Last week I made the point that, thanks to the Supreme Court, the Affordable Care Act remains the law of the land and that the business-dampening uncertainty Rep. Kristi Noem whines about comes more from her unwillingness to give up "Repeal!" as her main talking point.
As Rep. Noem and Mitt Romney continue to beat the repeal-and-replace-with-God-knows-what drum, I need to make that point again:
Until recently, Dan Martin had little positive to say about President Obama's health reform law. Although his tiny San Diego tech firm, IFX, already provides employees with health insurance, he worried the law would unleash burdensome regulations.
Then he discovered the law brings no added rules to companies with fewer than 50 employees, and gives them a new option to do comparison shopping for health insurance on state exchanges starting in 2014.
He's still concerned about increased government intervention. But he's more worried that the nation's leaders will keep changing the rules of the game.
"As a business owner, I can make decisions based on knowing what I'm dealing with -- good or bad. I can suck it up and map out my pricing strategy," Martin said. "Being in limbo is the worst thing to be in. I can't build my business strategy on the possibility the law could be rescinded" [Jose Pagliery, "Even Health Reform Critics Say: Quit Repeal Talk," CNN Money, 2012.07.03].
The CNN report cites other businesspeople who want Republicans to give them some certainty, drop the repeal rhetoric, and move on. Gee, it's almost as if Noem, Romney, and the GOP wanted to cause uncertainty and hinder economic growth....
Bonus GOP Confusion: Mitt Romney says the individual mandate is not a tax. Again, thank you, Republicans, for nominating the man least equipped to debate the Affordable Care Act on your terms.
Update 11:55 CDT: Is the Affordable Care Act complicated? Sure. We could have proposed "a simpler and more efficient system — something more like the single-payer systems that have been adopted by most industrial countries," but we would have had to overcome a lot more stick-in-the-mud opposition to completely abandoning our "catastrophically bad" employer-based system.
Perhaps the delegates to the GOP convention will pick someone else. There is Ron Paul standing in the wings.
Paul isn't standing so much as slumping in the wings, Sib.
The twitterverse has been awash in reports that Willard made millions with a company that mitigated medical waste that included the evacuated tissue from dilation and curettage procedures: hardly surprising for a capitalist with a Mormon education.
Cory,
You are quoting a company not affected by Obamacare (less than 50 employees). Great source Cory.
How about the hundreds of thousands of businesses are not using their cash to finance growth for one reason:
The cost cloud of Obamacare imperils a reasonable return on the investment.
P.S. Just to let you know some Obamacare planning that is going on? Companies on the threshold of 50 employees are being contacted for limited out-sourcing so they won't go about 50 employees.
If it weren't so serious, Obama's stupidity with regard to his utter moronic understanding of business, I'd be laughing.
But instead, there are millions of people unemployed and it looks like you guys don't give a damn. It really is sick.
"Tim H. Please understand, I don’t agree with the wisdom of rejecting federal money and requiring our local counties to use property tax dollars to continue to pay the medical costs for those who would be covered if we accepted the Medicaid expansion." bearcreekbat at Mount Blogmore.
ObamaCare may pay for medical cannabis in some states: Thanks, Barack!
This repetitive faux-rage about my supposed lack of compassion for the poor really grates my cheese. You know that's a false propaganda line, or something you tell yourself to preserve your worldview.
I do give a damn about regular folks being able to keep their jobs or start businesses. That's why I support taking the burden of providing health insurance off businesses' shoulders completely and moving to a simpler, more efficient single-payer system that would leave more capital in the economy to support jobs and entrepreneurship. Single-payer would make life a whole lot easier for businesses and workers alike. They could move from job to job without worrying about losing coverage. They could quit their jobs and start their dream businesses without that worry. The economy would have much less friction.
But no, go ahead, keep defending the current Rube-Goldberg system that makes it too expensive for individuals to switch jobs or start businesses. (You want the pissing contest about who cares more for whom? I'm ready to roll.)
Notice, folks, that when small businesses don't support Troy's position, they suddenly don't matter. Baloney, Troy: the small businesses in the CNN story make a very important point: contrary to GOP bluster, small businesses aren't sandbagged by the Affordable Care Act. And these businesspeople are realizing that the ACA isn't going to hurt them and that they would rather operate within that regulatory certainty than have Noem and Romney rip out this certainty and replace it with months and years more of wrangling and surprises with a plan the GOP hasn't formulated yet.
If you're preaching certainty for small business, you're preaching ObamaCare. If you're preaching give a damn for small and large business, you preach an end to employer-based health coverage: Medicare for Everyone!
Troy,can you give an example of such a large company that doesn't supply health insurance now and will be destroyed thanks to the requirement? That would be swell!
Two comments:
1) If you really care about the poor, then consider your ideological agenda might actually be hurting them. Just consider it. The results are in: The poor and middle class are worse off than they were four years ago.
2) Your example of one who says "stop the talk" is one not affected. C'mon. So we should quit finding a better solution because the solution isn't needed by some? You got to be kidding me.
3) I believe we have four challenges with regard to health care.
Cost containment: The reliance on government fiat never reduces costs. Only expenditures by affecting care. The better solution is put power in the consumer's hands (ala health savings accounts and other direct incentives to contain costs).
Access to care for the poor: Well, the best solution is a job. But, there are others that fall through the cracks. I support the exchanges (which doesn't go far enough as they should be able to sell policies across state lines) and the use of subsidy for people above Medicaid eligibility to get such assistance. We can just do it much more efficiently than Obamacare.
Portability and pre-existing conditions: I combine them as the solution is related. While not complex, it takes more time than I have to outline it. Just that it uses re-insurance and a flat across the board re-insurance premium to cover them to transfer pre-existing conditions when people change jobs and plans.
Mike,
Good question. Just like Dodd-Frank had the unintended consequence of giving market advantage to the "Too Big to Fail" banks and made them larger, Obamacare actually will benefit the largest companies who have the infrastructure to accommodate the complexity while placing greater disproportionate burden on the medium and smaller companies (above 50 employees) who actually are the engines of innovation and growth.
Sidebar: How many companies will go above 50 employees, bear this new cost, especially if they might later fall back under 50 employees. This monstrosity just insures companies will stop growing at 50 employees. Great job creation strategy Cory and Barack.
Is inside the box the only way you know how to think, Mr. Jones?
If so, Troy: purge Amerikan Carrion from the blogroll at DWC.
Any idea what PP wants for that site?
I made a buttload of money on SIRI today.
Here's why:
http://www.nytimes.com/2012/07/04/business/us-car-sales-climbed-in-june.html?_r=1
Still waiting for an answer to Mike Larson's question:
"Troy,can you give an example of such a large company that doesn’t supply health insurance now and will be destroyed thanks to the requirement? That would be swell!"
Dear Low-wage Earners, Families with Children, and Everyone Else Living Without Health Insurance: You will soon not have health care insurance coverage worries. Your kids will be insured longer under your new plans, your aged parents get prescripts cheaper, and your employer will get a tax credit by having this coverage available to you, helping to secure your job.
If that is more important to you and your families than what the hair splitting is by people that can afford insurance and consider you baggage to the system, please raise your hand.
You're welcome, from President Barack Obama.
I like that, Taunia. I like that a lot. Let Troy focus on the mythical job creators; we'll focus on the job doers and see who wins.
Troy, your aprehension about "job creators" doesn't square with this data, unless of course by "job creators" you mean "government jobs." LOL.
http://thinkprogress.org/economy/2012/06/01/493849/obama-bush-jobs-record/
Look we can spin numbers. Bush came into office at the beginning of the end of a business cycle at its top (tech bubble and 9-11) so he had a downturn in his first/second year and was building his way out.
Obama came in with slightly different timing (started before he came into office) so in effect he has had more time post trough and still little happening.
Cory, you go ahead and pander promising food stamps, birth control, free health care, and an unemployment check. We will go out and do something so they can get a job.
Troy...seriously? "We will go out and do something so they can get a job."
Oh, Troy, do please tell us what that something is. Is it the Reagan Plan of increasing taxes and spending? Or is it getting rid of all regulations on business so that "privatizing profits and socializing risk" is the law of the land. Hey maybe we can have the bankers acting like a drunken frat boy saying..."don't worry, I got this."
Maybe it's the mysterious Romney Economic Plan that he is going to hide only to be revealed if he is elected, just like McCain's plan to get Osama Bin Laden.
Or maybe even the Ryan budget built on incredibly deliberate false assumptions and a willingness to trash the lives of seniors and those most vulnerable for the benefit of the top earners and companies...(I know...companies are people too)...on the off chance that they will hire someone at a lower wage than they were paying 10 years ago...and only if they feel generous enough to keep those jobs in America.
Because if your trickle down theory worked...we would have a pretty amazing economy right now, considering profits are at all time highs while taxes are at their lowest and current government spending is far below the last administration's drunken sailor ways.
"We will go out and do something so they can get a job." I'd feel better if you said "Trust me."
Just a thought, but could the Romney Economic Plan be in a vault in the Cayman Islands. Right along with the income he's trying to hide from being taxed as a productive member of the United States...does that make him a "free rider" letting others pay his way?
Jana,
Economics 101: If you add to the costs of production via taxes and regulation, you will get less production. Less production, less jobs and less profits and less tax revenue.
As much as you might hope and wish, you can't change the laws of economics.
Justify your taxes and regulations to the unemployed. I'm sure he'll be willing to suffer for the "public good." Just don't pretend your ideas don't have consequences.
"We will go out and do something so they can get a job."
Really Troy? We're supposed to trust the people who gave us 8 years of job loss?
I'm facing a layoff at the end of October. Guess where mine went to-India! I'll be lsoing my health insurance, but luckaly I'll be able to get on my wife's plan. of couse she's a South Dakota teacher who can afford me getting on her Sanford Insurance. Wait, I guess maybe not. what little raise she got was gone when her insurance went of 15%. Now more if I get on it. Hopefully I can a decent job in Mitchell. But I'm not a welder so I might be in trouble.
First we need to get rid of the incentives for employers to go overseas so the jobs will stay here. Second we need the ACA now. I'm not a lazy bum but I could end up on assistance.
Most people don't want a handout but sometimes to survive you have to take it.
But what's most disheatening is looking at my computer and see people from India doing my job and in real time. Right now I see it everyday.
I hope none of you ever have to face that.
This is as real as it gets folks. I would love to hear Noem or Thune explain how the Republicans are going to help. I'd love to have a really discussion and not a bunch of BS.
For that matter I'd love to talk to the President with the same requirements.
Hey Owen, if it makes you feel better, it's not a handout. You pay for it with your taxes.
And Troy, you can stuff it with your anti-regulation talk. You might want to look into something we used to have here in the Stated called robber barons.
Troy, what's the old saying?
You can line up all the economists in the world end to end and they still can't reach a conclusion...and you are saying there are finite and exact economic laws?
Are these economic laws of yours like the laws of gravity?
And these economic laws you speak of and embrace, when was the last time they worked trickled down to the benefit of the greater good?
Troy, I am going to give you a real macroeconomics 101 lesson. Many economies must rely on a strong human capital that they can use to invest in their businesses. If the workers are constantly sick, worrying about how they are going to pay for the medical bills for their children, or many of the other concerns related with a lack of healthcare, then their productivity is way down leading to a loss in output. You are not actually talking production, but costs. If I have a business that requires a skilled worker, then it benefits me to make sure that worker is able to stay with the company as long as possible and be there as many days as possible. Healthcare makes sense. If I have a job for non-skilled workers that I believe could be replaced by trained seals and are not important then I might view that I can fire them if they get sick and replace them with anyone else, except they will also not be able to add to the economy, and that means that my goods will not be sold, hurting profits. The impact is a little longer than the valuable employee who gets sick without healthcare, but it is real nonetheless.
So, you are worried about the bottoms line of the business? Okay, that is fair, but that feeds the fact that profits are up for businesses while unemployment stills struggles. Business profits do not equal hiring people; however, business still need to produce and therefore, will still need workers. Healthcare will have little impact because many business can begin to figure the benefits Cory and Obama mention with the potential costs you mention.
Remember, do not mix up production output with business costs. Basic economics 101.
Ewps...
Should be: ...when was the last time they worked AND trickled down to the benefit of the greater good?
Speaking of uncertainty...just to get back on track here.
Two rock stars of American capitalism, Jack Welch and Rupert Murdoch, appear to have some uncertainty surrounding Mitt Romney's leadership and management abilities as evidenced in the way he's running his campaign.
Captain Jack tweeted:
"Hope Mitt Romney is listening to Murdoch advice ont campaign staff..playing in league with Chicago pols..No room for amateurs"
Seriously Jack?...you are afraid of the Chicago pols bogey man? What are the Chicago Pols anyway...a crazy minister, some random community organizers, and a wrinkled old retired "terrorist" all carrying around a book by Saul Alinsky to figure out why Republicans were buying so many?
If they don't think Romney can take that on, how's he going to handle making a decision on what he wants for lunch, let alone take on the Chinese economy, al-Qaeda or the continuing threat of the designated hitter.
And we should be encouraged by Welch and Murdoch's faith in Mitt's management and leadership abilities to run the largest economy in the world?
Not sure... but just maybe, they want him to offshore his staff and source his votes from less developed countries where you don't have to have a social safety net. Of course they could create some derivatives around Intrade where they actually get votes that don't actually exist and then hedge those against votes cast on Fox's American Idol (don't be fooled, Murdoch has hacked the cell phones of the judges and knows who will win.)
Mike,
I agree that healthy workers are a good thing. So you think it justifies a boondoggle? This bill has more perverse incentives than a Whitehouse.
While profits of the Dow Jones companies are up, profits are down for everyone else (look at tax collections). So rather than trying to give lessons on incomplete information, why don't you learn something. Makes reasoning more productive.
Jana, I agree with Welch and Murdock. Romney needs to improve his campaign. But we found out how running a good campaign does not translate into running the nation.
P.S. If you assert BO is a good manager, I will just laugh. Even his supporters concede this is his largest weakness.
Not a boondoggle, Troy. Mike is right. Add to the economic argument the fact that lower- and middle-income Job Doers will not be bankrupted by medical care. Lots of insurance holders will have more money left in their pockets. When people have more money left in their pockets (and when good coverage keeps them alive), they can spend more money on other things. That means more consumer demand for all the things you think ObamaCare will cause big companies to quit making.
Make coverage affordable and more accessible, give folks with pre-existing conditions and others more financial security, and you see those folks boost the economy with healthy smiles on their faces.
Losing your job sucks. Owen at least ought to have the freedom to look for a job he'll really enjoy and be good at and not make his wife feel pressured to keep her job so they both have health insurance in the interim. Moving off the employer-based system would be good for business owners (reduce their direct labor costs, remove one complication to expanding staff) and for workers. The Affordable Care Act gives workers like Owen lots more personal fiscal certainty. That's good. Knocking off the repeal talk and working to build onto ACA the cost-containment we'd all like to see reduces uncertainty for everybody. That's better than Noem's and Romney's vagueness.
Troy: Regarding those four challenges that you "believe we face with regard to health care" and the "solutions" that you cite: How are you going to pay for them? And you actually believe we consumers can someone magically acquire some mystical power through savings accounts to contain costs? I'm pretty certain you're not Harry Potter, Troy. This is the real world. You can't just wave your magic wand and make things better. You have to come up with viable solutions that have a chance to actually work. Both Obama and Romney (while Massachusetts governor) have proven that Obamacare has the potential to make a positive difference. Yet you strangely reject it at every turn, and give us one your bogus abracadraba "solutions" instead.
Re-insurance? If I have a pre-existing condition, I'm simply supposed to take your word that yes, this will work, even though it's so complicated you can't find time to even explain why it's a viable alternative to the status quo?
Talk about uncertainty.
one more thing. lets go back to making health care and health insurance not-for-profit. I think it was supposed to create more competition and lower prices. How did that work out?
Noem talks about letting people buy insurance across state lines. Think that'll bring down costs? Nope
Right on, Owen: insurance across state lines brings a race to the bottom, just as South Dakota's lax usury laws led to the race to the bottom in the credit card industry. More thoughtless ideological rhetoric from Noem.
Dave if you understood the simple principle of re-insurance, no explanation is needed. You just prove you don't know enough about insurance to have an intelligent opinion. Makes it easy to ignore your opinion.
And I get a kick out of the "how to pay for it." You only know government fiat as a solution.
If you have know knowledge, the intelligent thing is to learn before you form an opinion. It once was an expectation of the liberal mind.
Out of bounds. You're benched for this quarter.
See what happens when people who need and deserve speak with people who don't want you to have?
I'm happy for the now-insurable people. This has to be a huge relief to them. Health shouldn't be a luxury or a rich man's commodity.
Troy:
Thanks for clearing things up for me.
So, back to your four "challenges" and your "solutions." How will they be paid for? Why do you instantly assume I'm talking in the realm of "government fiat?" It's a term you like to kick around, not me.
I do know that the Affordable Care Act includes reinsurance provisions designed to stabilize premiums in the individual and small group markets as insurance reforms and the Affordable Insurance Exchanges are implemented, starting in 2014. But you're against the Affordable Care Act, so I guess we have to throw that idea out. Plus, I believe that the reinsurance idea in the Affordable Care Act is designed primarily for early retirees, and not to cover people with pre-existing conditions. I'm just not certain on that point, however.
Some states have attempted to address the pre-existing coverage challenge by imposing price controls on health-insurance premiums -- requiring insurers to sell to all comers, regardless of their health status and at standard rates. But this caused insurers to increase the premiums they charge everyone else -- including the young and the healthy – in order to make up for the losses insurance companies incur by accepting more expensive cases at below-cost premiums. When premiums rise for younger and healthier customers in a voluntary marketplace, a significant number of these people simply drop their health insurance and hope for the best. They hope they will stay healthy and not need expensive health care coverage. Of course, this means the remaining people enrolled in the insurance companies' plans become a group that's older and less healthy. And, whammo, that drives up the premium costs for the remaining enrollees.
This trend likely explains why Romneycare works so well in Massachusetts, where over 90 percent of the population has health insurance. It's why Obamacare has potential.
Helping people with pre-existing conditions is complicated. There's a lot involved. There are HIPAA requirements to deal with. HIPAA is in place to provide that "portability" that you linked with "pre-existing conditions" in your list of "solutions." I know some states have tried implementing high risk pools, but those have proven to be expensive. State-based pools have been underfunded and closed off to many potential beneficiaries.
If states can't come up with enough funding to guarantee portability with people who have pre-existing conditions, how in the world are insurance companies going to do it through re-insurance? Where will the companies who take on the higher risk pools of people who need insurance get the funding they need to pay their customers' premiums? How will a "flat across the board re-insurance premium to cover them to transfer pre-existing conditions when people change jobs and plans" work in such a scenario?
And if it's such a dandy idea, why isn't it being used? In fact, why are so many of your dandy ideas just that -- ideas -- that will never see the light of day? Could it be because they aren't so "dandy?"
I'm certain you could enlighten me on these various points, Troy, with your vast knowledge and wisdom, but alas, I'm not worthy.
Usually when I ask someone a question, and they respond by not providing an answer, and in a patronizing manner, to boot -- "there, there, you're too ignorant to understand" -- I know they're full of BS.
Dave,
None of the alternatives were discussed because Obama and Pelosi didn't need GOP votes so they decided to disregard GOP ideas.
And frankly, you have the same mentality as Obama. The only good ideas are Dem ideas.
Your "assumptions" only reinforce your ignorance. I like the concept of exchanges but not this stupid thing because we didn't open up the ability to trade across state lines. Do we really need an exchange in SD when it doesn't add new options/companies to choose from?
Regarding funding portability, it is actually easy. Insurance is shared risk. It will be built into premiums. I will pay for the privilege of portability and protection against pre existing conditions.
Finally, why the knee-jerk reaction against Health savings accounts? Empowering users of health care to be sensitive to costs can only help contain costs which is critical for our nation to afford quality care. Ever ask yourself why the biggest organized opposition is hospitals? They want you to be immune to price. Wonder why?