http://www.europeword.com/blog/europ...n-health-care/

Not everyone agrees with you that Europe is a healthcare nirvana.
No country has solved this healthcare dilemma.

Lower costs, better outcomes.

I know, I know. Too many fat black people.

Too many fat white people.
Too many fat Hispanics.
Asians born in the U.S. have a life expectancy of 89 years.

Jesus riverman step up your posting

I can make an educated guess, especially when a major premise of successful implementation is that states will create exchanges and 33 states do not creates those exchanges; and when all of those people who were directly promised by the President, that if they liked their current plan and current doctor they would be able to keep them, find out their employers will simply stop offering coverage because it has become too expensive and all of the sudden those people who were happy with their plans now have to buy through the exchanges and can't keep their doctor or network; and when the burden on medicaid becomes a crisis; and when cost controls in medicare drive out good doctors from participating.

My educated guess is that implementation will indeed be a "train wreck". I didn't even mention the issues relating to implementation being overseen by HHS and major power resting with the IRS. What could go wrong?

Sometimes I wish I had a strong belief in our government to actually do something right, but history is too powerful a lesson to chase that carrot.
It would be great if they could pull off a system as beautiful as the one they promised, but it ain't gonna happen. I would much rather profit be the motivating factor for a better health care system, rather than the quest for power and control in a political setting.

Your guess is not educated.

While my post may have been somewhat of a summary of a few of the recent and relevant facts that form the basis for my view, I am sure you could posit a more substantive response to support your position and have probably done so previously. Maybe when I have more time I will go back and read some of your more thought provoking posts.

Frisbeeeeedog,

Why don't all those employers stop offering health insurance right now? Why didn't they in 2010? Why didn't they in 2009? Why didn't they in 2008?

Well, so far obamacare hasn't exploded premiums, hasn't created death panels, hasn't created government controlled health care. hasn't.. what else evil was it supposed to do again?

The short and obvious answer if because of the increased costs of the mandates placed on them by the ACA that did not exist from 2008 to the present.

More specifically because employers of 50 or more are now required to purchase more expensive coverage as mandated by the new law or pay a penalty and the penalty would be less expensive; because employers can now drop coverage and let the taxpayer pick up the burden of paying for their employees to be covered, leaving them with lower employee costs; because the perceived competitive advantage of offering premium plans will no longer exist if the employer can simply cut hours and reduce FT employees to PT and lower costs that way.

Whatever the reasons any particular employer chooses to counter the increased labor costs associated with the ACA, it is a fact that some employers are in fact dropping coverage or changing their labor models to include more part time employment. It seems perfectly rational for employers to look for ways to counter the increased burden placed on them to comply with the ACA.

Thanks for addressing at least one of the issues I raised.

We know exactly the kinds of coverage Obamacare requires-- it's laid out in the silver plan. We know how much it costs in many states. It's actually cheaper than the experts expected.

If the employer is paying his employees above the federal poverty line, taxpayers won't be picking up the entire tab of the dropped health insurance. If they are paid more than 4x the level, the tax payers won't be paying one red cent of the coverage. The employee will have to foot the entire bill.

Companies can stop offering premium plans and cut hours and reduce FT employees to PT right now. They could cut labor costs tremendously by firing a bunch of people. Why don't they?

Prior to Obamacare, even granting your premise that premiums will be higher, there was no penalty on the other side of the equation. They could have saved even more by dropping employees' health benefits in 2009 than they could in 2014. But they didn't drop coverage.

http://www.libertynews.com/2013/02/u...-of-obamacare/

As 2014 approaches, more unions want out of Obamacare.

Excellent use of the word "exploded" rather than something more benign such as "increased", "substantially increased" or even "significantly increased".

You have also made wonderful use of selecting death panels and universal healthcare as strawmen to avoid the more practical issues relating to the implemantation of the ACA, such as cost, availability, delivery, and most of all quality of care both now and in the future, meaning the effect on innovation, invention and creativity.

As for your question, it was "supposed" to limit available care, reduce quality of care and perhaps most significantly, push, even further, control of healthcare in to the hands of those with political motivations, including the primary incentive of getting re-elected.

I suspect you will disagree, but I would rather have control of innovation, access and delivery of healthcare in the hands of those seeking to provide products and services based whether or not they are better, more efficient and competitive than in the hands of people who are politically motivated.

I disagree with your statement that many states have predicted cheaper than expected rates. First, without checking I think only about 5-6 states have announced rates "less than expected". Not quite sure what that means, but with respect to your comment and particularly California the most recent state to announce expected rates, commentators have selectively focused on the silver plan. Why not look a the expected rats for all four tiers? A skeptic might think if they focused on all the available plans the expectation might not be so promising.

Additionally, availability and quality of care can be expected to suffer as more doctors shift their practices to concierge or private medicine type delivery, once again due to the mandates of the ACA and changes to medicare.

Some businesses, as I said, are in fact dropping coverage and or changing their labor models. Others I assume are still waiting to see what changes might be forthcoming and still others may opt to maintain the coverages mandated by the ACA.

As for you last comment, the reason they didn't drop coverage prior to 2009 is most likely the reason healthcare through employment became the standard to begin with, favorable tax treatment and competition for better workers, certainly those reasons still exist, but are clearly being evaluated by companies because those benefits are now offset by increasing costs of meeting the requirements of the ACA.

I would imagine that each individual company will do what it believes is best for it. As we have recently learned, if we already didn't know. Companies that play ball can put themselves in a better position when it comes to things like enacting favorable regulation and competing for government contracts and god forbid, politically motivated IRS audits or other unwanted scrutiny.

The number of states that have announced rates higher than expected is 0.

No one has to buy anything more than the silver plan. If the platinum plan is too expensive, don't buy it. But the prices for the platinum plans are publicly available. You can peruse them at your leisure.

You're asserting that costs will increase to meet Obamacare's requirements, but that's not necessarily true. We know the costs of meeting Obamacare's requirements in many states. They are published. The costs are quite a bit lower than what most people were expecting. If an insurance company posts a rate on the exchange that is lower than what they charge a company for employee health care and tell you it's because of the increase costs of complying with the PPACA, they are lying to you.

PPACA hasn't "increased", "substantially increased" or even "significantly increased" healthcare premiums either.

This **** is so stupid you should feel ******ed for posting it.

Hint: waivers are for one specific portion and are extremely limited in time

You are perfectly entitled to believe this.

Everything in this post is wrong. And this guy has a much higher than average level of understanding of PPACA among its opponents.

All exchanges that have released rates provide better coverage for less money as compared to what is presently available. Also this nonsense about 'focusing on the silver plan' just reveals a fundamental lack of intelligence - do you really think they're pricing the silver plan really well but are somehow going to really stick it to people buying other coverage? What is it, a loss leader?

The rest of your post is talking point soup that reveals that you don't understand the law. What exactly are 'costs of complying with ACA' for companies that already provide coverage? You know that for substantially all employers the $2k/yr fine, which is not deductible, is far more expensive than providing deductible minimum coverage, right?

An article written by Ezra Klein on how wonderful Obamacare is? No way, I would have never seen that coming. Unfortunately for readers, Ezra Klein has no idea what he's talking about.

Here are the premiums today for plans that are most comparable to a silver plan, using zip code 90001 and a 40-year-old male for comparison:



Compare those rates with the exchange rates:




All of the plans on the exchange have very limited provider networks compared to the PPO plans that are available on the market today. Here's a link to the booklet - http://www.coveredca.com/news/PDFs/C...ns_Booklet.pdf

If you read through the company listings, you will see that some companies have networks as small as 6 hospitals and 176 doctors. Who exactly would buy a plan from a company with such an incredibly small network? Even the major companies like Blue Shield of CA and Anthem Blue Cross have limited their provider networks to 30-40% of the regular PPO network that they offer to keep the prices down.

None of the plans in the exchange include access to the national BlueCard network which allows people to see BCBS providers while out of their area. Even the network PPO plans do not give BlueCard access. Exactly zero of the companies listed for the exchange plans seem to have any type of nationwide in-network coverage at all.

It's pretty convenient that rates were only posted for 40-year-olds and 20-year-olds. They did not post any rates for 60-year-olds or families, probably because the rates are going to be so much higher and they didn't want to sticker-shock the public. Using the same 90001 zip code and a 40-year old husband, 40-year-old wife, and 13-year-old child, the same plans I posted are $350-450/month with today's rates. There is no way they will be anywhere near that low through the exchange.

IMO, the system will turn even more towards a difference of the poor and the well-off with people who can afford it buying outside of the exchanges to gain access to the nationwide PPO provider networks and different plan designs that will be available, while the poor and lower-middle class will be stuck with Medicaid or these exchange plans that have very limited provider networks and high out-of-pocket maximums. How many people making $30-40k/year can afford to pay a $6,450 bill if they hit the annual OOP max?

There will be carnage when this **** kicks in.

It is already kicking in. There is the opposite of carnage. There will be some speed bumps, primarily because GOP frothers are blocking medicaid expansion and refusing to fund implementation, but this will ultimately be a huge success.

You have already assumed the conclusion. It's the new post-reality GOP way.

Just wow.

So Jim, just out of curiosity, fast forward to 2016 - what combination of facts would lead you to say "I was wrong about Obamacare"?

If 25% of what the liberals ITT are predicting occurs, I would say "I was wrong."

I'm playing poker right now, will post later.