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Healthcare? Not again! What will it do to your bottom line?

Trumpcare will work fine if you're:

1) Young
2) Healthy
3) Rich
4) Already on Medicare
5) A Pharma-Bro or Broette (hello Senator's daughter!)

For the rest of us, well - we can fuck off and die*...

*After we've gone bankrupt
 
Trumpcare will work fine if you're:

1) Young
2) Healthy
3) Rich
4) Already on Medicare
5) A Pharma-Bro or Broette (hello Senator's daughter!)

For the rest of us, well - we can fuck off and die*...

*After we've gone bankrupt

Well that is an unbridled opinion :).

But how does one plan payroll and expansion when there is this unknown, large portion of the benefit package is in the balance? I see nothing in the repub plans that is digest-able by the dems and will not cost more than what the status quo is. This chaos only will benefit the insurance co. Jokes aside, this was a serious inquiry,on how others are planning for this?

dee
;-D
 
Be a while before the details are sorted out.

Far as I can tell, the main savings will be in capping Medicaid payments; especiallly in future years. Not a big savings in the short run -- but could trim costs in the future. This also raises some ethical questions. Some wil say, screw 'em, they're poor, out of work, lazy, layed-off, disabled, whatever. Others will say all our citizens deserve basic health care; as other countries manage to do.

Second source of "savings" is expected to be a proliferation of new insurance plans that don't cover much under the umbrella of competition. Still some good may come of that for younger folks, at least those who don't have the bad luck of getting seriously injured or sick.

I suspect older folks on Medicare will gradually be squeezed. We've already seen Medicare basic and supplemental premiums go up faster than the cost of living increases for Social Security. Over ten or twenty years of this year by year, seniors may be in a serious bind as politicians watch medical prices rise while finding various excuses to short Social Security. Formerly, they raided the funds, saying "we'll pay it back as the economy grows." Instead, the economy crashed and then crashed again. Now they'll just skim a bit off the top each year? Long term solvency for both Social Security and Medicare isn't rocket science and an easy fix. But judging from what's heard so far, apparently too hard for our Congress. They also seem to want to keep their own better-than-the-rest-of-us medical plan.

So far haven't heard any thing about requiring disclosure of costs and outcomes beyond what was in the ACA. Nothing about negotiating drug prices, so we don't see other countries getting drugs developed here, cheaper there. Nothing to introduce truly meaningful compeition in the delivery of medical services.

Bottom line, far as I can tell, is that the average US spend per capita will still be near 2x what other countries pay. All at a time when US life spans (especially old white dudes) are decreasing for the first time in maybe a century. Also heard, just in today's coverage, that half the births in this country are paid for by Medicaid. That figure is probably slightly high and some states have extended birth coverage to those somewhat above the poverty line. Still, it looks like our poorest 20% or so are having 40% of our babies. So we have a situation where we want to simultaneously deny contraception to poor folks -- making sure that more of them have babies they aren't prepared and in some cases interested in caring for -- and then working extra hard to limit their health care and education once those kids are born. Brilliant.

The extra 1x in the 2x per capita we pay for care is going to insurers, pharma companies, hospital chains, those gaming the system, etc.. Most of our medical providers are skilled, honest, and working daily to dor their best. Yet enough of them -- especially those who see health care as a financial play -- are sucking money out of the system. We now have what is likely the world's least cost-effective health care system. Neither political party seems willing to take that on, with Republicans historically a bit less interested. And the percent of citizens without coverage (that % being zero in most first world countries) will likely go back up in the US.

Wouldn't surprise me to see some arm twisting done to give the appearance of lower premiums (by covering less) in the next year or two. Meanwhile medical insurance costs are likely to continue to escalate faster than the cost of living until folks both understand the situation and get seriously sick and tired of it.

Used to be that large companies, with ample bargaining power, got decent rates for their employees. That will still probably be true; though more and more large companies are doing their best to not cover folks (putting more on part-time as with Walmart, Sears, fast food chains, etc.). State exchanges were a hope to give small business owners and individuals some bargaining power; however that was pretty much derailed in most states. I suspect small business owners and individuals won't find much in the way of either savings or better health care. Small business owners will, however, likely to able to offer their employees crappy plans at lower prices. Depends if the final plan gets rid of minimum coverages. Eventually, that sort of thing may lead to more buying drugs overseas, more dentistry, heart surgeries, cancer treatments etc. overseas. So, kind of like parts of our car industry -- we may be able to eventually get cost-effective alternatives. Just not from US providers formely too concerned with quarterly profits to focus on care.
 
I look at the American version of "HEALTH CARE" as the greatest social experiment ever carried out by any country to prove or disprove Darwin's "SURVIVAL OF THE FITTEST".
 
The "reform" plans are designed to make the public pay more. The debates are about flavoring the Public Relations to make us think it's better.

Too early to develop a strategy until the "final" version comes out.
 
Well that is an unbridled opinion :).

I am literally, and deadly, serious. Americans seem to accept the status quo of having the worlds largest parasites sucking out tens to hundreds of times the dollar value for our medical care than other (civilized) countries. I consider it second only (and maybe on par) with the damages done by our financial system, which have been gamed by major players (with the full buy-in of Congress) to allow high-level medigarchs and finagarchs to do what they wish, and pocket enormous amounts of money, with basically no consequences.

Look at what happened to Mylan CEO Heather Bresch (daughter of Senator Joe Manchin, D), when she was called to testify before Congress on why the cost of the Epi-pen had risen by 600% (from $100/two pens in 2009 to $600 in 2016), while the actual cost of manufacture was on the order of a few dollars. This was due to protection offered by patent, and legislation written to favor large Pharma companies at the expense of generic producers AND patients (many children).

http://www.cnbc.com/2016/09/27/myla...to-the-entire-pharma-industry-commentary.html

After trying to justify the pricing, there was a meaningless apology and offers of coupons and a "bargain" pen set for only $300. Yeah, thanks.

About the only actual "victim" in the Pharma industry was Martin Shkreli (where we got Pharma Bro from), who was pushed out, not for the needless 5,500% increase of a critical AIDS drug after he got control of the company, but for the unforgivable arrogance with which he boasted that he could do whatever the hell he wanted. And it took quite a while for the pressure to build for that to happen, after the Feds finally looked into some of his previous antics and found serious financial skulduggery.

And I'm sure that Officer Renault was "shocked, shocked to find that gambling is going on in here".

No, this national scandal is the result of Republicans AND Democrats playing us, milking us, and we sheep/cows/fools accepting it willingly. Yes, willingly, because we keep electing the same bastards (or new ones we know will be bastards) into power.

Mr. and Mrs. America, this is on you. You are the livestock that demand entrance to the abattoir. Dammit...
 
I am literally, and deadly, serious. Americans seem to accept the status quo of having the worlds largest parasites sucking out tens to hundreds of times the dollar value for our medical care than other (civilized) countries. I consider it second only (and maybe on par) with the damages done by our financial system, which have been gamed by major players (with the full buy-in of Congress) to allow high-level medigarchs and finagarchs to do what they wish, and pocket enormous amounts of money, with basically no consequences.

Americans seem to take to the streets to protest about almost everything except their health care. Maybe somebody has put something pacifying in the drinking water?
 
Be a while before the details are sorted out.

Far as I can tell, the main savings will be in capping Medicaid payments; especiallly in future years. Not a big savings in the short run -- but could trim costs in the future. This also raises some ethical questions. Some wil say, screw 'em, they're poor, out of work, lazy, layed-off, disabled, whatever. Others will say all our citizens deserve basic health care; as other countries manage to do.

Second source of "savings" is expected to be a proliferation of new insurance plans that don't cover much under the umbrella of competition. Still some good may come of that for younger folks, at least those who don't have the bad luck of getting seriously injured or sick.

I suspect older folks on Medicare will gradually be squeezed. We've already seen Medicare basic and supplemental premiums go up faster than the cost of living increases for Social Security. Over ten or twenty years of this year by year, seniors may be in a serious bind as politicians watch medical prices rise while finding various excuses to short Social Security. Formerly, they raided the funds, saying "we'll pay it back as the economy grows." Instead, the economy crashed and then crashed again. Now they'll just skim a bit off the top each year? Long term solvency for both Social Security and Medicare isn't rocket science and an easy fix. But judging from what's heard so far, apparently too hard for our Congress. They also seem to want to keep their own better-than-the-rest-of-us medical plan.

So far haven't heard any thing about requiring disclosure of costs and outcomes beyond what was in the ACA. Nothing about negotiating drug prices, so we don't see other countries getting drugs developed here, cheaper there. Nothing to introduce truly meaningful compeition in the delivery of medical services.

Bottom line, far as I can tell, is that the average US spend per capita will still be near 2x what other countries pay. All at a time when US life spans (especially old white dudes) are decreasing for the first time in maybe a century. Also heard, just in today's coverage, that half the births in this country are paid for by Medicaid. That figure is probably slightly high and some states have extended birth coverage to those somewhat above the poverty line. Still, it looks like our poorest 20% or so are having 40% of our babies. So we have a situation where we want to simultaneously deny contraception to poor folks -- making sure that more of them have babies they aren't prepared and in some cases interested in caring for -- and then working extra hard to limit their health care and education once those kids are born. Brilliant.

The extra 1x in the 2x per capita we pay for care is going to insurers, pharma companies, hospital chains, those gaming the system, etc.. Most of our medical providers are skilled, honest, and working daily to dor their best. Yet enough of them -- especially those who see health care as a financial play -- are sucking money out of the system. We now have what is likely the world's least cost-effective health care system. Neither political party seems willing to take that on, with Republicans historically a bit less interested. And the percent of citizens without coverage (that % being zero in most first world countries) will likely go back up in the US.

Wouldn't surprise me to see some arm twisting done to give the appearance of lower premiums (by covering less) in the next year or two. Meanwhile medical insurance costs are likely to continue to escalate faster than the cost of living until folks both understand the situation and get seriously sick and tired of it.

Used to be that large companies, with ample bargaining power, got decent rates for their employees. That will still probably be true; though more and more large companies are doing their best to not cover folks (putting more on part-time as with Walmart, Sears, fast food chains, etc.). State exchanges were a hope to give small business owners and individuals some bargaining power; however that was pretty much derailed in most states. I suspect small business owners and individuals won't find much in the way of either savings or better health care. Small business owners will, however, likely to able to offer their employees crappy plans at lower prices. Depends if the final plan gets rid of minimum coverages. Eventually, that sort of thing may lead to more buying drugs overseas, more dentistry, heart surgeries, cancer treatments etc. overseas. So, kind of like parts of our car industry -- we may be able to eventually get cost-effective alternatives. Just not from US providers formely too concerned with quarterly profits to focus on care.

...."all our citizens deserve basic health care"....
We can't even agree on what a ctizen is. We are providing healthcare for anyone who happens to be here.
....."don't cover much under the umbrella of competition".....
This is what for many people is the meaning of the word insurance. A policy bought to protect against unforseen issues thereby avoiding financial disaster...not financial hardship, but disaster.
..."at least those who don't have the bad luck of getting seriously injured or sick."....
Actually, that is exactly the purpose of these plans. To insure against serious illness rather than the sniffles.
...."(especially old white dudes)".....
you seem to have an issue with that.
....."deny contraception to poor folks "
You can't be serious about that. Between generic birth control pills, condoms being given out like candy at the middle schools through college, health departments, and every low income clinic in the country if someone seriously says they were DENIED contraception...they are a liar. They were too lazy to get it, too horny to wait, to stupid to use it. Unless of course you are considering abortion to be equal to contraception.
...."(putting more on part-time as with Walmart, Sears, fast food chains, etc.)....."
This in part is due to our wonderful politicians deciding they know whats best for everyone. They come up with rules and regulations that make it difficult for people and companies and then act surprised about the unintended consequences. They expect everyone to be static and accept what they dictate then bitch when some person or company works around their new mandate. We are just supposed to accept and do as we are bid? (European like)
...."Just not from US providers formely too concerned with quarterly profits to focus on care"...
This is not, and never has been a provider issue. This is an insurance and large corporate medicine issue that also is affected by the law industry (lawyers and courts). I won't defend insurance companies or corporate medicine. Some things are easily insurable ....others are not. Healthcare is not...in fact, health insurance in large part has driven the escalating prices.
 
Americans seem to take to the streets to protest about almost everything except their health care. Maybe somebody has put something pacifying in the drinking water?

Truth of it is health (in general) just ain't a top priority over here.

Not for most, anyways.
 
...."all our citizens deserve basic health care"....
1) We can't even agree on what a ctizen is. We are providing healthcare for anyone who happens to be here.
....."don't cover much under the umbrella of competition".....
This is what for many people is the meaning of the word insurance. A policy bought to protect against unforseen issues thereby avoiding financial disaster...not financial hardship, but disaster.
..."at least those who don't have the bad luck of getting seriously injured or sick."....
Actually, that is exactly the purpose of these plans. To insure against serious illness rather than the sniffles.

...."(especially old white dudes)".....
you seem to have an issue with that.
....."deny contraception to poor folks "
You can't be serious about that. Between generic birth control pills, condoms being given out like candy at the middle schools through college, health departments, and every low income clinic in the country if someone seriously says they were DENIED contraception...they are a liar. They were too lazy to get it, too horny to wait, to stupid to use it. Unless of course you are considering abortion to be equal to contraception.
...."(putting more on part-time as with Walmart, Sears, fast food chains, etc.)....."

2) This in part is due to our wonderful politicians deciding they know whats best for everyone. They come up with rules and regulations that make it difficult for people and companies and then act surprised about the unintended consequences. They expect everyone to be static and accept what they dictate then bitch when some person or company works around their new mandate. We are just supposed to accept and do as we are bid? (European like)


...."Just not from US providers formely too concerned with quarterly profits to focus on care"...
This is not, and never has been a provider issue. This is an insurance and large corporate medicine issue that also is affected by the law industry (lawyers and courts). I won't defend insurance companies or corporate medicine. Some things are easily insurable ....others are not. Healthcare is not...in fact, health insurance in large part has driven the escalating prices.

There's so much I disagree with in your post I hardly know where and how to begin. Still that's never stopped me before so here goes but just the worst two.

ad 1. Tax financed health care in countries that have NHS in one or another form is for all. Both for them with "sniffles" (do you have a medical degree that makes you able to distinguish between serious and minor?) and much worse. "I'll wait and see if I can get better" can be deadly.

ad 2. "We are just supposed to accept and do as we are bid? (European like)"
LMAO You do know that there isn't a single country in Europe that doesn't have NHS in one or another form and some have better health care for less cost than the USA? In fact why stop at Europe. Look at most countries in the world.
 
I am literally, and deadly, serious. Americans seem to accept the status quo of having the worlds largest parasites sucking out tens to hundreds of times the dollar value for our medical care than other (civilized) countries. I consider it second only (and maybe on par) with the damages done by our financial system, which have been gamed by major players (with the full buy-in of Congress) to allow high-level medigarchs and finagarchs to do what they wish, and pocket enormous amounts of money, with basically no consequences.

Look at what happened to Mylan CEO Heather Bresch (daughter of Senator Joe Manchin, D), when she was called to testify before Congress on why the cost of the Epi-pen had risen by 600% (from $100/two pens in 2009 to $600 in 2016), while the actual cost of manufacture was on the order of a few dollars. This was due to protection offered by patent, and legislation written to favor large Pharma companies at the expense of generic producers AND patients (many children).

http://www.cnbc.com/2016/09/27/myla...to-the-entire-pharma-industry-commentary.html

After trying to justify the pricing, there was a meaningless apology and offers of coupons and a "bargain" pen set for only $300. Yeah, thanks.

About the only actual "victim" in the Pharma industry was Martin Shkreli (where we got Pharma Bro from), who was pushed out, not for the needless 5,500% increase of a critical AIDS drug after he got control of the company, but for the unforgivable arrogance with which he boasted that he could do whatever the hell he wanted. And it took quite a while for the pressure to build for that to happen, after the Feds finally looked into some of his previous antics and found serious financial skulduggery.

And I'm sure that Officer Renault was "shocked, shocked to find that gambling is going on in here".

No, this national scandal is the result of Republicans AND Democrats playing us, milking us, and we sheep/cows/fools accepting it willingly. Yes, willingly, because we keep electing the same bastards (or new ones we know will be bastards) into power.

Mr. and Mrs. America, this is on you. You are the livestock that demand entrance to the abattoir. Dammit...

Look i understand the sentiment, and yes the only real solution is a single payer system, and to take the burden off of business to provide health care. In the mean time what do you do? plan for the 25% increase and try to pass it on to your customers?


dee
;-D
 
Obviously, nothing is passed yet.
And the republicans are already fighting tooth and nail about what goes in this bill- significant amounts of more conservative republicans are refusing to vote for it.
So it will probably change a LOT from this first draft.

But the first draft that has leaked out would cost me, personally, around $500 more a month.
 
Obviously, nothing is passed yet.
And the republicans are already fighting tooth and nail about what goes in this bill- significant amounts of more conservative republicans are refusing to vote for it.
So it will probably change a LOT from this first draft.

But the first draft that has leaked out would cost me, personally, around $500 more a month.

Yup same here, but for average a 25% hit is very likely. That is on top of last years increases. Not a sustainable situation, i think the only way to deal with is regulations, if it stays market driven.



dee
;-D
 
Americans seem to take to the streets to protest about almost everything except their health care. Maybe somebody has put something pacifying in the drinking water?

Do you realize what forum section you're in?

How are you contributed to company management and budget planning, here? There are other topics for you to spout off about American culture and politics. This is an area for discussing shop management.

To reiterate:
In the mean time what do you do? plan for the 25% increase and try to pass it on to your customers?
 
There's so much I disagree with in your post I hardly know where and how to begin. Still that's never stopped me before so here goes but just the worst two.

ad 1. Tax financed health care in countries that have NHS in one or another form is for all. Both for them with "sniffles" (do you have a medical degree that makes you able to distinguish between serious and minor?) and much worse. "I'll wait and see if I can get better" can be deadly.

ad 2. "We are just supposed to accept and do as we are bid? (European like)"
LMAO You do know that there isn't a single country in Europe that doesn't have NHS in one or another form and some have better health care for less cost than the USA? In fact why stop at Europe. Look at most countries in the world.

You do know America is not Europe? You do know that most Americans have no desire to become European? I assume most Europeans have no desire to become American. In fact, many of us have European ancestry....they left for a reason.I know that is difficult for you to understand.
I do not have a medical degree.....a degree should not be required to know when its appropriate to go to the doctor.
I also notice that if a person types "best hospitals in the world" into Google etc. no hospitals from Denmark are listed (at least on the first page or so. In fact of the first 12 (on the list I get, your may vary slightly) I see only 1 that is not American. So....yeah....I am ok with not emulating the rest of the world. In fact it seems they may want to emulate us a little more.

Of course .....if you are lucky enough to live your life needing nothing but boiler plate type health care...I am sure a free NHS doctor will do just fine.
 
We have averaged 10% cost increases per year for the last decade with the highest per annum increase of 18% and the lowest about 3% and we have switched insurance providers 5 different times playing hopscotch to avoid higher annual increases along the way (as in moving from United Healthcare to BC/BS just last month to avoid a 35% increase). The largest jumps equating to about 75% of these increases have been in the last 4-5 years with the advent of the ACA.

In other words, a 25% increase isn't out of line when compared to the various annual increases that have been made in recent history.

Our costs have gone up along with the price we charge our customers. We have learned to be more efficient and worked hard to remain competitive.

An interesting new source of business has been the in the area of states who have voted in the new $15/hour minimum wage. Lots of robotic systems being developed to replace workers in food processing plants that had previously been the domain of unskilled workers who had insurance. With technology deployment going up in this space, prices for this technology are dropping and cost justification of eliminating manual labor and associated cost of benefits is getting easier to do.

We are hiring and expanding to meet the need . . . Replacing low skilled workers with an automation system designed and manufactured by higher skilled engineers, machinists, and technicians. I don't know what the ultimate ratio is for low skill jobs lost to high skill job creation . . . but certainly the jobs that are easily done by a robot are going the way of the good Danish healthcare of old.
 
For now, it looks like business owners will have trouble planning for future health insurance costs. It sucks, but in recent years unpleasant surprises have been part of the equation. Hopefully thing will be better at the end of this process.

The currently proposed bill likely won't pass, and shouldn't. The lack of such promised items as selling across state lines etc. have already hit a roadblock with people like Sen. Rand Paul and others who have said they won't accept it. IMO Trump is being a bit cagey by letting a bill get introduced that will force a large portion of the Republicans, many of whom opposed his candidacy from the start, to step up and play a visible role in reshaping this bill. I expect the final bill will be a bipartisan compromise

Everybody knows the ACA has broken the system, including the guy who wrote it. I saw a recent piece with Dr. Ezekial Emanuel (Rahm's brother and the architect of the ACA) where he suggested that part of "replacing and repealing" should include automatically enrolling every American in a minimalist Medicare like system that would provide basic checkups and catastrophic emergency care. What he is proposing is in effect the seed of a National Health Service and coming from the guy who co-wrote the ACA it IMO lends credence to those who claimed that Obamacare was intended to break the system so we would be forced to adopt a NHS system.

What this very sick patient (American health care) actually needs is increased competition to drive costs down. What has been occurring is the exact opposite as insurers and "nonprofit" providers have gotten larger and larger as they absorbed or destroyed competition and used the resulting monopolies to raise prices of everything.

I recently saw an interview with Dr. Elaina George. What she said mirrored exactly what I have been hearing from doctors and others within the system. According to her doctors only receive about 7% of the total health care dollars and much of the rest is being absorbed by players in the system. She predicts the doctor's share will decrease further as the big players squeeze them even more. Some of you may disagree with what she says but IMO it is well worth reading at least some of it.

Elaina George | Just another WordPress site
 
A good example of what health care should be in my opinion is lasik eye surgery. Not paid for by any insurance or the government. It is highly competitive, the prices come down every year. I say get the gov.out completely, Health insurance should only be for catastrophic cases, cancer, etc. All the small shit should be paid out of pocket. Does your car insurance pay for oil changes? Sell insurance across state lines immediately. No government subsidies at all, what incentive do insurance cos. or hospitals have to be competitive when you have uncle sam deep pockets handing out the loot. All those that are considered uninsurable go into a pool divided among all companies that want to sell insurance. Everyone buys a catastrophic policy for a few hundred dollars every year. Now all you socialists tell me what an ass hole I am.
 
Do you realize what forum section you're in?

How are you contributed to company management and budget planning, here? There are other topics for you to spout off about American culture and politics. This is an area for discussing shop management.

To reiterate:

You do realise it might be a good idea to look at what other countries do?

Maybe even most US companies and shops would benefit from not having health care as part of their operations?
 








 
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