set retirees afloat on ice flows. It's still the right the thing, the only thing a functional health system can do. Lacking that, you don't have a health care system.
Continuing your great analogy: A $25 oil change with lubrication avoids what costs? New valves, new rings, an engine ceasing up, a break down on a highway with a tow truck called to haul you to the garage? It can catch problems before they become expensive. All that savings, just for $25. If you had insurance covering wear and tear, wouldn't the insurance company want to cover the $25 oil change?
As for the CBO. The only numbers that they take from politicians are those found in the bill, or proposed to be included in the bill. All other numbers, assumptions, forecasts they develop on their own.
There's a story in The New Yorker in December which has an interesting take on the cost controls which ARE (or at least were in December) in the Senate bill. Great story. http://www.newyorker.com/reporting/2009/12/14/091214fa_fact_gawande
You can thank the corrupt and inept
Why does the employer have this power over life and death today? You can thank your government for that one too! Wage freezes imposed during WW2 made employers unable to attract good workers by increasing salaries. Employers were left to increase benefit packages to attract workers. As time went on the average American directly paid a smaller and smaller share of their healthcare costs. This leads to huge amounts of waste. When people do not pay these costs directly than they are far less efficient with how the money is spent. The government creates a small problem and then turns it into a giant one with fix after fix after fix. What in the world gives you so much faith in this collection of the corrupt and inept?
You are correct, a $25 fix avoids a lot of additional costs. Have we become so helpless that we can't pay that $25 fix ourselves? Are you seriously going to make that argument? Is this not one of the dangers of "the nanny state"?
The CBO makes all sorts of errors. I wonder how much revenue they estimate the 40% tax on Cadillac (another government takeover) health plans? These will be just like the Millionaire tax my state passed. Hey, where did all the Millionaires go? These idiots actually wonder why they don't pan out!
Practicality Over Ideology
"Have we become so helpless that we can't pay that $25 fix ourselves?"
Incentives work. Disincentives also work. Insurance incentives to go to the gym work, to quit smoking work, to wear a seat belt work, and to have regular checkups should work. Don't have to do any of them if you don't want. But we, the insurance company are investing in your health, and we, the insurance company, don't want to pay for your sickness.
"You can thank your government for that one too!"
If there was not a single payer system, and not an employer based system, I'm curious what system you think there would have been? An individual, non-group system? Each individual buying insurance for him or herself? A risk group of one or one family? An un-regulated insurance market with risk pools of one? Getting chucked out with the slightest sickness. Children with chronic health issues never able to get their own insurance. Families with chronic health issues never able to change insurance companies, if their current company didn't expel them.
As a health care consumer, I don't think I would be entirely delighted with that, but as an investor...........I would put all my cash in health insurance stocks.
Who's ideology is practical?
Perhaps you should revisit this article www.washingtonpost.com/wp-dyn/content/article/2010/02/04/AR2010020403698.html as you imply that it is only YOUR ideology that is practical. Me I will take the facts and real life situations. I purchase my own auto, life and homeowners insurance directly from the insurance companies. I shop for them. I compare the prices. I buy the services that I want. The market is competitive. The companies are aggressive about competing for my business with lizzards, cavemen, cartoon characters and more. All of these insurance products are affordable. Health Insurance is much more heavily regulated and will be more so. There is much less choice for me. There is much less competition. It is much more expensive. Everybody complains about it. Exactly how do you define practical?
Ideology vs Practicality II
Ideology: Def: the body of doctrine, myth, belief, etc., that guides an individual, social movement, institution, class, or large group.
Practical: Def. adapted or designed for actual use; useful
I believe that we were discussing medical checkups. Your opinion was that checkups should not be covered by insurance, while I thought they should be since people would be more likely to actually have checkups and therefore catch problems before they become worse. Your argument was not based on facts, experience, or evidence, but it was based on an ideology that government should be reduced or minimized. Sometimes no evidence exists for things and ideology is all you have to make a decision. At least in this case, "incentives", there is plenty of evidence that they do work, that they are practical.
This is where the title of our comment came from.
Your Insurance
The proof is in the "use" not the "purchase" of insurance. Your car insurance is easy to buy because every insurance company has a "hyperspace" button called "Totaled". Try "Totaling" Grandpa Cupcake. Beyond all of that I cannot comment on your individual insurance market. I come from the most regulated insurance market in the country.........everybody........everybody seems pretty happy with it. Not entirely a scientific survey.
Check-ups Question ...
I offer my own history for your consideration ...
Just about the only thing our insurance does not pay for is an annual physical, and/or any preventive medical visits ... so, we bit the bullet once a year because we could afford it, but that was it !!! Had that physical been able to be extended, might they have caught my problem developing years ago ??? I don't know, it's a moot point for me, but it is not moot for many of you !!!
When you take your car for it's 3000 mile oil change, don't you want the mechanic to have a look around and see if there are other potential problems which could cause you a greater expense if you did not catch it @ it's inception ???
Same thing with your body, but if you break down, it might be permanent ... take it from someone who could not know it more succinctly !!!
Incentives - Pay the cost or pay the price
There are no better incentives than those provided by a free market. If you continue to stuff pie into your face, smoke 3 packs of cigarettes and drink a six pack every night you will pay a higher insurance rate. When someone else is paying the cost medical care gets over used. When the cost is payed by the user they are much more selective about what they spend their money on. That is fact. Either way, when it comes to medical care the market will sort it out. We can either pay the cost or pay the price. Incentives work both ways.
You Forgot One Important Thing ...
Plain and simple, HealthCare would not cost as much as it does if we had real and substantial TORT REFORM ... which would allow for lower insurance premiums by providers, developers of medicines, and other research !!!
If you do not understand how this has affected the medical industry, just look @ the ### of OB-GYN's who have quit delivering babies !!!
The Health Care Quiz
Health care, I believe is not "free marketable", or at least not well. Krugman riffs on it.
I think many of your issues are simply false. Lack of doctors? Leaving the profession? To become what? Are you picturing doctors getting the minimum wage + tips? That's a fantasy. The bottleneck is the medical university system, not constraints from income. But you never answered my original question.
What is your plan? Here are some folks, tell me what they do?
1) 10 year old with Cystic Fibrosis. Has insurance from parents through employer. At age 22 falls off his parent's insurance.
What is he doing to receive both emergency and non-emergency care?
2) 45 year old man receives heart transplant under employer's insurance, but with complications passes annual cap after 2 stints in intensive care. He should live 10 more quality years, but because of complications cannot continue in his profession, and has no hope of significant future earnings.
What is he doing to receive both emergency and non-emergency care?
3) 25 year old ski instructor. Has insurance from employer for job related health issues ONLY. Joins an optional non-work employee "fun night" skiing event on the mountain but has an accident which damages her knee and requires surgery. Though she receives emergency care to stabilize the knee, she requires additional orthopedic surgery which costs $45,000 which is not covered by instructor's work insurance and not provided in the ER. She files suit against the employer and loses. She has no marketable skills. 14 months later she remains on crutches.
What does she do to receive this specialized care?
4) 10 year old with Spina bifida, with medical expenses of $30,000 per year, every year. Family receives insurance through father's employer. Father is laid off, remains on Cobra for 12 months, and get's new insurance when hired at a new company (hell.....how about the same company 14 months later). The insurance company at the new employer refuses to cover the child's health care costs.
How does the family get health care to their child?
5) 35 year old female pedestrian without health insurance is in hit and run accident. Emergency Room sets and casts legs, but 6 months of physical therapy is required, and physical therapy is not provided in the Emergency Room. In the mean time she requires a wheel chair, but she cannot afford one.
How does this woman receive the wheel chair and the care she needs to regain her short term and long term mobility?
War costs
Bush made no bones about draining Social Security and taking us from a budget surplus to deep...deep...deep debt to prosecute a war nobody wanted. So forgive me if I sound cynical. We can pay for Healthcare by pulling out of Iraq and starting a gradual pull out from Afghanistan. A lot of money has been wasted there, and we have made very few gains...let's cut our losses and invest the money into our own infrastructure for a change. We may have something to show for it in the end. These two wars are a waste in the most proverbial sense...
Seeking Health Care Reform Comment
Seeking Health Care Reform Comment