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Heeeeeeere's Obamacare!

We are still awaiting the final implementation of ICD-10 (not to mention a standardized EHR system) which was originally scheduled to be phased in half a decade ago. Not that this is an end all to such issues, but with virtually everyone trying to avoid changing and updating their systems and training due to the expense of equipment, implementation and converting all existing records to the new standards, I can understand a bit of the foot-dragging, but it is starting to get ridiculous.

Mostly just a lurker around here but I have to say I'm a little surprised by this.

The hospital system I worked for until retiring last year upgraded probably ten years ago (not ICD10, of course), using Epic patient management system. We market our system to most every physician's office in the area and sell client use to them, and most every office has taken us up on that. Yes, it was a several million dollar investment subsidized by Medicare but it has streamlined our industry immensely and provided another revenue stream.

3 years ago we upgraded our enterprise management system to Lawson getting off the 35 plus year old IBM system we were using. That was another 5 million dollar investment.
 
Yes, I have a problem with the "essential" health benefits too. That's just creating a complicated cross-subsidy, which is also subject to lobbying by various provider groups who want their services to be considered essential. It's a recipe for inefficiency and abuse.

You can do a little experiment. Go to the health exchange and shop for plans, using AGE as the variable. You'll notice that the age is the predominant indicator of how much you pay (prices goes up many times from 20 year old to 60 year old.) And keep in mind that the law actually capped the age "penalty" in insurance plans. If the "cross-subsidy" was a big player then the age wouldn't matter as much. A young man having female birth control coverage is not hitting his premiums very much at all.

It seems to me that the "catastrophic" care is what is the most expensive part. But I suppose that depends what we consider to be "catastrophic". Common medical procedures on the elderly would be included in my book.
 
Cost of Obamacare dropped once again:

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In 2010, the CBO and the Joint Committee on Taxation projected that the ACA “would cost the federal government $710 billion during fiscal years 2015 through 2019.” The agencies now report that “those provisions will cost $571 billion over that same period, a reduction of 20 percent.” The CBO says the reasons for this are many, but it highlights a key factor. “Another notable influence on the downward revision to projected federal costs is the slowdown in the growth of health care costs that has been experienced by private insurers,” the report notes, “as well as by the Medicare and Medicaid programs.”
 
Indiana just got the approval today to do Medicaid expansion under an alternative plan, called Healthy Indiana Plan 2.0 (HIP 2.0), based on the old HIP, which covered about 10% of those eligible, and was in part funded by tobacco taxes.

It's a question on if it's going to get going this year, but by 2016 elections it should be easy to compare Kentucky (which did traditional Medicaid expansion), and Indiana's alternative plan.
 
Saw this article today in Bloomberg:

Obamacare Is Barely Causing a Ripple in Corporate America

(Bloomberg) -- The biggest entitlement legislation in a generation is causing barely a ripple in corporate America.

The Patient Protection and Affordable Care Act -- otherwise known as Obamacare -- is putting such a small dent in the profits of U.S. companies that many refer to its impact as “not material” or “not significant,” according to a Bloomberg review of conference-call transcripts and interviews with major U.S. employers.

That’s even after a provision went into effect this year requiring companies with 50 or more full-time workers to provide coverage, and after more workers are choosing to enroll in existing company coverage because of another requirement that all Americans get insured.

“It’s just part of doing business,” said Bob Shearer, chief financial officer of VF Corp., which owns the North Face and Vans apparel brands. “Obamacare has added costs, but not so much that we felt we had to talk about it specifically.”

The collective shrug from the nation’s biggest employers undermines the arguments of Republicans, who call the law a job-killer as they seek its repeal.

So the argument that it will kill jobs and make companies reluctant to hire workers doesn't seem to be borne out. In the first year of Obamacare going into effect, the economy created more jobs than any year since 1999:

(From Forbes)
The United States Economy Is Turning Into A Jobs Machine - Will It Continue?

  • After current revisions, the U.S. economy created 3,116,000 jobs during 2014. This is the highest raw new jobs creation level since 1999.
  • As compared to the last few years, job creation rose dramatically in 2014. In 2011, 2.080 million jobs were created as compared to the 3.116 million new jobs created in 2014.
  • In the 70 years since the end of WWII there have only been 10 years when more jobs were created in the U.S. economy than were created last year (1946, 50, 77, 78, 83, 84, 88, 94, 97 and 99). This view ranks 2014 in the top 15 percent of job creating years since 1945.
  • The rapid pace of raw jobs creation during 2014 was carried forward into the beginning of 2015 as job creation on an annual level is 3.084 million new jobs.

So, rather than slowing down, job creation is in fact accelerating. To be sure, I wouldn't credit Obamacare for the job creation (and I am aware of other theories about that), but the argument that it is a job killer seems to be blown out of the water.
 
Saw this article today in Bloomberg:

Obamacare Is Barely Causing a Ripple in Corporate America



So the argument that it will kill jobs and make companies reluctant to hire workers doesn't seem to be borne out.

Too early to say what the effects are since the provision just went into effect for companies. Anecdotal evidence from two companies cherry-picked by reporters who seem to be writing opinion rather than straight news isn't convincing. There is also anecdotal evidence that companies are keeping part-time employees working below 30 hours per week because of Obamacare. Obama called out Staples for this just the other day, although Staples denies that it's doing it for "nefarious" reasons.

In the first year of Obamacare going into effect, the economy created more jobs than any year since 1999:

(From Forbes)
The United States Economy Is Turning Into A Jobs Machine - Will It Continue?

First, it's about time that the economy is creating jobs. I would have expected a much quicker and more robust bounce from such a severe recession. Also, it's quite the "tell" to compare absolute numbers of jobs "created" on a historical basis since the population is growing steadily. I remember that during the Bush administration, job growth below 250,000 per month was considered disappointing since it barely kept up with the net growth in the working age population. Last year's job growth, which the mainstream media reports as impressive, is about 260,000 per month. I haven't done the calculation adjusted for demographic changes, but the population of the US is growing at over 200,000 per month.

So, rather than slowing down, job creation is in fact accelerating. To be sure, I wouldn't credit Obamacare for the job creation (and I am aware of other theories about that), but the argument that it is a job killer seems to be blown out of the water.

First of all, why do you say that job creation is accelerating, when the projected growth for 2015 is lower than for 2014 according to the article you're quoting? Second, if there are other factors or other theories (how about a little credit to Republicans for putting an end to the routine extension of unemployment benefits?), then you can't say much at all about whether Obamacare is a job killer. The claim that Obamacare is a job killer certainly hasn't been blown out of the water. We don't have the data for the counterfactual scenario in front of us.
 
Saw this article today in Bloomberg:

Obamacare Is Barely Causing a Ripple in Corporate America

So the argument that it will kill jobs and make companies reluctant to hire workers doesn't seem to be borne out.

IIRC, I don't think the expectation from my field is that it will "kill" jobs. Companies are more nefarious than that ;)

First off, as sunmaster already pointed out, many of the provisions that affect corporate business weren't in effect in 2014. The imjplementation date got pushed back, and employer business in the 50+ employees range has only just now begun to roll in ACA impacts. The requirement to have minimum value compliant plans started for plan years with Jan 2015 effective dates. Employers with effective dates that don't fall on calendar year bases haven't even transitioned yet.

As for the actual impact... I'll be surprised if it is ever as big as it looked like on paper. The estimates of massive impact to employers is based on the assumption that they don't react, and the assumption that the amount of change required to their plans is significant.

In terms of the significance of plan-level impacts (the cost of providing coverage all else being equal), most employer plans were already above the 60% minimum value level, and most already covered the required benefits. So the change due to benefit plan changes is not all that large.

The large "OMG the world is ending" impacts would have to come from the requirement that all full time employees be offered coverage. Note a few key words in there: full time, and employees. For those companies that either did not provide coverage, or provided sub-par coverage, there are ways to work in the gaps. We have seen some companies handling turnover by re-designating a previously full-time position as two part-time positions. We've also seen some companies drop dependent coverage and only cover the employees. Or more insidiously, we've seen companies increase the contribution level for dependents, shifting more of the cost burden on to the family and off of their books.

The reality, however, is that *most* large companies don't do these things. Most large companies are either already compliant, or are very close to compliant. So in the end, the impact to larger employers is not all that big.

Smaller employers are a different matter. Many small employers (<50 employees) didn't offer coverage prior to ACA, so it's a material cost to them. Of course, it accounts for a small number of total covered lives... so it ends up getting lost. When the author of the piece focuses on the larger employers, and looks at total profit for the nation over all... all of the impact to small employers is washed out.
 
Saw this article today in Bloomberg:

Obamacare Is Barely Causing a Ripple in Corporate America



So the argument that it will kill jobs and make companies reluctant to hire workers doesn't seem to be borne out. In the first year of Obamacare going into effect, the economy created more jobs than any year since 1999:

(From Forbes)
The United States Economy Is Turning Into A Jobs Machine - Will It Continue?



So, rather than slowing down, job creation is in fact accelerating. To be sure, I wouldn't credit Obamacare for the job creation (and I am aware of other theories about that), but the argument that it is a job killer seems to be blown out of the water.

But... But... My apartment owner sent out a letter detailing that the reason he was increasing the rent 20% over the previous year's was because of the onorous burdern of Obamacare. Now, he sent out this letter in January 2010, several months before the ACA was passed, and several years before it could have possibly had any effect on companies, but I'm sure he wouldn't lie to his tennants in an attempt to sway their feelings toward this law.
 
First, it's about time that the economy is creating jobs. I would have expected a much quicker and more robust bounce from such a severe recession
.

If Congressional Republicans cared about working for the people of the United States, the recovery probably would have been quicker and more robust. But they don't, and so on literally the day of Obama's inauguration, Republicans decided that their number one priority going to do to make sure that he leave office a one term President. And they figured that the best way to do that was to obstruct his every move and blame him for everything. Didn't work and he when he leaves office a two term President, the country will be better than he left it, despite the best efforts of Republicans.
 
Ahh, they did that because raising the minimum wage and forcing Obamacare does nothing to get the economy going.


Nope, your precious Republicans opposed everything (not just those two things) as a matter of strategy. They didn't help Obama fix the mess he inherited because they care more about making him fail than they do about serving the people of the United States. In their minds, a Democrat coming in and fixing the mess left to him by a Republican was about the worst outcome possible. They are all worthless and so their only hope is to try to prevent Democrats from from helping the country. Otherwise more and more people would start to realize that maybe government can do good - so long as it is lead by good people, ie not Republicans.

http://www.theguardian.com/world/2012/apr/26/democrats-gop-plot-obstruct-obama
http://swampland.time.com/2012/08/23/the-party-of-no-new-details-on-the-gop-plot-to-obstruct-obama/
 
Quick reminder that each and every "worthless" Republican in the House and Senate was placed there by a constituency that voted them into office.

Unless you also wish to denigrate all those voters as equally "worthless" or otherwise belittle them, it's kinda how democracy works.

Back on topic, let me just say that so far, Obamacare has not been as bad as I had imagined. Here's hoping it stays that way.
 
prevent Democrats from from helping the country.

What a load, democrats were busy, as usual Tony, trying to pass their wish list. They weren't doing anything to help the economy. What they did get passed directly hurt the economy. Six years later, are you blind?

What did Obama EVER propose to actually help the economy?
 
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Nope, your precious Republicans opposed everything (not just those two things) as a matter of strategy. They didn't help Obama fix the mess he inherited because they care more about making him fail than they do about serving the people of the United States. In their minds, a Democrat coming in and fixing the mess left to him by a Republican was about the worst outcome possible. They are all worthless and so their only hope is to try to prevent Democrats from from helping the country. Otherwise more and more people would start to realize that maybe government can do good - so long as it is lead by good people, ie not Republicans.

http://www.theguardian.com/world/2012/apr/26/democrats-gop-plot-obstruct-obama
http://swampland.time.com/2012/08/23/the-party-of-no-new-details-on-the-gop-plot-to-obstruct-obama/

What precisely did Obama want to do which the Republicans blocked?
 
If the shoe fits...

That was just cryptic enough that I'm not sure what you meant.

My first instinct was that you think I somehow denigrate and belittle Democrats and Democratic voters.

If, so, maybe point out examples for me.

Or do you really hold about half of the American electorate to be worthless - which upon reflection was probably your intent

Anyway, could you please clarify what you meant.
 
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It would be reasonable to say that every person is stupid and ignorant about something and that a whole lot are willfully ignorant about many things.

There are tons of surveys where a disappointingly high portion of people don't know very simple things that frankly everyone should know. There are tons of studies that show how easily people can be manipulated. Groupthink, confirmation bias, and on and on.

I never understood why it's so unreasonable to assume a great many people regardless of political affiliation vote like idiots.
 
What a load, democrats were busy, as usual Tony, trying to pass their wish list.

Their wish list of things to help the country.

They weren't doing anything to help the economy. What they did get passed directly hurt the economy.

Say Republicans. But Republicans don't know what they are talking about.

In reality, under Obama, the private sector has now added 11.8m jobs over 59 straight months of job growth, extending the longest streak on record.

The stock market has also been at all time highs.

Six years later, are you blind?

In reality, not the right wing echo chamber.

What did Obama EVER propose to actually help the economy?

From the link I gave you.

On Jan. 27, 2009, House Republican leader John Boehner opened his weekly conference meeting with an announcement: Obama would make his first visit to the Capitol around noon, to meet exclusively with Republicans about his economic-recovery plan

Now that passed anyway without them, and despite Republican lies, it did help in the recovery.

http://www.nytimes.com/2014/07/30/u...ed-the-economy.html?ref=topics&abt=0002&abg=0
http://www.washingtonpost.com/busin...nds-stimulus/2012/06/06/gJQAnFnjJV_story.html
 

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