Obamacare

[Craig Jessop]

We need to hire 3 more workers, but that would put us over 50 employees. We'd then be required to provide health insurance. However, providing health insurance for all our employees would completely negate the earnings made by the 3 additional workers, as we pay our employees close to double than the industry average. Our margins are therefore much smaller than similar companies.

In addition, the plan we would be able to offer would hurt many of our employees. Right now, many can go and get subsidized insurance through the marketplace at a very reasonable rate. Should we offer an insurance plan, they would lose a substantial portion of their subsidy and their costs would double or, in many cases, triple. Buying through us (where we pay more than half the premium) would give them a similar, expensive rate. We pay far too much for most employees to qualify for Medicaid.

So, our choices are:
1) Make a big cut in pay and replace it with insurance
2) Reduce company profits to the point of "is this really worth the stress"
3) Not grow

Obamacare sucks for businesses that are too big to be small, but too small to be big. It sucks for young people on group plans who have to subsidize the healthcare of menopausal women and heart attack-y men. Employer-based healthcare is the actual worst. It's a bad deal for the insured and it's a bad deal for the employers. It's a bad deal for insurers, who have no way to provide coverage for those who really need it, without pricing out those who probably don't but can't afford it (i.e. the young).

Can we cover again why a single payer system is bad? I get that it has disadvantages to our current system (inefficiencies, more bureaucracy, etc etc), but it sure seems like a much more workable option than the current mess. And even if a Canadian/NHS-style system is undoable in the US, why can't we try the Australian way?

[Whistler]

It sucks for young people on group plans who have to subsidize the healthcare of menopausal women and heart attack-y men.

So, I'm with you that this situation sucks for your employer, but isn't the point of insurance that healthy people contribute to the exorbitant healthcare costs of the unhealthy because it could be you being injured/unhealthy at some point?

[Marduk]

Honestly, though, a single-payer would be more efficient even in terms of bureaucracy. The difference is that people get outraged at any issue within a government system, even when those same issues are worse with a private company. Insurance companies can be way more inefficient than medicare for all would be, which raises the costs of healthcare and means that we all have to pay more, but so many people don't care, because they have the illusion that they can choose their way out of those inefficiencies.

[Zedability]

Doctors in Canada spend about 1 h/wk on paperwork, as opposed to the 18 h/wk that American doctors spend.

Source: I did a research project freshman year and that's the one statistic I remember.

[NovemberEast]

If our hypothetical single payer system would look anything like the VA, then a big fat no thanks to that.

This is why it's bad: http://www.huffingtonpost.ca/bacchus-ba ... 05110.html

And this story doesn't look great either: http://www.dailymail.co.uk/news/article ... anada.html

As for insurance subsidizing the healthcare of the "less-well," it kind of is how things work. But, it's gotten to be that way even more so due to new rules about preexisting conditions. You can't get flood insurance after your house floods. So....??? But, I do think it's wrong to kick someone off insurance after they get sick and actually need it, because people get insurance to hedge against the financial impact of future illness/accident. Moral of the story? Life is expensive. Hate it, then plan accordingly.

[Zedability]

I think it's worth pointing out that because chronic illnesses can impact work and personal finances, sick people have the most trouble keeping up consistent insurance coverage. It's common to end up in a catch-22 situation where you get sick, lose your job, lose your insurance from your job, and then your financial difficulties prevent you from getting private insurance that covers your condition, which makes you sicker while also requiring you to pay out of pocket, which makes you get less effective treatment, which makes you sicker, which makes it harder to cover insurance... and so on and so on, until people can't maintain consistent insurance coverage. For a lot of people, having their insurance lapse isn't something they can feasibly avoid, and denials based on pre-existing conditions stop them from getting better.

I do agree, though, that if people have an attitude of "eh insurance isn't important" until they experience a health crisis, that's a crappy and irresponsible way to approach insurance.

[Genuine Article]

We never had insurance growing up because my dad is self-employed. I had my shots up through age six, and every other year or so we all went to the dentist. I can't imagine how stressful that must have been for my parents. When my brother was six he broke his arm and years later my mom told me how she cried when she got that bill. My freshman year at BYU I got a toothache. I spent a whole semester with a throbbing toothache I couldn't do anything about, except leave class every 10 minutes to put more Anbesol on it. I finally saw my family dentist over Christmas break and I had to have a root canal. As I left they slid me the bill across the counter and when I got into the car and read it I just sobbed and sobbed. I drove home a complete wreck, wondering how I was going to come home and explain a $1500 bill for one tooth. At Christmas-time. When a new semester's tuition was due.

I don't have a solution for healthcare, and I'm sure my super-right-wing dad, who lived with a hernia for 30+ years because he wasn't insured, hates the idea of the ACA, but I'll support any sort of healthcare reform from either party so long as they're actually trying to accomplish something instead of sitting on their hands saying, yeah, sucks to be poor and sick.

[Shrinky Dink]

There are a few things I do like about Obamacare the two main ones include that you generally can't be denied coverage for a preexisting condition and they can't put a lifetime coverage amount. Unfortunately, in order to fund treatment and care for these people, the money does have to come from somewhere.

As for insurance subsidizing the healthcare of the "less-well," it kind of is how things work. But, it's gotten to be that way even more so due to new rules about preexisting conditions. You can't get flood insurance after your house floods. So....??? But, I do think it's wrong to kick someone off insurance after they get sick and actually need it, because people get insurance to hedge against the financial impact of future illness/accident. Moral of the story? Life is expensive. Hate it, then plan accordingly.

I got cancer when I was 19. Luckily my parents had good insurance and enough savings to be able to handle it without going into debt for it. My treatment finished when I was 20. Luckily, I am still in remission and haven't relapsed. Hypothetically under the previous regulations, if I had lost insurance when I was 21, gotten insurance through a different company when I was 22 and relapsed when I was 23, the second insurance company would have been able to deny coverage for my treatment because it would be linked to the first occurrence and been a preexisting condition even though I had been completely insured during both instances. Thank heavens this isn't the case anymore because I am currently insured through my employer and if I relapse in the next six months, it would still be a preexisting condition. Considering that the first round of cancer treatment cost the insurance company about $150,000 and my parents $20,000, I would probably be bankrupted, lose my job (I am currently the primary source of income for me and my spouse), our credit score would go through the toilet, and it would take us a whole lot longer to be able to purchase a house (if ever). So, do you still think preexisting conditions are like floods?

Is Obamacare a perfect solution to the issues in the health care system? No. Does it help in some areas? Yes. Does it hurt in some areas? Yes. Does it hurt more than it helps? I honestly don't know.

[Portia]

gosh guess you shouldn't get cancer or need a root canal, like me

hashtag blessed

[Craig Jessop]

I'll support any sort of healthcare reform from either party so long as they're actually trying to accomplish something instead of sitting on their hands saying, yeah, sucks to be poor and sick.

This.