May 17, 2013
Small businesses left in the lurch?

Maybe the voice from the corn was wrong. What if you build it, and hardly anybody is interested?

That's a question the state's Health Benefit Exchange (HBE) board is pondering about the Small Business Health Options Program (SHOP), the small business health insurance exchange being set up under Obamacare. Only one provider, Kaiser Permanente, wants to participate in SHOP, and it only operates in Southwest Washington.

Washington was supposed to be a shining example of the power of the insurance exchanges in Obamacare. Some states took a slow, wait-and-see approach to setting up their exchanges. Others flat-out refused to implement the exchanges and left the task to the federal government.

But Washington embraced the task early and vigorously. While many insurance providers are lined up to participate in the individual exchange that goes live in October, the soundtrack of the small business exchange is chirping crickets. Some have suggested that too few small businesses will buy through the exchange, making it unattractive to insurance providers, but Oregon has attracted eight providers to its SHOP despite its much smaller market.

For most small businesses in Washington, this means they won't receive the tax credits for covering low- and middle-income workers they were promised in the run-up to Obamacare's passing. That's because the law was written to allow those tax credits only for plans purchased through exchanges, not small business plans bought outside of the exchange. Small businesses that aren't in Southwest Washington, or ones that are but don't like Kaiser Permanente's plan, will be out of luck.

While small businesses will miss out on the tax credits, they could keep their employees in an exchange plan by just buying them coverage in the individual exchange, right? No, because Obamacare specifically bans this. As the HBE staff noted in their report, "Employers cannot sponsor an employee's participation in the Individual Exchange."

Faced with the unpalatable options of moving forward with one geographically-limited provider or delaying SHOP altogether, the HBE board voted for the former. HBE staff, meanwhile, pledge to work with small employers on "the SHOP value proposition."

Posted by Adam Faber at May 17, 2013 11:13 AM | Email This
1. Single-payer, such as in Canada, could eliminate all of this nonsense, but that would also gut the massive profits which private health insurance companies make -- profits which consist entirely of the difference between what you paid for your health care, and the amount of health care you received. Health care CEOs don't want to lose their private yachts, and, thanks to profiteering on your health care dollars, they have plenty of money to buy their way into Congress.

If we'd just adopt the program Rep. Jim McDemott was sent to Congress to enact, all of this trivia about exchanges would never have existed in the first place.

Posted by: tensor on May 17, 2013 11:57 AM
2. I just want to keep what I have as far as health care goes. I'm reasonably satisfied with it.

Posted by: Ten Years After - Roger Rabbit is just a leftist progressive troll. on May 17, 2013 01:50 PM
3. I appreciate that Adam doesn't seem to be interested in tossing red meat to the angry crowd. That's a nice change (un)SP. One can reasonably agree with Adam.

Something has to change and I agree with Tensor.

Someone I know lost their job because the company he worked for went out of business. Before that happened, his hours dropped to the point that he was dropped from the group plan. Before he could sign on to a private plan he had a heart attack. Now he has a pre-existing condition and with the money he spent on care his dreams of retirement have vanished. He looks every day for a job but he's discovering that, even though he's really good at what he does, at his age, late 50's, he can't get even an interview. As ppproud a man that he is, he's still looked into DSHS, L&I and SSDI and yet there's no help available, seemingly because he hasn't spent his last dime yet and still hasn't lost the house. DSHS only offered food stamps.

He's worked all his life. He is unemployed only because his employer screwed up and lost a major client which was not the fault of this or any other employee.

This man wants to work. That's all. He kept working out of pride and refusal to live on the dole and his hours kept dropping. When the company folded he discovered his hours had dropped to a level where he no longer qualified for unemployment benefits. He paid 35 straight years into the system and now it's not available.

You're seemingly into the minutiae, Adam, and I only ask you to look at the big picture for a minute. What is this man supposed to do? Crawl under a bridge and die as the likes of your hate-filled readers KDS, Leftover and Katomar cheer as he's passing away? Do you really believe as they do that he deserves to die? Do you really believe for a minute that you're immune to such a fate? It could happen to you or to someone you love, Adam.

Is this what America has come to? Is that what you want, Adam, good, hard working Americans dying as extremist haters like KDS cheer their death as though they actually deserved to die? Believe me when I say it, KDS would cheer you or your wife's death as well.

Posted by: Doctor Steve on May 17, 2013 02:59 PM
4. Is this what America has come to?
Kermit Gosnell
Is this what America has come to?
I couldn't get through the video without sobbing and wondering what in the hell is wrong with people on this earth. So consider that your disclaimer and warning.

Is this what America has come to?

What America has come to is its citizens lazy, stupid, selfish with an overblown and totally unearned sense of entitlement.

Insurance began after World War 2 as an incentive companies used to lure the most talented veterans who had many choices of employers who couldn't hire enough people in a booming post war economy. Prior to that it was pay as you go. I know: it's exactly what my immediate and whole extended family did. We all saw the doctor/dentist brothers who shared an office in the neighborhood of their and our ethnicity... when it was absolutely necessary.

My family never had insurance until my Dad was lured to the American Safety Razor Company.

Somehow that employment incentive meant to lure the very best became an entitlement. Now we run to the doctor with the sniffles and demand to be "cured".

The problem is now that no one CARES what medical care costs, because hey, they've "got insurance". Americans have become stupid. We know the cost of every other important purchase. We would not buy any consumer product, not a car, not a house, not even a microwave oven without shopping around and/or researching the product.


The saddest part is the the government put its intrusive nose into the healthcare industry and now we have insurance companies that each and all make their own contracts with each and every health care provider, further obscuring the real cost of health care.

This was brought home to me during the Obamacare debate when at that time my unemployed and uninsured son broke his leg. We did not go to the hospital to be accepted and treated for "free". We did the responsible thing went to the urgent care of our medical group and paid cash to be seen and for an x-ray. They handed him the x-ray and said yep, it was broken and he needed to see an orthopedist. Again, at this point, we could have gone to the hospital ER for "free" treatment. We again chose personal responsibility and chose to see our orthopedist (yes, with 3 sons, we have a family orthopedist). We called ahead of going, explained the no insurance and was told it would be $250 up front. The doc chose to use the existing x-ray so as not to needlessly run up the charges. Yep, it was broken. THAT was the good news. The bad news was he needed surgery to put it back together. His assistant got on the phone with the hospital to try to get him some charity to cover the surgery. We were sent to the hospital billing office who told us that 123 minutes of surgery would cost $18,000. That did not include our orthopedist surgeon, nor the anesthesiologist. We were further told THAT SINCE WE DID NOT COME THROUGH THE ER, he was not "entitled" to charity, but they would offer him a 50% discount if he financed the remaining $9000 through the hospital... Or if we paid right that moment, they would accept $4500 as full payment. I whipped out my Visa. We negotiated cash terms/discounts with the surgeon, with the anesthesiologist and with the physical therapist. The final tally for the broken leg, IN CASH was about $10,000.

Now, if they can reduce the price by 2/3 for cash, what the hell does that tell you about the out of control craziness of health care costs? What does that tell you about what health care REALLY costs?

We would all be a lot better off if we simply shopped for healthcare with the diligence we show shopping for a damned energy efficient car. If we did that, if we were ABLE to do that, all we'd need would be catastrophic coverage - which we'd also be able to shop and compare along with the healthcare.

I hope and expect to see a brave medical group/hospital somewhere will have enough of the insurance/government bullsh*it and announce they are posting their prices for cash patients. We are already seeing concierge medicine on an individual doctor level.

In a sad way, the reverse has already happened to Medicare/Medicaid patients - the government refuses to pay the value of the medical service so the providers are refusing to see the patients.

Take the government OUT of healthcare. Take the insurance industry OUT of healthcare. Learn some personal responsibility and shop for your own care with as much care as you shop for your lawn mower.

Posted by: RagnarDanneskold on May 17, 2013 04:54 PM
5. Rags,

The problem is that, unlike most other "consumer products," medical treatments can be sudden, necessary, and expensive. That's why we have health insurance; it's less expensive and more effective than piling up money in a bank account against the day a medical emergency comes.

Sadly, modern "Heath care insurers" have become little more than the classic "takers": providing no product or service worth the vast sums they drain from our economy -- from all of us. Of the major industrialized democracies, Americans spend more, and get less, than anyone else. We have both high premiums AND medical bankruptcies, and Canadians just shake their heads and wonder why we tolerate such a state of affairs.

Debating trivia, like exchanges, does nothing to get us to the root of the problem -- eliminating the moochers who stand between you and a high-quality medical outcome. That's why I vote for Jim McDermott.

Posted by: tensor on May 17, 2013 05:25 PM
6. Our portion of our employer provided insurance is about $1100/month, which is about equal to the amount the company pays. So, our coverage comes to about $2200/ month, and that does not even include the cost of the "time" to deal with the business aspects of providing insurance, For example, our oldest son, who has about 18 employees working under him spent over 5 hours in the last 2 weeks in HR meetings about insurance. What a totally unproductive use of his employers time and another hidden cost of "insurance".

$2200/month = $26400 per year.
Allow employees to take that as a health savings account. Make EMPLOYEES responsible for using it wisely. Teach them to be healthy and to be good health care consumers. Give them incentives to do so. Let the unused money roll over every year. Make it potable with employment changes.

Posted by: RagnarDanneskold on May 17, 2013 05:39 PM
7. The problem is that, unlike most other "consumer products," medical treatments can be sudden, necessary, and expensive.

Which is why catastrophic insurance, formerly known as major medical, exists. You don't carry homeowners insurance for minor issues, you carry it for catastrophe's: fires, trees falling through your roof, burst pipes in the walls, accidents, theft. Ditto car insurance: it doesn't and shouldn't cover your oil change or a little scratch on your bumper.

You accept personal responsibility for that. I have faith that Americans can be equally responsible for our own health care. Isn't that what Michelle Obama has been encouraging us to do - with loud lefty enthusiasm, I might add. Why have you no faith in your fellow citizen to responsibly manage their own heath care and money?

Posted by: RagnarDanneskold on May 17, 2013 05:54 PM
8. Rags, I love, love, love how you followed a comment describing how failed our system is with a comment demanding we work within it. You're part of the problem, and you don't even see that.

I once worked for a small company, where we designed and manufactured advanced scientific instruments. It was a great place to work, filled with talented folks in a relaxed and supportive atmosphere of innovation and creation. Every year, we grew in profits, product lines, engineering accomplishment, customers - we were living the American entrepreneurial dream, right down to having started in the founder's garage. (No, I didn't make that up!) We went from $10M/year in sales to $20M in the years I worked there.

Also every year, we had a company-wide meeting -- our only one except for our end-of-the-year luncheon -- on our new health insurance plan. Every year, our business manager spent hundreds of hours on getting us a plan, and every year, it was worse than the plan we had the year before. Health insurance companies are killing the small American business, which is why we need to decouple insurance from work.

That's why I vote for Jim McDermott.

Posted by: tensor on May 17, 2013 06:56 PM
9. Every year, our business manager spent hundreds of hours on getting us a plan,

And you see nothing wrong with that metric? Is thatreally the best use of company resources?

The message of "government healthcare" is no different than the message of unions: you're too damned stupid to act in your own best interest, so pay us and we'll pretend to do it for you.

When you argue for that you admit your own impotence and inability for self interest.
You abdicate out of ... what, exactly? Laziness? Inertia? Lack of confidence? Lack of self worth? All of the above?

Posted by: RagnarDanneskold on May 17, 2013 07:30 PM
10. Is this what America has come to? Is that what you want, Adam, good, hard working Americans dying as extremist haters like KDS cheer their death as though they actually deserved to die? Believe me when I say it, KDS would cheer you or your wife's death as well.
Posted by Doctor Steve at May 17, 2013 02:59 PM

WTF - Haters ? You are an deranged extremist and most people of sound mind loathe your existence here, but the First amendment prevails. Does it just come natural that you are a flaming horse's a$$ ?

Posted by: KDS on May 17, 2013 08:57 PM
11. Rags and Tensor, you may be disagreeing with each other but you're doing so cordially. I like that. And I'm glad that you're taking the discussion in this direction - talking about the big picture and not the minutiae of Obamacare.

For my part, I do not believe that Obamacare is the answer. It's a mess that just might get a lot worse. I see the answer as being the simplicity universal health care. I read your discussion while keeping in mind someone I know who worked all their lives and with pride refused to ever go on the dole and yet has found himself in a very bad situation. I see this as something that could happen to anybody posting or commenting here, left or right.

I'm relating to someone I know because of what is happening to him and see how it is rippling through family and friends, hurting their lives as well. But believe me, if this was instead, say, a story involving Rags and her husband and their recent unexpected health crisis, it would be every bit as disturbing to me. Rags was ready for this and her husband is with her still, God bless them. My friend was ready too. But two things went wrong, both beyong his control. His boss screwed up and then he had a heart attack before he could sign up for a private plan. Something like that could happen to any of us. It doesn't matter if you're a maker or taker, Democrat or Republican, black or white, something like that could happen to you. I say that isn't right and something needs to change.

I'd like to ask, do either of you see anything that might be common ground between you in the points you're bringing up. I think I see some but I wonder if you do as well. At this stage, what you might find that you do agree on is far more important to me than where you disagree.

@10 Excuse me, but the adults are having a conversation. Please go play somewhere else.

Posted by: Doctor Steve on May 17, 2013 11:26 PM
12. Can we at least agree to stop subsidizing illegal alien healthcare? Once they are identified, force them to leave. It would be far cheaper to deport them and pay for healthcare in their home country than to allow them to stay here and receive care.

Posted by: Smokie on May 18, 2013 07:09 AM
13. from 11,

Yes, the debate is a lot more cordial over here compared to

Posted by: Ten Years After - Roger Rabbit is just a liberal progressive troll. on May 18, 2013 08:20 AM
14. Steve, in the past, there were many private charities, churches, family and friend that would step in to help relieve the burden on your friend in such dire need. The problem is that with increased dependence upon government, with increased taxes to support that dependence, those private charities have closed or have less resources with which to help.

I don't understand how you can see the need so clearly with your friend, yet not see that the growing government largesse and dependency is a self perpetuating, ever shrinking circle.

Posted by: RagnarDanneskold on May 18, 2013 09:33 AM
15. Rags, I see that there are poor towns all over America with poor churches and struggling charities and they can't do it alone. I see that charity should be the primary path to help, the first thing we should think of when someone we know needs help. But this is our government. I see no reason for the government that represents us to not to reflect the charity in our hearts as well.

I hear you loud and clear when you talk about culture of dependency. I've seen it. Where I disagree with you is that I believe that this is a problem that can be addressed without ending our social safety nets.

The problem isn't just Republicans to my mind. It's also Democrats. It's like thay haven't learned a single damned lesson from decades of equal rights, affirmative action and everything else that's been tried. It doesn't mean that we've failed as a nation. It only means that Democrats have failed to learn from their mistakes. The best example I can think of how Clinton had to drag his party kicking and screaming towards much needed welfare reform.

As Republicans developed a Southern Strategy I also saw Democrats begin to pander to every minority group in America whether they needed help or not. When they did that, all hope of helping blacks get out of the whole they were in was lost. To this day they still can't see what they did wrong. Not a single damned lesson learned.

Posted by: Doctor Steve on May 18, 2013 10:00 AM
16. "Can we at least agree to stop subsidizing illegal alien healthcare?"

If you mean programs and stuff like that, then yes. If you're talking about turning away a human being from the emergency care they desperately need then I disagree. Give them the emergency care they need and then in most cases pack them up and send them back to wherever they came from. But there are complexities galore and there will be many cases that would require special consideration. But I see no reason why we can't do this.

Posted by: Doctor Steve on May 18, 2013 10:09 AM
17. Obamacare: A solution to a problem that didn't exist that creates problems with no solutions.

This is what happens when people with no knowledge or expertise in a field are placed in charge of regulating it. A mandate to purchase a good or service that does not exist, and then being fined for not complying. Stupid, just plain stupid.

Posted by: Roger in Republic on May 18, 2013 11:17 AM
18. "a problem that didn't exist"

I disagree. When the monthly cost of private health care insurance plan rivals or exceeds a middle class family's mortgage or rent payments then a problem truly does exist.

We have no problem too big for us to solve. We just have to work together to find solutions that most of us can agree on. That's why I'd prefer to see us find whatever common ground it is that we might share and build on that, working towards agreed upon solutions to a very real problem. That in a nutshell is my problem with Adam's post. It would lead us in a direction where that wouldn't happen.

If we must, we could talk about the effect that ACA has on small businesses in Washington. However, if you want to get rid of ACA it's going to take coming up with a better idea.

Personally I prefer Tensor's approach. I'm against vouchers because it would leave the elderly, usually those most in need of health care, to wander the streets looking for a private plan which they could afford and unless something fundementally changes I don't believe many of them are going to find it. We'd only shift discussion from the problem of ACA's effect on small business to the problem that the effect of vouchers has on the elderly.

I'm saying that neither ACA nor vouchers are solutions to the problem. What I want to hear is a better idea and so far Tensor's is the one I lean towards. If anybody thinks they have a better idea than that then I'd love to hear it.

Posted by: Doctor Steve on May 18, 2013 02:39 PM
19. The Most Insane Health Care Billing System
A few years ago, I went to the doctor for a simple procedure. I had high-deductible health insurance and would be paying for the procedure out of pocket.

Before heading in I asked the receptionist what I thought was a simple question: "How much is this going to cost?"

She had no idea. And she had no way to check. She looked at me like it was an unreasonable question. A manager contacted a third-party billing agency to get me a quote, which ended up being nothing close to what I actually paid in the end.

Economic models assume participants have perfect information. In reality, they often have no information whatsoever.

I thought this was a glaring example of how screwy health care pricing is. But I had no idea

My sons new mother-in-law recently had two cochlear implants. It cost Blue Cross (and everyone of us who pay for Blue Cross coverage) over $80,000. Rush Limbaugh is also known for his hearing loss and cochlear implants. He paid cash for his. Who do you think paid less? Whose cost less in terms of rules, regulations, minutia and paperwork time?

Rollover, potable HEALTHCARE SAVINGS ACCOUNTS would solve that problem.

Further, three would be no worry over pre-existing conditions, no angst over paying, through your pooled contributions, for procedures you might find morally objectionable.

From boobjobs to bunions, invitro to killing your child in your womb - it would truly be a transaction between you and your doctor.

Yes, there will be those who squander their health savings accounts on butt lifts and belly tucks - but it is no ones job to prevent others from acting stupidly.

Further, since the money follows the person, think how wonderful it would be to pass it down to your children and grandchildren.

We all see heartbreaking stories on news followed with 'you can make a contribution to help' at ABC Bank. Right now, one of our priests is dealing with a deadly re-occurrance of cancer - there is nothing left to remove. HSA's could be set up to contribute a certain percentage FOR charitable contributions.

Ability to bequeath
Ability to contribute
Ultimate privacy

And for those who worry about catastrophic medical events, the money in your health savings account can, and should be, be used to buy high deductible major medical. THAT"S what we have already for the $26,000 per year going to Blue Cross on our behalf: $5,000 deductible.... but we have NO health savings account from which to draw that first $5000, so it comes out of our savings account/living expenses in addition to the $26,000.

Posted by: RagnarDanneskold on May 19, 2013 10:00 AM
20. What infuriates me:

5 freedoms you'd lose in health care reform
If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.
July 24, 2009

1. Freedom to choose what's in your plan
2. Freedom to be rewarded for healthy living, or pay your real costs
3. Freedom to choose high-deductible coverage

4. Freedom to keep your existing plan
5. Freedom to choose your doctors

More Americans Using HSAs--Under Threat from Obamacare
June 22, 2011

Friday, 06 July 2012
ObamaCare Putting Squeeze on Health Savings Accounts

* * *

Replacing ObamaCare: Health Savings Accounts July 02, 2012

Health savings accounts are pretty simple, really. It's a savings account for your medical expenses. Deposits made to your HSA aren't hit with an income tax at the time of deposit, and the money in your HSA can be used tax-free at any time to pay for qualified medical expenses. Similarly to individual retirement accounts (IRAs), the tax treatment of HSA withdrawals for non-medical expenses differs according to the time of withdrawal. Health savings account funds can also be invested, just like IRAs. Money saved in an HSA rolls over from year-to-year, and can be passed on to a beneficiary after death.

HSAs encourage people to save for their future medical expenses. They also provide an incentive for people to take more care in making medical decisions, instead of agreeing to any and all proposed tests and treatments regardless of their medical benefit, since it's their money on the line. This will help to reduce health care cost inflation. In addition, they expand patient freedom and choice by providing more flexibility, allowing patients to make health care decisions without government bureaucrats or insurance providers always acting as a gatekeeper.

As of now, only Americans with high-deductible insurance plans are allowed to start an HSA. If you're unfamiliar with high-deductible insurance plans, they're just health plans with low monthly premiums and high deductibles. Even if you're on such a plan, the current law caps your total annual contributions to your health savings account.

Posted by: RagnarDanneskold on May 19, 2013 11:25 AM
21. @19, 20 Very good comments! Darn you, I'm going to have to reread what you wrote later to make sure I clearly understand what you're suggesting here before trying to reply. This is the kind of stuff I was hoping to hear, ideas with which I'm not familiar. Thank you.

Posted by: Doctor Steve on May 19, 2013 02:19 PM
22. "If you're unfamiliar with high-deductible insurance plans, they're just health plans with low monthly premiums and high deductibles."

Actually, I've heard of HSAs although I haven't looked into them. I'm someone who only needs insurance for the big stuff as I deal with life's cuts and bruises even when it's covered. I don't want doctors ever getting their hands on me! They'll never let go! Through my career I've really had no say in what insurance plans we were on when I worked for someone else. With my own business I've gone the route quoted above.

More later.

Posted by: Doctor Steve on May 19, 2013 02:30 PM
23. One more thing before I go. A friend recently had a very serious accident while playing catch with his grand daughters in the street in front of his home. He fell going for a ball. What intitially appeared to be cuts and bruises was in a few minutes profuse bleeding from both ears. Then it got worse. A lot worse.

Anyways, I had the opportunity to read a series of emails by his wife describing the experiences at the hospital and follow up care that she had written to keep family up to date. Although she writes with gentle humor it read like a nightmare. She had one heck of a time just visiting her own husband in the hospital and that was the upside of the story. So many insensitive people and so few with any heart. It was a real eye-opener to read her emails. I now suspect that insurance isn't the only problem facing us with health care these days.

I've never been a hospital patient and I'm so glad for that.

Posted by: Doctor Steve on May 19, 2013 02:46 PM
24. @23 You do not inspire any well-wishes with your hate-filled comments. Seriously, just something to consider for the future - if your little egg-shell ego can handle it !

If you play nice, that could change - its all on you.. After you treat people here like they are a joke - you reap what you sow, dude.

Posted by: KDS on May 19, 2013 05:08 PM
25. @19-20 - You're on the right track. Obamacare (ACA) is a leftist-initiated disaster - way more costly than universal payer/Canadian health care and very little improvement over Canadian health care.

There a good number of ways to prevent this impending economic and health care disaster. Limited measures can be taken as you mentioned (McCain's health plan in 2008 would have been way better, many health professionals have proclaimed). Health savings accounts were here, but they disappeared with Obamacare & they were a good idea. I agree that all of those freedoms below have been lost.

1. Freedom to choose what's in your plan
2. Freedom to be rewarded for healthy living, or pay your real costs
3. Freedom to choose high-deductible coverage
4. Freedom to keep your existing plan
5. Freedom to choose your doctors

Let's just hope we are able to retrieve these freedoms before it's too late for many. It will take a repeal and replacement of a good chunk of the ACA. Obama and his leftist regime will make that difficult with their hardball tactics and their zest for overreach. Some Democrats who see the handwriting on the wall are now willing to push for repeal/replacement of parts of Obamacare, motivated by the 2014 elections, no doubt.

Posted by: KDS on May 19, 2013 05:29 PM
26. @24 "If you play nice, that could change"

You could have left that crap on the other thread but you just had to bring it here too, didn't you?

Posted by: Doctor Steve on May 19, 2013 05:42 PM
27. You reap what you sow.

Posted by: KDS on May 19, 2013 05:46 PM
28. I'm putting you on ignore for the duration of this thread out of respect for those who are seriously trying to share their ideas for health care solutions. You can talk to yourself the rest of the way for all I care, KDS. I won't even acknowledge that you exist. Good riddance to you.

Posted by: Doctor Steve on May 19, 2013 06:12 PM
29. OMG, Adam is so much better than pudge. I can finally start visiting this blog again! YAY!!!!!

Posted by: DA on May 19, 2013 06:16 PM
30. For those who don't know, and there is somebody here who doesn't, the ACA actually originated with the Heritage Foundation. Refer to the 1989 Heritage Foundation brief titled "Assuring Affordable Health Care for All Americans". It was intended to counter the single-payer system the Democrats wanted.

Posted by: Doctor Steve on May 19, 2013 06:25 PM
31. "OMG, Adam is so much better than pudge."

Agreed. I hope that Adam can resurrect this site and make it relevant again.

Posted by: Doctor Steve on May 19, 2013 06:28 PM
32. From the Heritage Foundation brief,

"Many states now require passengers in automobiles to wear seat-belts for their own protection. Many others require anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement."

Sound familiar?

To me it doesn't matter who came up with the idea. Perhaps you do care. But if you believe it was a communist plot or something, I believe to be mistaken.

It's now law and I believe it needs fixing or replacement. I don't see repeal as addressing the health care crisis so I believe the solution to the problem will be found in fixing or replacing the ACA with something better.

Any more ideas?

Posted by: Doctor Steve on May 19, 2013 06:38 PM
33. By the way, a form of the ACA first made it to Congress in 1993 and was called the Health Equity and Access Reform Today Act. It's what the Republicans proposed in reaction to President Clinton's attempt at health care reform.

That's just offered as clarification because someone has attempted to mislead you in this thread.

Posted by: Doctor Steve on May 19, 2013 06:47 PM
34. You can talk to yourself the rest of the way for all I care, KDS. I won't even acknowledge that you exist.
Posted by Doctor Steve at May 19, 2013 06:12 PM

LMAO !!! You have zero self control, but just for kicks, I'll hold you to account and you will break that soon. Why don't you call someone who cares ? Better yet, go back and crawl in your little bubble with the rest of your leftist scum brethren at, with all due respect to HA.

Posted by: KDS on May 19, 2013 08:03 PM
35. "By the way, a form of the ACA first made it to Congress in 1993 and was called the Health Equity and Access Reform Today Act. It's what the Republicans proposed in reaction to President Clinton's attempt at health care reform."

Resurrected Red Herring from the left - there were similarities in the framework, but that's where it stopped. It was crafted far differently than that retarded ACA was. The Heritage Foundation knew what was in it, unlike the corrupt and fecalheaded Dems in the House that passed it, from whence the Speaker dumber than a box of rocks and corrupt to the core Pelosi who exclaimed "We had to pass it to see what is in it", and noone at the time knew all of the ugly details nor did they care. All the Social Democrats wanted was a tyranny, with the ACA being the cornerstone of it.

Those are the facts that leftist scum never reveal because they disdain and can't handle the truth. Mike BS, tensor, socialdemokid ; where are you ?

Posted by: KDS on May 19, 2013 08:17 PM
36. The abortion lobby claims that as long as we have tight regulations on abortion, a black market will exist. Abortion, they argue, is like any product or service that consumers want and government prohibits or overregulates. If they can't get what they want legally, they will get it illegally.

"Abortion, they argue, is like any product or service that consumers want and government prohibits or overregulates"

Ahem, can't we say the same about healthcare?

Oh, yes we can.

And we do, as we point out the hypocrisy.

Poll: Already Scant Support for Obamacare Erodes
According to the latest Reason-Rupe poll:

The president's health care law is losing public support... Only 32 percent of Americans say they liked the health care law when it was passed and still like it today. Seven percent liked the law when it was passed, but like it less now. Meanwhile, 45 percent disliked the health care law when it was passed and still dislike it. Four percent of Americans say they disliked the law when it passed, but like it more now.

These results are consistent with the Kaiser Family Foundation Health Tracking Poll, which has always reported a higher level of support for the law than other polls, yet whose latest results show support for Obamacare slipping to just 35 percent of adults.

Posted by: RagnarDanneskold on May 19, 2013 10:32 PM
37. There's a person here continuing to try to ruin this thread and it's not me. From my perspective since he stands alone, he's trying to ruin it for everybody. He's ruining it for Adam and everybody else be they left or right. I will not address him in this thread. You folks deal with it as you will.

Rags, I've been reading up on HSAs but it's very late and I'll comment more fully tomorrow. I have no problem with HSAs. However, I wouldn't want an account limited to funds and such. I would want it like my Roth/IRA account where I can own individual stocks.

Off the top of my head I wonder what benefit these would be to the poor. Also as part of a complete heath care law redo I would want to start addressing things like preconditions. I don't like the ACA but there's elements in it like that which I think should be addressed. Without something being done it'd leave someone with a precondition stuck with the insurer they had when the condition came about or they won't have insurance available at all. I don't want to throw the baby out with the bath water.

Having once not been free, I certainly appreciate freedom too, although we express ourselves differently. Perhaps also on equality. Are you free and equal to others when they can shop around for or simply even obtain insurance and you can't? What if an infant is born with a genetic-based defect? Is that a sin to be passed from father to son as far as insurance goes? I'd rather leave condemnation of this sort for God when he gets their hands on them and meanwhile see to it that these people get access to the care they need.

And I'm talking here about people with the means to pay for insurance. Not moochers. Given the very nature of what insurance is all about, spreading the costs around, it seems rather absurd to leave them on the outside looking in. If the door is open to exclusion, then who else might insurance companies leave out someday?

Posted by: Doctor Steve on May 20, 2013 02:53 AM
38. Off the top of my head I wonder what benefit these would be to the poor.

Even the poor have jobs and part of those jobs would include both employer and employee contributions to HSA, which again is potable - it goes with the person. How well that person manages their health care spending is up to them. Do they run to the doctor for a runny nose? Do they shop prices for basic care? Do they actively participate in good health ideals? Should not the poor have the same responsibilities to their health as the rest of us?

And, with the time savings of managing insurance crap converted to actual dollars, isn't it conceivable that those earning below a set level could be given a bit more specifically toward their health savings account? And/or earn toward their health account a bit more with provable good health habits? I'd rather that than the humongous rise we've seen in food stamps, where the government is literally throwing money at people and spending more money actively campaigning for them to take it.

Off the top of my head,let's think about the concept of no-fault car insurance. The money you and I and everyone pays for our coverage also protects us from those who don't (illegally, I might add) have coverage. Instead of a monster like Obamacare, why not a pool of money FROM everyone to cover those truly in need? If my HSA value is $26000 per year and even if the amount withheld for the 'pool' is only 5% - that's $1300 - multiply that by hundreds of thousands of middle class earners! I read that there are actually 146,743,000 actually working in the US - if, say $1000/year was the AVERAGE withheld for the poor - that's $146,743,000,000 - yeah I think we can work with that.

There are solutions out there to all these problems/objections.

The one thing that is not the answer, will never be the answer, is Obamacare.

Posted by: RagnarDanneskold on May 20, 2013 09:05 AM
39. I would want it like my Roth/IRA account where I can own individual stocks.

While I do not oppose earning interest on unused funds, I do not agree it should be investable money.

Like retirement, there is no guarantee people will invest wisely. If they lose their funds then we are in the same place we are now with an unsustainable social security.

Posted by: RagnarDanneskold on May 20, 2013 09:13 AM
40. @28,

I'm putting you on ignore for the duration of this thread out of respect for those who are seriously trying to share their ideas for health care solutions. You can talk to yourself the rest of the way for all I care, KDS. I won't even acknowledge that you exist. Good riddance to you.

That is what most people who read this blog do every time they see "Doctor Steve" or "Dave Matthews" or similar inane commenters who just come here to "push buttons." If you do not understand the Dave Matthews reference, you have not been around long.

Posted by: Anonymous on May 20, 2013 12:12 PM
41. @38, 39 Points well taken. I'm very busy at the moment but I'll try to find time to give this some thought and respond later today. Thanks!

Posted by: Doctor Steve on May 20, 2013 12:26 PM
42. I've given this a lot of thought these past few days and I've decided to help Adam try to turn this blog around. Anybody not heading in that same direction will be ignored from now on. I will not even acknowledge their existense. In the future I'll only comment and respond to people like Rags who have shown a willingness to talk about our nation's problems and look for solutions together.

Posted by: Doctor Steve on May 20, 2013 12:43 PM
43. I've given this a lot of thought these past few days and I've decided to help Adam try to turn this blog around.

LOL. I will believe this when I see it. I would be willing to bet $50 that within a week Doctor Steve will by right back to his typical rants about angry wingnuts, and other such paranoia and be back to just trying to argue with KDS. It is hilarious that Doctor Steve now suddenly thinks he is going to be the high ground that is going to make this a great blog. Go back through months of comments and all you see is aggressive hate, personal attacks and incitement coming from Steve. Granted, there are those like KDS who respond and only encourage Steve.

But a sweet commenting angel full of reasoned insight, Doctor Steve is surely not. Prove us all wrong and heal thyself Doctor Steve.

Posted by: Anonymous on May 20, 2013 01:06 PM
44. Washington residents will see lower health insurance rates.

The Washington Healthplanfinder has been notified by nine insurers that they intend to offer their 57 plans on this state health insurance exchange. The premiums, deductibles, and coverage options that they have now submitted are different from those that had previously been predicted in the state. That said, the state has yet to evaluate these submitted plans in order to make certain that they confirm to the "essential health benefits" of the law, such as preventive care coverage.
According to Michael Marchand, a spokesperson for the Washington health insurance exchange, "We were pleasantly surprised at how great the rates look," adding that "After subsidies many people will pay even less, and they'll get more benefits" than are offered in many current policies."

Posted by: MikeBoyScout on May 20, 2013 01:41 PM
45. @43 - I plead guilty as charged with NO apologies However, I will be contributing less in the ensuing days.

Yes, like you I will believe the referenced transformation when I see it. Until then, my proven theory still stands; Steve has zero self control.

Posted by: KDS on May 20, 2013 01:42 PM
46. All the time spent the last twelve years or so agonizing and shopping around to deal with the skyrocketing costs of group insurance plans have been a pain in the ass for businesses and has cost them huge sums of money. It used to fairly stable, a company had a plan and could stay with it. Then came the era when I kept finding booklets and cards for our new plans show up in the inbox every year as ours and so many other companies tried to combat soaring costs.

To borrow from Rags, I wasn't free to chose anything. It's just "Here's the new plan". No choice and a lot of company overhead dedicated to the effort. Great.

Can you think of a better way? I was wondering if there could be something set up so that, maybe call it an exchange without mandate that allows the individual to make their own choices. The business dedicates so much money per employee for health care insurance and if the employee chooses a plan that costs more or less, they receive a little money or pay some more in. If your business provides for insurance, the employee is eligible to shop at the exchange. If the employee doesn't have the initiative to even pick a plan, he won't get one. The business keeps the money because the employee simply didn't accept the benefit. That's his or her problem.

The upside I see is the introduction of individual choice and responsibility as well as businesses no longer wasting overhead shopping for and managing group plans for the office.

Just an idea.

Posted by: Doctor Steve on May 20, 2013 04:47 PM
47. Washington residents will see lower health insurance rates.

Obamacare supporter shocked that employers moving to bare bones coverage

Benefits advisers and insurance brokers--bucking a commonly held expectation that the law would broadly enrich benefits--are pitching these low-benefit plans around the country. They cover minimal requirements such as preventive services, but often little more. Some of the plans wouldn't cover surgery, X-rays or prenatal care at all. Others will be paired with limited packages to cover additional services, for instance, $100 a day for a hospital visit.

Federal officials say this type of plan, in concept, would appear to qualify as acceptable minimum coverage under the law, and let most employers avoid an across-the-workforce $2,000-per-worker penalty for firms that offer nothing. Employers could still face other penalties they anticipate would be far less costly.>

The explanation here isn't exactly long division. As employers seek to obtain plans which will meet the new mandate without busting their budgets, they will bring on bare bones, low premium plans which qualify. Younger workers, particularly those who are healthy and don't have families yet, will flock to those options to save money. This means that the more expansive plans which offer full coverage will essentially be flooded with those who are ill, worried about their health, have dependents with high medical costs or who have many children. With fewer healthy, low cost employees in the system, per capita costs rise and those costs are passed on to the employer and then to the employees.

And yet, when the Wall Street Journal asked some of the key planners of Obamacare, they seemed mystified that this might happen.

Yep, lower rates ... and less coverage! I wonder if that lower coverage will cover my MBS eyeroll headache

Posted by: RagnarDanneskold on May 20, 2013 06:44 PM
48. "are pitching these low-benefit plans around the country"

Pitching, yes. Analysis, yes, although not offered. But following the links, there's no evidence presented in the articles that anybody's buying. No offense intended. Just sayin'.

Posted by: Doctor Steve on May 20, 2013 10:34 PM
49. I see where MBS had a C&P section saying 9 insurance companies.....why not 29? I wish we had more choices and that I wasn't being told by the Insurance Commissioner that I had to have what he thinks I need. Allowing more choice and competition have normally reduced costs....except where the government is in control like health insurance.

Posted by: Dengle on May 20, 2013 11:10 PM
50. Read it and WEEP what you sowed

More Labor Unions Bail on ObamaCare

* * *

Another Obamacare Lie

Here's the question of the day: If you have a choice (and you many not for long because companies are abandoning grandfathered plans) Should you skip Obamacare and keep your old plan?

Comparison Points

Grandfathered plans don't have to provide full, co-payment-free coverage of preventive services, such as flu shots, mammograms and cholesterol screenings.

Grandfathered plans don't have to cover a government-designated "essential benefits package" of procedures and treatments.

Grandfathered plans may require prior authorization for out-of-network emergency care, unlike with new plans.

Grandfathered policies bought by individuals carry their own exclusions, like a $750,000 annual cap on reimbursement for the aforementioned essential benefits, including hospitalization, emergency services or pediatric care.

The online insurance broker eHealthInsurance found that premiums were 47 percent higher and deductibles were 27 percent lower than for individual plans that will incorporate all of PPACA's new rules.

Average monthly premiums for individuals in plans without the newly required benefits -- the closest equivalent to grandfathered plans -- were $190 versus $279. Average deductibles for individuals were $2,257 versus $3,079.

Obamacare Lie: "You Can Keep Your Existing Plan"

That difference in monthly premiums of $190 vs. $279 will entice many to keep their existing plan, assuming it is still offered. However, that setup won't last very long because companies cannot raise premiums on grandfathered plans.

Simply put, Obama lied when he said "you can keep your existing plan", knowing full well the law was purposely written to make sure that would not happen over time.

Eventually you will be stuck with a new Obamacare plan and higher premiums whether you like your existing plan or not.

* * *

WSJ: ObamaCare Could Reduce Employee Health Benefits

According to the Wall Street Journal, employers and employee-benefits consultants have found, and federal regulators now confirm, that the law actually requires most employers to offer no more than very flimsy coverage. Many employers are now exploring the option of offering limited-benefit health plans that cover preventive services and maybe "$100 a day for a hospital visit" but "wouldn't cover surgery, X-rays or prenatal care." Indeed, the law could push many employers to reduce the amount of coverage workers receive on the job.

* * *

Cost overruns devour under-populated ObamaCare program

No group in recent political history has been more thoroughly vindicated than ObamaCare critics, and none more discredited than its advocates, whose every estimate of the program's cost was either a deliberate fraud or a stunning miscalculation. Look now upon the wonder of an early ObamaCare program that only drew about a quarter of the anticipated enrollees, but swiftly went bankrupt anyway. From the New York Times...

The Obama administration said Monday that it was cutting payments to doctors and hospitals after finding that cost overruns are threatening to use up the money available in a health insurance program for people with cancer, heart disease and other serious illnesses.

The administration had predicted that up to 400,000 people would enroll in the program, created by the 2010 health care law. In fact, about 135,000 have enrolled, but the cost of their claims has far exceeded White House estimates, exhausting most of the $5 billion provided by Congress.

Oh, well, that's no problem then. We'll just pay the providers of medicine less, and they'll keep on pumping out the same quality and quantity of service. Our future under President Obama's health care scheme looks bright indeed!

Hey, weren't we just told a few weeks ago that cancer clinics were turning Medicare patients away due to sequester cuts?

* * *

Yet Another Obamacare Design Flaw

The result? In the individual and small-group markets, where many people now have no health insurance at all, it will be increasingly hard --if not outright illegal, once Secretary Kathleen Sebelius finishes issuing her largely unchecked decrees -- to find the kinds of low-premium, high-deductible insurance plans that cost people less and give them more control over their own health-care dollars. In these markets, essentially the only plans allowable under federal law will be expensive ones that give insurance companies -- who, it's worth recalling, supported Obamacare -- a piece of nearly every medical transaction.

Meanwhile, in the market involving larger employers, Obamacare will (A) largely exempt people from the costly mandates that it will inflict upon those in other markets, and (B) require that "preventive services" -- like the abortion drug ella -- be covered, while not requiring coverage of the kind of things that genuine health insurance would cover, like expensive hospital visits. In other words, it will lead to people having a sort of reverse insurance -- coverage of most things that most people could easily pay for out of pocket, with no coverage for most things that most people rely on actual insurance to cover.

* * *

It's Not 'Universal Coverage'
The law is best understood as a costly entitlement program with Medicaid's shortcomings.

* * *

Former Senator: Obama Told Me Resistance to Obamacare Would Fade After 2010

* * *

Lean Forward

* * *

and Resist

* * *

But if you criticize Mr Obama, you are a racist. Thus, quod erat demonstrandum, Mr. Obama cannot be criticized. So, he did not for a moment know that his IRS was tormenting the political movement that laid him low in 2010. And, if you doubt it, you're a Klansman.

Let's see what else we are supposed to believe....Oh, here's the best one: that it's fine, in fact, super fine, for a mother to kill a baby in the womb when it's physically and mentally identical to a baby that's just been born. That it's fine to kill them if you don't like their sex. But it's anti-woman to want to keep them alive and not kill them because they are female babies.

And, it's fine to kill 800,000 babies a year in abortion mills, but, it's heinous to own a gun that you keep locked up in a closet and don't even take out for years at a time and have never even aimed at a human being. That it's urgently compelling to protect lizards in West Texas....but perfectly good -- even a fine example of the progress women have made -- to have women use abortion as a form of birth control.

God help us. Who would have ever dreamed things could go so wrong? And if Mr. Obama can never be held accountable because his father was a Kenyan, when does this ever stop?

Posted by: RagnarDanneskold on May 21, 2013 10:45 AM
51. Yet another union boss takes umbrage with ObamaCare
The number of labor unions now calling for the repeal of or changes to ObamaCare is starting to stack up as they progressively realize that in many cases they cannot, in fact, keep their same health care plans, as much as they may indeed like them -- which is all rather interesting, seeing as how Big Labor was falling all over itself in support of getting the law passed back in 2010.

In an op-ed in The Hill today, the president of the 1.3-million member strong United Food and Commercial Workers International Union, Joseph Hansen, complains that ObamaCare as-is is going to undermine the current setup of UFCW members' health insurance, and asks that the White House provide a fix to protect the multi-employer plans...

... Huh. So far, the White House has been disinclined to acquiesce their request -- though one might be able to summon a bit more sympathy for them if they hadn't actively pushed for and applauded ObamaCare's passage in the first place.

* * *

What Happens If the Uninsured Can't Register Under Obamacare?

Posted by: RagnarDanneskold on May 21, 2013 11:27 AM
52. It will take political will to repeal/replace portions that are malevolent to all people except congress who is trying to exempt themselves from Obamacare, but remember - a social democrap Speaker of the House once said "We need to pass it see what it is in it". She wants to be exempted from it now.

It will take backbone from the GOP with a plan in place. Obama and his corrupt cronies will continue to play hardball and stonewall. There are already alternative plans out there that need to be moved forward.

There will be some changes in the ACA, we just don't know how much - keep a stiff upper lip, Rags. Looks like the Don't Tread on me crowd's hornet's nest has been agitated, but it's too early to tell the significance of the blowback from the scandals.

Posted by: KDS on May 21, 2013 03:40 PM
53. President Incompetent, who I hope does NOT face impeachment nor leaves office, is facing a drip, drip, drip water torture of scandals and problems. Well done and well deserved Barry!

Sharp shoppers scuttle Obamacare
The young drop coverage to avoid higher premiums

Now why would I, an avowed conservative who stands against just about everything this incompetent president stands for, not want him impeached. removed or pushed to vacate his office? Because I believe he - and his party, sycophants and supporters need to live with the humiliation of his problems and the consequences of his policies. He has had not one successful policy. That's not so say he hasn't won policy fights, but in the winning he lost so much more. Everyday the drip grows stronger, every day he is more irrelevant in the eyes of the world. Everyday his excuses and blames grow - his white house has resorted to saying 'we didn't cover up, we're just inept and stupid'. Really, that's their defense? YES! Great Sargent Schultz impersonation there, Barry - "I SEE NOTHING!" Let it be. Let it be heard and acknowledged, let it be sycophant defended and and then (deservedly) mocked.

Posted by: RagnarDanneskold on May 21, 2013 04:26 PM
54. Barry's Buck

And, not one word of embarrassment or shame

I'm ashamed for you.

Posted by: RagnarDanneskold on May 21, 2013 04:37 PM
55. @53 - I agree, let him twist in the wind. If there is anyone who should be impeached - it is Eric Holder, for Fast and Furious, the scandal involving AP and throw in his involvement the IRS audits and Benghazi may even have his fingerprints on it.

Why the House has not moved on this is rather astounding.

Posted by: KDS on May 21, 2013 04:39 PM
56. ObamaCare, IRS Creating Chaos for Docs, Patients
As an internist, I have dedicated my 30-year career to advancing the long-term health of all of my patients, one patient at a time.

Unfortunately, the greatest barrier to this goal is government intervention into my professional judgment, my office management and my patient care. This has been increasingly true long before enactment of the onerous Affordable Care Act (ACA), but it's especially true now.

ObamaCare is being increasingly recognized as a "train wreck." Trust me: it is demoralizing doctors, distracting providers toward bureaucracy and away from patient care. It is disrupting quality and access, and damaging health.

* * *

Is Obamacare's Fatal Flaw Taking Effect?
The healthy must subsidize the sick, and the healthy are opting out.

* * *

Community organizing, Obamacare style

In any event, today's hearing wasn't about Republicans thwarting Obamacare; it was about overseeing its implementation. And oversight certainly seems necessary when it comes to Obamacare "outreach."

The context is this: Obamacare is predicated on inducing young, healthy people, for whom purchasing insurance may not be the best cost-benefit option, to enter the insurance market and subsidize older, not-so-healthy people. Moreover, the Obamacare penalty (I mean, tax) for not purchasing insurance may be insufficient inducement, given that the cost of a policy may well exceed the amount of the "tax."

In this setting, outreach becomes a tricky proposition. Will those who are conducting it (the "navigators"), for the avowed purpose of maximizing participation, present a fair and balanced picture to the uninsured? Cohen testified that they will answer all questions honestly, but will not volunteer the fact that the cost of purchasing insurance exceeds the Obamacare penalty.

... The view that the government is authorized to do whatever it takes to accomplish its function -- even in the face of statutory language barring the contemplated method -- lies at the heart of the threat to liberty posed by the modern bureaucratic state as conceived by the left. Cohen provided a real service by articulating that position for all to hear.

Democratic Congresswoman: It's 'Un-American' Not to Fund Obamacare 'Outreach'

* * *

Obama's "Idiot" Defense

"We're portrayed by Republicans as either being lying or idiots. It's actually closer to us being idiots." So far, this is the administration's best defense.

* * *

Leno: Obama Holds Press Conferences to Find Out What's Going on Not Explain It

* * * promotion to IRS

* * *

Enemy Lists and Record Seizures and Spying...OH MY!

* * *

Obama has lost the New York Times editorial board

Many conservatives have moved beyond caring what the [NY] Times thinks or writes. But the newspaper acts as a pilot fish for the rests of the media, so its position on this move toward authoritarianism is highly significant. Particularly now that the Obama administration faces major scandals (with more to come), turning the media against itself may be a fatal error.

The members of the editorial board represent some of the most important beats the newspaper covers. This is what Vice President Biden would call a "big (expletive deleted) deal." The last thing the Times wants to do is back-up Fox News, but Obama has now forced them into this uncomfortable position.

* * *

The liberal progressive momentum is at least stalled, if not dead. Benghazi killed the Dems foreign-policy agenda, the IRS intimidation has dealt a deadly blow to "trust" in big government and crippled the administrative mechanics necessary for ObamaCare. The AP wiretapping and overreach into news reporters First Amendment sanctuaries has spoiled the ball park franks and ten-cent beers shared between Obama and his fawning press corps.

* * *

Ex-IRS Chief Asked Why He Visited White House 118 Times: I Went To The Easter Egg Roll

Posted by: RagnarDanneskold on May 22, 2013 11:14 AM
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