Most liked posts in thread: Healthcare: Yay or nay.

Being a self employed small business owner for the last 27 years, I can tell you that with the new Obamacare and having to furnish health insurance or pay a penalty from the get go, removes all thoughts of hiring any new employees. The time it takes to make an employee profitable in my business is just to long as it is, add immediate insurance cost and it's an investment I'm not going to make.

 

Blimey, that describes one of my best friends situation to a tee. His company does the wiring for Pierce (firetrucks), a division of Oshkosh Truck. He's been expanding, and adding jobs to his company consistently over the past five years--despite the economy collapsing. They already pay a huge chunk of change for employee insurance; he's scrambling right now to figure out what is best long term--it may be better for him in the long run financially to keep the company smaller, turn down orders, and limit growth. Not exactly conducive to improving the economy; sometime we cut off our nose to spite our face...

 

Yeah, add to that stupid things like requirements for coverage (and corresponding costs) that kick in at 50 employees... so the operating expenses for a company with 51 employees could be millions more than for the same company with 49 employees... Hmmm... I wonder whether I'll hire that threshold guy/gal who helps me make an extra $20,000 a year gross profit but costs me half a million bucks in federally mandated benefits or fines?

It pretty much makes it economically unfeasible to have a business with between, say, 50 and 75 employees. Brilliant tactic for a President who said "Jobs are the number 1 focus for 2010" in his State of the Union address.

 

And what about this from a friend of mine who is a recently retired Labor Attorney for a major Corp.:

Quote:
You won't find much about it in the mainstream press , but this law
will increase the corporate tax on retiree health care plans to 35 %
and eliminate a tax deduction for retiree prescriptions, which may
cause many companies to drop retiree health coverage.. The law also
calls for cuts in Medicare and increased premiums and reduced
benefiits for Medicare Advantage Plans. When you consider this along
with increased taxes on annuities and other investment income ,
ObamaCare seems to have targeted Retirees .I can't believe the AARP
endorsed this bill.

 

Comedy GOLD. Legally, Congress now has NO health care coverage. Oooooooops.

Washington Memo - Baffled by Health Plan? So Are Some Lawmakers - NYTimes.com

[ame=http://www.youtube.com/watch?v=KoE1R-xH5To]YouTube - Pelosi: we have to pass the health care bill so that you can find out what is in it[/ame]

 

Leadership?rrr:

 

Japan and the Netherlands have similar systems with similar satisfaction rates. This is what the USA needs, but the insurance lobby has prevented it. Our country suffers greatly by having politicians dependent on lobbies for campaign funding. Government by the lobbies and for the lobbies. It isn't Washington we need to take the country back from, it is from special interest groups.

Really, you don't think the Post Office is giving value for money? As a very small business, I depend on it. I couldn't export my telescope accessories as well if I had to use UPS or FedX. They have very high costs and horrible systems that require brokers (with fees) at the destination country. Most of my small contribution to balancing the trade deficit would go away without the Post Office. I also use it extensively for shift knobs and wheel hangers. It is more efficient than UPS, and costs less. For $5 I can send parts anywhere in the USA, and it usually takes two or three days. UPS prices would start around $10 and take ten days to many places. Without the Post Office many small and some large business would suffer. How would ebay function without the Post Office?

Unregulated mortgage banking broke the treasury.

I was saddened when California instated the helmet law. A great source of organ donors was eliminated. Without helmets, there were so many deaths due to head injury with the body still intact. In car crashes, the body tends to get damaged.

:yesnod:

 

I spent about 19 years as a partner in an S corp. that sometimes did over $1 million per year. I know exactly what you mean about the disbursements. However, the S corp. category was intended for professionals such as doctors, lawyers, and similar services wouldn't be taxed twice on what really is a personal income. It was not intended for typical business corporations. If S corp. stops being cheaper than paying corporate taxes, switch to the category your business was supposed to be in.

Yea, it would be nice if small businesses didn't have to pay taxes, but then poor companies like EXXON would have to pay taxes. :lol: :cryin:

 

Here is a statement by the CEO of the hospital corporation that I work for a couple days ago, I did some editing, get ready for the hospital in your city to close down :frown5:

FROM: Tim Joslin, CEO
RE: CMC, Health-Care Reform, and the Economy....

To be sure, health care remains a noble career, and medical science today is a field of great advancement, and of
hope. But as an industry, health care is often an awkward and financially unstable business. My prior memos to
you have noted Community Medical Centers’ many recent accomplishments, as well as our financial challenges.
Our two biggest challenges now are the continuing sour economy in central California and the new health-care
reform law. ....

But the first half of this fiscal year has been
difficult for us, too. As more and more patients arrive at our doors without insurance in these tough times, we’ve
fallen behind our financial goals.This is true of many other hospitals across the land, of course – especially those
that care for the sickest patients and serve as their communities’ “safety nets.†.......

The federal health reform law enacted last month poses additional challenges for Community. The legislation
attempts to get millions more Americans insured and seeks to eliminate inequities in insurance coverage. Sounds
good. But in order to cover the costs, the government also plans to scale back reimbursement to hospitals. For
hospitals such as Community Regional, with the vast majority of its patients being Medi-Cal and Medicare, this is
bad news. At Community, we anticipate reduced reimbursement in excess of $250 million over the next 10 years.
So the reform law, in its own way, will force large safety-net hospitals to become extremely efficient in delivering
care – or risk going out of business. ......

The impact of health reform will play out over the next three to four years as the legislation is phased in. But
already, Community has suffered a cutback in supplemental Medi-Cal reimbursement, as the state anticipates
insufficient revenues to meet this year’s health-care costs. We expect state cuts to recur next year, and they may
worsen.....

Over the next few weeks management will be examining cost-efficiency options and
making some tough decisions......

As I noted back in January, Community hopes to offset government-reimbursement cuts through a so-called

“provider fee†process that California hospitals are negotiating with the state and federal governments. It’s a way

to obtain federal matching funds to help safety-net hospitals, such as ours. But the proposal is still not certain.
And regardless, it would be only a temporary fix.


Look out people, this is coming :frown2:

 

What do they mean when saying "extremely efficient"? Does it literally mean efficient or do they mean quantity over quality?

The latter would be concerning...but if it's literally "efficient"....that doesn't seem like a bad thing :confused5:

Edit: Guess it could also mean "cost efficient" (i.e. firing people)

 

It is interesting to me that the complaint is about the reduction of government support, and at the same time people are calling it government take over of health care, and socialist. ut:

 

If you can't see the difference then :rolleyes5:

 

Exactly. This is the paradox of government control / socialism / nationalization / etc. By replacing the market mechanisms which match costs, supply and demand with different mechanisms based on "price setting" and rationing, you get this outcome. The government ultimately can't afford to put the amount of money into any system that would otherwise flow if free market mechanisms were allowed to operate. Removing supply/demand mechanisms result in shortages of resources in some areas (the unprofitable ones). As the government decrees what things "should cost", they make larger and larger portions of the pie unprofitable.

 

Shocker!

Inquiry Says Health Care Charges Were Proper - NYTimes.com

 

Well, thanks to Obama Care, my out of pocket for my insurance at work just went up 67% starting July 1st. :mad2:

 

Yep it's starting :frown5: Luckily I missed out on this round of layoffs:



Community Medical Centers to lay off 150
Written by Business Journal staff
Thursday, 03 June 2010 09:17

Community Medical Centers announced 150 employees, or about 2% of its workforce, will be laid off as part of cost cutting measures to close a $30 million budget hole from operations.

The layoffs will take place in corporate-based and facility based staff and some management, according to a letter by CEO Tim Joslin posted on MedWatchToday.com In addition, some employees will see reduced work hours.

Joslin attributed the operational loss to its hospitals seeing more patients without insurance and to state and federal cuts to reimbursements for Medi-Cal and Medicare.

As I have noted in prior memos to staff, Community Medical Centers unfortunately is feeling the negative effects of two external developments. One is the continuing poor economy in the San Joaquin Valley, which means fewer patients with insurance or other means to cover their health care costs. The second is state and federal health reform efforts that include reductions in reimbursement to hospitals. Hospital organizations that care for high numbers of Medi-Cal, Medicare and uninsured patients, such as Community, will be affected the most.

 

http://rds.yahoo.com/_ylt=A0geujAEOR1M4sgATgRXNyoA;_ylu=X3oDMTB1a3M0bWNxBHNlYwNzYwRjb2xvA2FjMgR2dGlkA01BUDAwNF85Nw--/SIG=13sn9k3lc/EXP=1277069956/**http%3a//abcnews.go.com/Politics/Health/medicare-doc-fix-passes-senate-wait-house-vote/story%3fid=10952420

Congress hasn't addressed the automatic 21% medicare cuts and the SGR issue--the cuts went into effect Friday. If something isn't done about the SGR and the 21% cut soon, it's going to be a disaster for medicare patients until a new bill replaces the current one.

In the meantime, docs who take care of medicare patients are screwed--this is effectively a retroactive cut. And if it's not fixed SOON, primary care is going to get killed. I'm a specialist, and have a fair number of medicare patients, but the primary care physicians in certain areas of the country stand to take a huge beating. Right at a time when the government is pushing for more folks to go into primary care to take care of the 30 million new people added to the insurance pool...

The Senate passed a reasonable fix late Friday, but the House was already recessed, and there is no guarantee they'll go along with it (at least according to Pelosi). If they don't, Medicare is in deep trouble. Until that happens, the 21% cut is in effect, and if it isn't fixed by the House early next week, watch out....

 

While I absolutely agree that the "doc fix" needs to happen somehow - eventually - Pelosi and Obama INTENTIONALLY held that out of the "reform bill" so they could do the CBO voodoo and claim it cost less than $1T and was going to "save money" - while they knew full well that they were going to have to spend a few hundred billion more dollars after the fact to fix this. LIARS.

The need to FEEL THE PAIN of being completely disingenuous and non-transparent through this whole process. They had the ability to be forthright and honest with the American people through this process. They chose to play "politics as usual" and sweep the real costs under the rug to advance their agenda. Screw 'em.

Unfortunately, the only way the Dems will feel the pain is by letting the repercussions of their actions play out - which creates pain for docs, health care systems, and patients. But, as they say, elections have consequences.

 

But here's the thing--there is no way that 21% cut is sustainable. Everyone knows it needs to be fixed (and it looks like it will wind up being a 1-2 % increase), the question is when. You are right that Obama and Pelosi were disingenuous out the wazoo on this--the cost of this was always shoved under the rug and completely ignored--i.e. most of the calculations were done with the 21% cut in place. And Obama and Pelosi KNEW the 21% cut was not realistic.

It is in effect a retroactive cut going back 10+ years--I'm not even sure it's legal. For those interested, the cuts have been proposed for years--1 to 2 % per year. But they never go through, because congress knows full well what will happen if they do--docs will give up on medicare (many already have given up on medicaid, which is essentially charity work for those of us who DO see those patients. And for every doc who quits seeing them, it's more of a burden for those of us who do-we end up seeing even more medicaid as the pool of doctors who continue to see them shrinks). So what congress did was add 1-2% to the next years cuts--then once again, when the time came to implement it, delayed it for another year, while again adding another 1-2 % in cuts to the NEXT year. This process then repeated itself over and over. It's ridiculous, we've been asking for a permanent solution for years, but we've had this hanging over our heads on an annual basis instead, until it hit the fan this year.

So if you practiced for the last ten years and retired, you're golden--cuts were delayed, and you never lost a cent. However, if you're just coming out of residency, about to start practice, you're getting 21% of cuts that began 10-15 years ago dumped at your feet TODAY.

This is one of the single biggest issues in health care reform--compensation based on a flawed SGR formula, and has huge cost implications--but the average person has no idea what's going on with it.

Inconvenient truths and issues are being swept under the rug. If this isn't addressed today/tomorrow, there are many people who are going to be hurt--and it'll be the people who can afford it the least. I have the luxury of waiting to submit my bills for the past three weeks until this is fixed; practices on the edge (and there are many out there, especially primary care), who need money now, don't--if they submit their bills from June 1st onwards, they're getting paid 21% less. And I seriously doubt they'll get that money back once congress puts in a permanent fix.

Really not a great time to be in medicine.

 

Here is a simpler question: How can something as broken as our federal government have any hope of "fixing" anything, let alone something as complex as health care?

Our system is not set up for this kind of undertaking. They need to set rules, and then enforce them. Nothing more. The government should never be in charge of taking money and doling it back out, because they will always find other uses for the funds than the ones they were originally intended and it will always lead to problems -- in our case, the bast*rds running everything into the ground.