Skip to comments.With Obamacare now a reality, employers choose strategies
Posted on 11/12/2012 8:01:11 AM PST by Nachum
Love it or hate it, President Barack Obamas re-election Tuesday cleared the last major hurdle toward implementing the Patient Protection and Affordable Care Act.
Businesses are being forced to take a fast and hard look at how to handle the shift in health-care benefits and potential costs that are part of the law that goes fully into effect in 14 months.
This is here to stay, said J.D. Piro, a senior vice president at Aon Hewitt who leads the companys health law consulting group. Ive been saying for a couple of years this is by and large an entitlement program, and entitlement programs are very rarely repealed. They can be amended or changed around the edges. But it hasnt been overturned in court or at the ballot box.
(Excerpt) Read more at suntimes.com ...
>>Not complicated. Fewer jobs, lower pay.<<
Higher prices, fewer doctors.
Higher prices, fewer doctors.
Longer waiting times, poorer quality.
I’m curious to know how doctors feel about all of this and what their plans may be. If I understand correctly, their pay will be determined by the government as well as the growth of their practices. I haven’t seen much about where they see this heading. Does anyone know? Or can you direct me to some sources? Thanks.
The argument that part time workers will be less productive than full time workers is correct. The part time workers will be tempted to give it up and go on food stamps and other welfare programs if they find work too inconvienent (unlike the Great depression). However, employers MUST resort to the part-time option for their own survival. There are many headwinds for restaurants and retail business, chief among them are inflation and lower incomes. In depressionary times, these are typically the first businesses to go.
The reality, in my opinion, is that Boehner et al. have no gonads and, by the way, bend over America and welcome to Auschwitz. Also, my opinion—Obama, Pelosi, and Reid’s solution to healthcare and social security is to reduce the number of Americans over 65. Never again? Right.
Around every doctor's lounge in America, Doctor Atlas is trying to figure out how to shrug and they talk about it. The ones in a financial position to do so are definitely planning to work less and produce less. They have been personally insulted by this administration, in a deeply rude and vicious way. They'll cut back to pull their income under the new taxes.
The line I overheard, "What will WE do for medical care?" They believe that things are going to get very bad.
The biggest thing is that there are very few private practices--the docs have sold out to big hospital conglomerates and have become employees. That means they will serve the hospital's interests. There are clinical docs, who see you in their offices, and hopitalists who see you when you are in the hospital.
And I sense a big change in attitude toward patients. If you spend time on FR, you'll hear from freepers and freeper lawyers who say demeaning, resentful and envious things about "rich evil doctors." Doctors and their families hear and understand, and they aren't feeling too sorry for patients anymore, particularly when they vote Obamacare in. They are not stupid people, and a lifetime career of avoiding the predations of lawyers has taught them to avoid predation in general.
In short, that doctor you hate? He hates you right back.
Employers of faith, who oppose abortifacients, contraception, sterilization, or some other mandate under Patient Protection Affordable Care Act, face stark choices:
(1) They can organize under the exemption: certain houses of worship who qualify under the particular section of the Internal Revenue Code, serve almost exclusively members of their denomination, employ almost exclusively members of their denomination, and focus their primary mission on the inculcation of religious values. Because Patient Protection Affordable Care Act builds upon the taxing power, and particularly the income tax, none of the rights and liberties enumerated in the Bill of Rights apply; the income-tax amendment superseded them. So these employers must prove their eligibility beyond reasonable doubt to a party inclined toward bias against them. Moreover, these criteria raise troubling questions: is worship of God and preaching the Gospel, even exclusively toward believers, “inculcation of religious values?” Can churches oppose abortion (and voting for its proponents) on theological grounds yet maintain their exemption? How many new members can they accept? And more.
(2) Cease to offer any form of health insurance to any employees. If employer employs more than 50 persons at least 30 hours per week, then a special tax of $2000/employee may apply. Employers will want to stay below this threshold, hiring mostly part-timers. In a collapsed labor market, employees so hired will be grateful for any work. If, however, employee lives in household that earns more than the filing threshold ($12,850/year for a single parent), employee will pay a large tax ($2085/year if said single parent of said income has four or more children). Employees subject to the tax presumably will reduce remuneration of employees concomitantly to recoup the money necessary to pay said tax.
(3) Cease to employ anyone and leave business entirely.
(4) Provide the coverage at extreme financial cost here and the risk of eternal damnation hereafter.
The law grants no other options for employers. Because of the high cost of medical care, many Americans therefore will cease to use any professional medical resources. Fortunately, the law does not prohibit yet the dissemination of medically related knowledge through books, websites, and other media for amateur medicine; the provision of uncompensated first aid among friends and acquaintances, which may involve suddenly heavily taxed medical devices still publicly available over the counter; or the avoidance of the government-sanctioned pro-death medical establishment.
For women, these limited arrangements may increase significantly the risks associated with childbearing. For those of sufficient wealth, however, the law does not prohibit—at least as far as we yet know, but Congress passed the law so that we may find out what is in it—paying doctors and hospitals exorbitant fees as a cash customer. Nor does it yet require explicitly said doctors and hospitals to kill babies or engage in other ethically compromising behavior as a condition of their entry into or persistence in the profession. Nevertheless, further regulations not yet announced and future federal legislation may degrade even these caveats.
Put simply, health insurance soon will be a benefit of the past, and higher taxes a feature of the future. This situation will degrade access to actual health care for millions of marginally healthy Americans (i.e., those economically productive with significant medical expenses) who in the future will scavenge, die, or live in pain. Employers may have compassion on them but cannot provide any form of health insurance. The diminishing middle class continues an ever more precarious existence.
“the law does not prohibitat least as far as we yet know, but Congress passed the law so that we may find out what is in itpaying doctors and hospitals exorbitant fees as a cash customer.”
Not sure this isn’t already baked in. For Medicare and Medicaid patients it clearly already is. Dr’s already pay big fines if their treat a Medicare or Medicaid patient outside the approved payment schedules. For the rest of us, Section 1131 of the act prohibits Qualified Health Plans (all insurance companies, hospital plans HMO’s etc) from contracting or paying any doctor who doesn’t comply with HHS regs regarding quality health care. I strongly suspect that Dr’s who practice outside the government approved payment plans will be prohibited from receiving any payments from insurance companies, hospitals, HMO’s etc. That means Dr’s will have to opt out of the system entirely and that there would need to be an infrastructure of testing gear, emergency rooms, MRI’s etc that would handle their patients’ problems when it was beyond that doctor. Will there be enough demand to build that outside infrastructure? I don’t know.
Shorter hours, less pay, fewer doctors, longer waits, specialty medical care for those 'connected' to dem insider groups with 'pull'... Yeah, it's gonna be fun. We're one step from the European and Russian model - where people stop having children because the future's so bleak... and they commit cultural suicide.
As I have become fond of saying in recent days...Embrace your slavery, democrats!