CBO Report: Obamacare to cut work hours by equivalent of 2 million jobs

[weekender 0]

Andy9o8

***Now who is cherry picking?

That's silly. I linked the entire chart. Using simply the aggregated EU is artificial. Each country has its own health plan, and its economy is not 100% synonymous with the aggregate EU economy. Compare as many industrialized countries to the US as you wish. I stand by my point.

except we are not a European country. we are more like a third world country. liberals are always pointing out how the rich own all the wealth. conservative like to point out half the country doesnt pay income taxes. our make up is nothing like Italy or France. AND its getting worse because we seem to only want poor people from the third world to immigrate.

we are doomed and this is why i responded to another thread explaining why im retiring in Italy.

"The point is, I'm weird, but I never felt weird."
John Frusciante

[kallend 2,175]

www.washingtonpost.com/business/fact-check-anti-obamacare-chorus-is-off-key/2014/02/05/a4cc937e-8ea9-11e3-878e-d76656564a01_story.html?tid=pm_business_pop

www.deseretnews.com/article/865595684/CBO-report-Workers-may-reduce-hours-under-health-care-law.html

The Affordable Care Act may lead close to 2.3 million workers to leave the workforce or cut their hours over the next 10 years, according to a new Congressional Budget Office report.

But the change is about worker choice, not job loss, despite headlines to the contrary, said the Washington Post's Glenn Kessler in his "fact-checker" blog.

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The only sure way to survive a canopy collision is not to have one.

[brenthutch 444]

kallend

But the change is about worker choice, not job loss, despite headlines to the contrary, said the Washington Post's Glenn Kessler in his "fact-checker" blog.

Choice is awesome, I love choice. I think everyone should be able to chose not to work anymore. Instead of working we can all focus on our dreams! Just let the government pay for it. No taxes, we can just get it from Obama's stash.

I think I can hear billv and kallend chanting in the background.

http://www.youtube.com/watch?v=_Ojd13kZlCA

[kallend 2,175]

brenthutch

***
But the change is about worker choice, not job loss, despite headlines to the contrary, said the Washington Post's Glenn Kessler in his "fact-checker" blog.

Choice is awesome, I love choice. I think everyone should be able to chose not to work anymore.

Why do you hate senior citizens?

...

The only sure way to survive a canopy collision is not to have one.

[rickjump1 0]

kallend

******
But the change is about worker choice, not job loss, despite headlines to the contrary, said the Washington Post's Glenn Kessler in his "fact-checker" blog.

Choice is awesome, I love choice. I think everyone should be able to chose not to work anymore.

Why do you hate senior citizens? How do you come up with that? Everyone loves FOPs; especially the ones buying the beer.

Do your part for global warming: ban beans and hold all popcorn farts.

[turtlespeed 226]

lawrocket

What we hate is yet another program that provides an inducement for people to quit working and live off the dole. When people look at the numbers and say, "I'll net more money by doing nothing" then the relevant inquiry to me is, "where's the choice of those people who will be paying for 2.3 million more people?

Understanding, as I do, that this is yet another step toward liberal utopia.

Whoah Whoah Whoah . . .. When did Bob get elected and why are they living off him?

I'm not usually into the whole 3-way thing, but you got me a little excited with that. - Skymama
BTR #1 / OTB^5 Official #2 / Hellfish #408 / VSCR #108/Tortuga/Orfun

[brenthutch 444]

Andy9o8

***Now who is cherry picking?

That's silly. I linked the entire chart. Using simply the aggregated EU is artificial. Each country has its own health plan, and its economy is not 100% synonymous with the aggregate EU economy. Compare as many industrialized countries to the US as you wish. I stand by my point.

No more artificial that aggregating the United States. Mind you, each state has its own unique set of economic, social, political, cultural conditions and yes, policy prescriptions aka health plans. I was making a comparison between the United States and the European Union, you were equating Luxembourg with the United States, I stand by my point as well.

[Andy9o8 3]

I stood by my point first, so I win.

[brenthutch 444]

Touché

[PiLFy 3]

lawrocket

What we hate is yet another program that provides an inducement for people to quit working and live off the dole. When people look at the numbers and say, "I'll net more money by doing nothing" then the relevant inquiry to me is, "where's the choice of those people who will be paying for 2.3 million more people?

Understanding, as I do, that this is yet another step toward liberal utopia.

Yep. That's what this Country needs: another 2.3 MILLION TROGs ... Way to go, Obamanos. Jackass

[kallend 2,175]

It's a pity people don't read the ACTUAL REPORT, and instead rely on half-truths put out by right wing propaganda sites.

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The only sure way to survive a canopy collision is not to have one.

[PiLFy 3]

kallend

It's a pity people don't read the ACTUAL REPORT, and instead rely on half-truths put out by right wing propaganda sites.

I thought you were supposed to be a smart guy? The report is full of lies, from a lying Govt. agency. You've been handed far too much money in life, professor. You can pay a larger share of this latest TROG debacle.

[kallend 2,175]

PiLFy

***
It's a pity people don't read the ACTUAL REPORT, and instead rely on half-truths put out by right wing propaganda sites.

I thought you were supposed to be a smart guy? The report is full of lies, from a lying Govt. agency. You've been handed far too much money in life, professor. You can pay a larger share of this latest TROG debacle.

QED

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The only sure way to survive a canopy collision is not to have one.

[kallend 2,175]

www.theatlantic.com/business/archive/2014/02/the-spectacular-myth-of-obamas-part-time-america-in-5-graphs/283674/?google_editors_picks=true

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The only sure way to survive a canopy collision is not to have one.

[GD64 1]

Damn "job lock"!
/

[PiLFy 3]

kallend

www.theatlantic.com/business/archive/2014/02/the-spectacular-myth-of-obamas-part-time-america-in-5-graphs/283674/?google_editors_picks=true

QED: https://www.google.com/#q=majority+of+new+jobs+added+are+part+time&start=0

[lawrocket 3]

kallend

It's a pity people don't read the ACTUAL REPORT, and instead rely on half-truths put out by right wing propaganda sites.

Right. Because the whole report can explain how awesome it is! That's right. This is absolutely totally awesome! Imagine, 2.3 million people will no longer be listed as unemployed because they aren't looking. Can you imagine what 150 million people willfully without work will do for the unemployment numbers in the US? We'll be at full employment!
Sorry, John, but 2.3 million people leaving the workforce is a prediction. Who knows, maybe it'll be like a climate model, and we'll only have a few hundred do it. Then we can look for all the missing workers 20,000 feet under the Pacific.

My wife is hotter than your wife.

[GeorgiaDon 385]

Well, maybe we can repeal the ACA and EMTALA, and then use prexisting conditions to exclude them or just price insurance and health care so as to exclude all the part-timers (basically, apply the GOP/Libertarian plan), and hope a whole lot of them just go away to die quietly when they get sick. That's a win/win/win: we won't get stuck subsidizing their cancer therapy, they'll die earlier so we'll save on medicare and social security, and the unemployment numbers will look better. Plus that will make for shorter lines and wait times for the rest of us when we need to see the doctor. Yay! What's not to love?

Or maybe we can ask how it is that civilized countries manage to ensure health care for virtually all their citizens, yet still outperform the US in terms of productivity and standard of living.

Don

_____________________________________
Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996)
“Education is not filling a bucket, but lighting a fire.” (Yeats)

[lawrocket 3]

Quote

hope a whole lot of them just go away to die quietly when they get sick. That's a win/win/win: we won't get stuck subsidizing their cancer therapy, they'll die earlier so we'll save on medicare and social security, and the unemployment numbers will look better. Plus that will make for shorter lines and wait times for the rest of us when we need to see the doctor. Yay! What's not to love?

If cutting costs was the actual goal, then this is exactly what would happen. Instead of cutting costs, the focus is on lowering the price for select individuals while increasing the price on others and increasing total cost as the cheap healthcare is accessed.

Quote

Or maybe we can ask how it is that civilized countries manage to ensure health care for virtually all their citizens

I'll answer it. Rationing. Once again, there isn't an inexpensive, high quality healthcare system that isn't rationed. Are you so anti-science that you deny the data that stares you in the face?

I'd like to see you debate Bill Nye on the subject of cheap, high quality and on-demand accessible health care. The concept is as valid as intelligent design, but with a lot more data to falsify it. And yet, people keep thinking it can happen.

So what we've done in the US is try to ensure high quality health care available on demand. We've done it by increasing the cost of it, while lowering the PRICE for some.

In the end, we have high quality, on demand health care that costs a lot. To deny that is to put some religious ideal on the whole thing. Call me a heretic and burn me at the stake for pointing out that what the ACA gives us is the opposite of what is promised.

My wife is hotter than your wife.

[kallend 2,175]

lawrocket

***
It's a pity people don't read the ACTUAL REPORT, and instead rely on half-truths put out by right wing propaganda sites.

Right. Because the whole report can explain how awesome it is! That's right. This is absolutely totally awesome! Imagine, 2.3 million people will no longer be listed as unemployed because they aren't looking. Can you imagine what 150 million people willfully without work will do for the unemployment numbers in the US? We'll be at full employment!
Sorry, John, but 2.3 million people leaving the workforce is a prediction. Who knows, maybe it'll be like a climate model, and we'll only have a few hundred do it. Then we can look for all the missing workers 20,000 feet under the Pacific.

Nowhere in the report did it state that any kind of economic problem was going to be precipitated by the ACA. That is entirely a creation of the right wing to mislead the ignorant. I'm surprised YOU fell for it too.

I guess you hate retirees too.

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The only sure way to survive a canopy collision is not to have one.

[GeorgiaDon 385]

Quote

So what we've done in the US is try to ensure high quality health care available on demand. We've done it by increasing the cost of it, while lowering the PRICE for some.

In the end, we have high quality, on demand health care that costs a lot.

I disagree with the argument that our health care is expensive because we provide gold medal service to everyone on demand. We provide remarkably poor service to an astonishingly large fraction of the population, and pay more than anybody else for the privilege.

We pay several times the "going rate" for each and every service, compared to every other developed country, due in large part to two factors: inelastic demand and a completely byzantine and opaque billing system that makes it impossible to comparison shop for anything but the most trivial medical procedure.

If you have a condition that will kill you or ruin your ability to work/quality of life (or even worse if these apply to a loved one), you are in no position to bargain or negotiate anything. You have to pay whatever is demanded; this is inelastic demand.

As an individual, you may be able to negotiate a price for an office visit or physical exam, but that rapidly becomes impossible for anything more complex. Every doctor who touches your file will bill you, and you have no control over that. Hospitals treat fees for supplies and services as trade secrets.

Here's a small personal example. A while ago I had one of those "rites of passage" that come with getting older: a colonoscopy. I asked what my copay would be, and was told a figure that I thought was reasonable. What I was not told was that figure was only for the gastroenterologist, and I would also be getting a bill from the anesthesiologist and the clinic where the procedure was performed. Clearly the billing process is designed to break the bill into several parts, to make it difficult for the consumer to anticipate the total cost. How hard would it be to give a single figure that covers the gastroenterologist, the anesthesiologist, and the use of the clinic's facilities? On top of that, a small bit of tissue looked unusual and was excised for biopsy. I was billed a shocking amount for snipping the tissue, a one minute procedure, and billed separately for 2 stitches (over $300/stitch). Then I started receiving bills from pathologists. The sample got passed around to 3 of them, and of course they all sent me a bill. One of them billed me twice, with late fees added, after I had already paid his bill and had a cancelled check to prove it. At that point I had paid so many bills I almost paid those as well, before noticing they were from a pathologist I had already paid. In every one of these bills the "service" was listed as a number code, completely unintelligible to the consumer. Unless you spend a lot of time phoning, and dealing with ticked off people who treat you as if you are wasting there time, you just have to pay and pay and pay without knowing what you are paying for.

Now, this example was of course a perfectly mundane and simple medical procedure. The point is, unless you work in medical billing or are a practicing physician, it is almost impossible to anticipate all the expenses, or even to understand what you are paying for. How much worse would it be for something really complicated, like cancer? I think the billing system is deliberately constructed to make it impossible for consumers to understand, much less negotiate in advance.

When you combine a system where people require care (as in a serious medical condition) with a completely obscure billing system, you have a system set up for abuse.

Quote

I'll answer it. Rationing. Once again, there isn't an inexpensive, high quality healthcare system that isn't rationed.

If you think the US system isn't rationed, you're living in cloud cuckoo land. It's absolutely rationed, based on ability to pay. The problem is, for the poor access is denied until their conditions become life threatening. At that point, when treatment is vastly more expensive than it was early in the disease, we allow them to seek treatment through the most expensive possible venue, hospital emergency rooms. We couldn't have designed a more expensive or stupid system if we had tried.

The ACA has many provisions to try to bring down costs, as well as to make access affordable to more people. How well these will work I don't know; preventative care has potential over the long term, as long as people use it. Other carrot/stick measures aimed at hospitals seem to have the potential to encourage hospitals to avoid gravely ill patients and specialize in things like elective surgeries, so as to improve their "successful treatment" rates.

Anyway I think things like transparency in costs would help a lot, by encouraging competition and allowing customers to shop around in the case of non-emergency procedures. We have talked about other things in the past, such as having insurance cover major costs (protection from financial catastrophe) and covering routine costs out of pocket. If costs came in line with world standards, insurance premiums would fall and there would be less requirement for subsidization.

Don

_____________________________________
Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996)
“Education is not filling a bucket, but lighting a fire.” (Yeats)

[kallend 2,175]

lawrocket

I'd like to see you debate Bill Nye on the subject of cheap, high quality and on-demand accessible health care. The concept is as valid as intelligent design, but with a lot more data to falsify it. And yet, people keep thinking it can happen.

So what we've done in the US is try to ensure high quality health care available on demand. We've done it by increasing the cost of it, while lowering the PRICE for some.

In the end, we have high quality, on demand health care that costs a lot. To deny that is to put some religious ideal on the whole thing.

Must be why the USA tops the charts for life expectancy and infant mortality.

Oh, wait...

...

The only sure way to survive a canopy collision is not to have one.

[PiLFy 3]

I agree w/most of your points, but one thing doesn't add up. If the US has such world class health care for all. Why are we ranked 35th in life expectancy?

[Url]http://en.m.wikipedia.org/wiki/List_of_countries_by_life_expectancy[/url]

It isn't working...

[lawrocket 3]

GeorgiaDon

I disagree with the argument that our health care is expensive because we provide gold medal service to everyone on demand.

That's not my argument.

Quote

We provide remarkably poor service to an astonishingly large fraction of the population, and pay more than anybody else for the privilege.

And we provide remarkably awesome service to those who can afford it. Are we striving to provide the awesome service to everyone? Yep. And that takes $$$$.

Quote

We pay several times the "going rate" for each and every service, compared to every other developed country, due in large part to two factors: inelastic demand and a completely byzantine and opaque billing system that makes it impossible to comparison shop for anything but the most trivial medical procedure.

Want a CT in the US? No problem. You can get them on demand. That costs, and is something other countries don't have.

And the byzantine billing system? That whole thing STARTS with Medicare - the whole government system designed to make it inexpensive.

Think the billing system is going to change now that the government is more involved? HAHAHAHA!!!

Quote

If you have a condition that will kill you or ruin your ability to work/quality of life (or even worse if these apply to a loved one), you are in no position to bargain or negotiate anything.

Right. That's why you negotiate it when you're healthy. Now what have we had? Cover the asses of people who didn't do that.

Quote

You have to pay whatever is demanded; this is inelastic demand.

What about someone like me. Healthy and paying for insurance and not using it very often. Demand is remarkably elastic for those who have to pay for it. That's because each individual makes the choice, "Do I want to pay the $20 copay and take a day off of work or not?"

Quote

As an individual, you may be able to negotiate a price for an office visit or physical exam, but that rapidly becomes impossible for anything more complex.

I find myself negotiating health care bills every week. It actually happens a lot.

Quote

Every doctor who touches your file will bill you, and you have no control over that. Hospitals treat fees for supplies and services as trade secrets.

They aren't secrets. Just look what Medicare pays for things like operations. Really. It will open the eyes.

Quote

Here's a small personal example. A while ago I had one of those "rites of passage" that come with getting older: a colonoscopy. I asked what my copay would be, and was told a figure that I thought was reasonable. What I was not told was that figure was only for the gastroenterologist, and I would also be getting a bill from the anesthesiologist and the clinic where the procedure was performed. Clearly the billing process is designed to break the bill into several parts, to make it difficult for the consumer to anticipate the total cost. How hard would it be to give a single figure that covers the gastroenterologist, the anesthesiologist, and the use of the clinic's facilities? On top of that, a small bit of tissue looked unusual and was excised for biopsy. I was billed a shocking amount for snipping the tissue, a one minute procedure, and billed separately for 2 stitches (over $300/stitch). Then I started receiving bills from pathologists. The sample got passed around to 3 of them, and of course they all sent me a bill. One of them billed me twice, with late fees added, after I had already paid his bill and had a cancelled check to prove it. At that point I had paid so many bills I almost paid those as well, before noticing they were from a pathologist I had already paid. In every one of these bills the "service" was listed as a number code, completely unintelligible to the consumer. Unless you spend a lot of time phoning, and dealing with ticked off people who treat you as if you are wasting there time, you just have to pay and pay and pay without knowing what you are paying for.

Welcome to a world where a centralized bureaucracy determines how payment is accomplished. Turns out that procedures make the most money. A colonoscopy? That's a little bit. but add a couple of biopsies and the reimbursement goes up. Thank you to standardized billing.

Quote

The point is, unless you work in medical billing or are a practicing physician, it is almost impossible to anticipate all the expenses, or even to understand what you are paying for.

Welcome, sir, to the libertarian party. Where we say it's silly to suggest that we know the answers. And yet, people look for the answers and people are perfectly willing to provide answers. Got it wrong? Well, nobody ever said there wouldn't be problems...

Quote

I think the billing system is deliberately constructed to make it impossible for consumers to understand, much less negotiate in advance.

Correct. It's designed to make it smooth for government to pay. The Insurance industry tagged along, since it's simple and consistent. It is not designed for consumers. It's exactly what a government would design. Give it a number!

Quote

When you combine a system where people require care (as in a serious medical condition) with a completely obscure billing system, you have a system set up for abuse.

Right. And now everybody is required to buy into it. No choice! You get what you get, and it's exactly what the exchange will give you. You're young and healthy but live in an area concentrated with unhealthy people? Consider yourself hosed. You can't negotiate it. You get treated like everyone else.

Again, welcome to the libertarian party.

Quote

If you think the US system isn't rationed, you're living in cloud cuckoo land. It's absolutely rationed, based on ability to pay.

Yes. I've written that before.

Quote

The problem is, for the poor access is denied until their conditions become life threatening. At that point, when treatment is vastly more expensive than it was early in the disease, we allow have encouraged them to seek treatment through the most expensive possible venue, hospital emergency rooms.

Corrected for you. Again, this has been a policy success. Exactly what the laws wanted to accomplish was accomplished.

Note what your problem is: expense. Why is that your problem or my problem? If I want to drop $10k to get my rectum polished, why is that a problem for you?

No. Your problem is socialism. How much everybody else costs is a problem because you are picking up the tab. Where you and I differ is that I'd like to see how it is when we aren't picking up the tab.

And - how about a system where we each negotiate with doctors? Nope. Can't do that. That's for insurance companies, right? And that's why care providers stopped taking Medicare (see Mayo Clinic)

Quote

We couldn't have designed a more expensive or stupid system if we had tried.

Right. Amazing what happens when we put laws in place to build a system. Now we've put an even bigger one in place.

Quote

The ACA has many provisions to try to bring down costs, as well as to make access affordable to more people.

Limit costs? That's done by limiting reimbursement to care providers.

Quote

How well these will work I don't know; preventative care has potential over the long term, as long as people use it.

Yes. Potential. Too bad telling people to lose weight has a lousy history of efficacy. Preventative care only works when people act in accordance with medical advice. Which is rarely.

Quote

Other carrot/stick measures aimed at hospitals seem to have the potential to encourage hospitals to avoid gravely ill patients and specialize in things like elective surgeries, so as to improve their "successful treatment" rates.

I disagree. Highest reimbursement is for procedures. SO these places are set up to perform procedures, since the government carrot is that.

Quote

Anyway I think things like transparency in costs would help a lot, by encouraging competition and allowing customers to shop around in the case of non-emergency procedures.

Welcome to the libertarian party. What you are suggesting is the antithesis of the ACA, that actually doesn't even allow a lot of people to buy what they want. It actively penalizes working outside the system being set up.

Quote

We have talked about other things in the past, such as having insurance cover major costs (protection from financial catastrophe) and covering routine costs out of pocket.

Can't have that. Each plan must meet a minimum level of coverage. And preventative care, meaning routine stuff is outside of that which can be bargained for.

I think it's sad. I used to be able to pay cash for a bunch of stuff. Not anymore.

Quote

If costs came in line with world standards, insurance premiums would fall and there would be less requirement for subsidization.

I think that getting insurance out of 80% of it would lower costs because people would decide whether to pay $250 at urgent care or pay $50 to a doctor tomorrow morning. As it is, the option of pay $20 for a copay regardless. So use it up.

Imagine paying $800 per month for fuel. And $5 copay for each fill up. You think there will be people overutilizing the fuel?

My wife is hotter than your wife.

[lawrocket 3]

PiLFy

I agree w/most of your points, but one thing doesn't add up. If the US has such world class health care for all. Why are we ranked 35th in life expectancy?

[Url]http://en.m.wikipedia.org/wiki/List_of_countries_by_life_expectancy[/url]

It isn't working...

Several reasons:
(1) Diseases of affluence (obesity, diabetes, high BPetc);
(2) Failure to access care;
(3) Expectation that a pill will cure what they've got; and
(4) Melting pot.

Comparing ours to a country like Finland (about 6 million people with 93.5% Finnish and another 6% Swedish. The third most prevalent - Russian - there are fewer than 4,000 in the whole country) presents much simpler health issues. Whites, blacks, latinos, Asians - all have different prevalent health problems. The US has 50% more biracial people than Finland has people.

Finland has a one size fits all health system. Which is pretty efficient when 99.5% is white. Try a healthcare system primed toward whites in the US and see how effective it is.

My wife is hotter than your wife.