Some of us are wishing happy two-year birthday this week to the Affordable Care Act. Some of us are not and are praying the U.S. Supreme Court strikes it down.
And that's understandable because of the philosophical differences between those for and those against the ACA. Nevertheless, what many of us — except those who still regard America as having the best health coverage on earth despite the statistics — there is the recognition that our current system is unsustainable.
Small business is one of the segments of our economy that has especially felt the impact of our dysfunctional healthcare system, hard. Over half the bankruptcies in this country are a result of medical bills, and no doubt many small business owners have had to close up shop when they hit the financial rocks.
This fact is very true here in Wisconsin, which has some of the highest health insurance costs in the country. An independent contractor friend of mine recounts how his health insurance premiums are higher than his house payments.
The real job creators in this country are smaller businesses, and for years they have had to struggle with the challenge of hiring staff in the face of rapidly rising health insurance premiums while dealing with competition from big business for the talent they need. Too many have this choice decided for them. For those who feel that government has been the enemy of small business, they are forgetting the damaging effects big insurance companies have had on families and on small business success.
Until they become big businesses, the plight of small business owners and their employees is no different than the average person. During the first half of 2011, one in three Americans lived in a family that struggled to pay medical bills, and many small business owners, and especially new start-ups, are among those. A recent survey by the Small Business Majority found that providing health insurance was the prime concern of small businesses.
With all the burdens faced by small businesses to make it from year to year, a smart country would find a way to lift the healthcare load. Certainly the ACA is a step towards achieving that goal.
Over the past two years since the enactment of the ACA, small businesses throughout the country have already benefitted from new access to tax credits, which help to lower premiums. In 2011, 62,800 Wisconsin businesses qualified for a tax credit. This feature enables small businesses to offer comprehensive coverage like never before. Small Business Majority found in another survey conducted in 2011 that one-third of small business owners who didn't offer insurance would be more likely to do so because of these provisions.
Here are the unappreciated benefits. Most small businesses function like a team. For one of those team members to deal with a personal health problem affecting themselves or a member of their family is a major distraction. Throw in the collateral worries of having to pay for those procedures if all the team members "are going naked" in terms of healthcare coverage.
The Affordable Care Act enables a leveling of the playing field. The name of the game is attracting talent, and a small company is at a distinct disadvantage if they can't afford to offer healthcare to attract that talent.
Of course the big news is the announcement last week by Common Ground of a $56.4 million federal loan to set up a health care cooperative to serve the insurance needs small businesses and others in southeastern Wisconsin. The loan was made possible thanks to the Affordable Care Act, and like all of the other cooperatives sprouting up across the country, the plan will activate in 2014, enabling main street small businesses to have the mass buying power of big business.
It would be foolish for anyone to think we can afford to do nothing when it comes to reforming healthcare in America. The nibbling around the edge solutions proposed by the right is not going to cut it. For all the faults of the Canadian health care system, at least business owners don't have to waste hundreds of hours dealing with their company's health care plans like their competition in the States.
For better or worse, President Obama laid a pile of political chips on launching this bill, and many, including a fair number of Democrats, felt that early 2010 was the wrong time to do this, especially with the demands for improving employment in the depths of this recession.
But this was the only time to pass something this major when the President's popularity and political capital was at their peaks.
Turns out, in reality the President and the Congress enacted a jobs bill — for the long run. By working to lift the burden of health care coverage, small business owners and their teams can focus on what they do best and what is the best for this country — create jobs.
http://nation.foxnews.com/nancy-pelosi/2011/10/29/pelosi-defends-obamacare-waivers-1800-firms-theyre-small-companies http://dailycaller.com/2011/05/17/nearly-20-percent-of-new-obamacare-waivers-are-gourmet-restaurants-nightclubs-fancy-hotels-in-nancy-pelosi%E2%80%99s-district/ So, where's the waiver for my small business family restaurant? How come others received one, particularly in Pelosi's district, but not a small businessman's family restaurant in Wisconsin? I thought a federal judge just said that the government can't treat special interests differently in ruling against parts of Act 10, didn't he? So this selective picking and choosing of who gets an Obamacare waiver would appear to be unconstitutional under such a precedent, wouldn't it? After all, if restaurants politically connected to Pelosi get a waiver, then shouldn't all restaurants get a waiver? That would appear to be the crux of the judge's opinion in the recent Act 10 case. So what exactly am I missing here? You're honestly going to sit there and tell Hoffa that this doesn't stink to high heaven??? COME ON!!! I'm getting SICK of this CRAP!!! REPEAL AND VOTE THE BUM OUT!!!
The people I see objecting are those who have coverage and are afraid it will reduce in quality or they'll lose it altogether. And I'll say, are you content with a system like this? It can happen to you at any time regardless, and then you might see things differently.
I am willing to live with it though. If for no other reason than 6 years of Bush with Republican controlled congress did nothing significant about the issue. That was a shameful waste of that time. I personally think that our economy is being dumped on its head due to the ridiculous cost of health care. It is the sentinel domestic policy issue of our time.
@JRH -- What do you provide for your employees now? Do they have an insurance plan, and if not, do you pay them enough to purchase a plan of their own? If neither is the case, you should probably drop insisting how people should be responsible for their own care, because it's simply impossible.
Good question. I just think something is clearly out of whack. My best guess is that it is some sort of manipulation by those making better than 100 million a year off health care. In any case, it would be nice if someone could do us a favor in the middle and lower class.
Sounds like I fell through the rabbit hole.
Not soley, as a listed a couple of factors. However, if one group of people is not paying the rate required then the other group must suck of the slack. As for ins and dr negotiating the rates. Both has a vested interested and I don't think the dr. are going to negotiate a rate below what the service require. If insurance were left with fewer regulations, then consumers would be in a better position to shop around. This competitive shopping would force the insurance companies to be working harder to lower prices.
Really, complaining about the fact that emergency rooms have to treat everyone is a new low. I was in that position once (health insurance, but didn't have my card on me), so they treated me and sent me the bill. Worked just fine. If you want to know why the cost of health care is so high, read Atul Gawande's "The Cost Conundrum" (article in the New Yorker, won't take you more than 20 minutes). Then you can return with some more insightful, less threadbare things to say on the subject.
I'll answer your questions once you can adequately explain to me how it's fair that small restaurants in Pelosi's district, and some large-scale franchises such as McDonalds, were able to receive waivers from Obamacare, but not every restaurant or franchise was privy to that same privilege. According to Pelosi, those waivers were justified because "those businesses are very small." So, could you explain for me what liberals consider a 'large' business as being, cause personally, I always thought that McDonald's was pretty large. It's definitely bigger than my little one store front family restaurant!
Based on the limited discussion I had with him, the best conclusion I can draw was that his main concern was going to be the additional cost associated with having to provide insurance for his employee's kids 26 or under. I base that on what he said at the time. He doesn't strike me as the type that makes business decisions based on what he hears on talk radio. In fact, I'd be hard pressed to think of anyone who does. Let me ask you a question along the same lines. Are you basing this as being beneficial to you based on some figures you have that represent what things will cost, post ACA going into effect? Or are you basing it on something you heard on MSNBC? Big difference. Putting that nonsense aside, I don't think anyone knows exactly what the costs are going to be. But based on the fact that coverage is still going to be provided by the insurance companies and they aren't going to give away the additional coverage, as in my friend's case, free, I think it's safe to assume that if he thinks it's going to cost him more, he's probably right.
I think the hospitals spread out the cost of those very expensive MRI machines into the daily cost of a bed. It's a mixed blessing -- we can cure so much more, but it comes at the price of financial ruin for some of the people cured, or even those who die.
"Many of the waivers are for limited benefit or so called "mini-med" plans—controversial rock-bottom plans that provide a very limited amount of coverage (sometimes as little as $2,000 a year) to beneficiaries that are used heavily in low-wage industries like the restaurant business. New federal rules require such plans to offer a minimum of $750,000 of coverage annually, and the waivers exempt the mini-med plans from such rules on a case-by-case basis." Your three links are all basically for the same heavily slanted story that implies without proof that Pelosi is doing favors for someone. The waiver grants are mostly in Democratic districts because Republican areas are not getting the word. I think it's a shame that a lot of small business people have gotten bad info from right-wing sources and are missing the opportunity to get this waiver.
29 seconds ago Actually, here's another fascinating article by the same author, about how only a small number of super-unhealthy people require a massive amount of healthcare, driving up costs in a geographic area: http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=1 Now, what's the preferred approach to this problem? In JB's case, it seems to be "f--k those people; let 'em die." Or, you could take the holistic social-service approach indicated in the article, and wind up improving outcomes and decreasing the amount of care consumed by these few people.
Think it through, Randy. That's all we can do at this point. There are no guarantees that what you've been told is going to happen is even remotely close to what will happen, because the one thing that needs to be controlled in order for it to work as described, isn't being controlled.
I'm nervous about what will happen in 2014 -- whether I'll be able to find anything affordable even with the subsidies. But it's nerve-racking having no insurance at all.
It makes me angry when people talk about ERs as if they're free healthcare providers. They're not.
If you'll recall, the ACA originally included a public option that would have covered people without putting the burden on the private insurance companies. By the way, I have no pre-existing conditions other than my age. I'm computing my chances of getting cancer before age 65, and they are tolerable. If not, under the ACA, there is the high risk pool at least.
WRONG! I did apply. I was told that no more waivers were being offered. Also, why are the waivers only offered on a 'case by case' basis instead of a blanket covering the entire restaurant industry? And why are labor unions lumped into the groups that were given waivers? Was the IBT really only giving mini-med plans to those on their payroll? Wake up!!! You guys may not realize this, but my small family restaurant isn't pulling Bentleys, Rolls Royces, and Aston Martins in the parking lot every night like the restaurants that received waivers in Pelosi's district do. And yes, my restaurant currently does offer mini-med plans to full time employees, as something was deemed to be better than nothing. Under the new rules of the ACA, the coverage has to be higher so my cost will go up substantially. I'm seriously considering paying the fine instead of offering any coverage at all. May even have to close up shop. As it stands, the place only cleared 15k in profit last year. If the ACA eats into that profit margin, it won't be worth my effort anymore. Then, all those jobs and the tax revenues disappear. Is that really what you guys want to see happen? REPEAL AND VOTE THE BUM OUT!!!
You create a system that addresses the needs of those who can't afford health insurance w/o messing up the system for those who have it through employers - i.e., a public option. You start there. If the public option is workable, THEN if you want to encourage others to move to it, you do so. You don't start by enlarging the pool and then have them fend for themselves in the marketplace while you try to figure out how to make it "affordable" for them. You don't have an architect draw up plans for a building and then not build the first two floors due to a disagreement over the design and expect the building to support itself by hovering over the foundation. ACA w/o the public option is that building. Again, "something" isn't always better than nothing.
"There was a long struggle between Obama's advocates and free-market health care advocates over the question of a "public option", which would have created a federal public-benefit corporation subsidized to compete with the private companies in the exchange. Republicans and their allies eventually defeated this "public option" idea by arguing that the public nature of such a company would give an unfair edge over the private organizations in the exchange and would "unfairly out-compete" the private insurers. After a group of Corporate Senate Democrats and Joseph Lieberman joined Republicans in their objections to the public option, the PPACA was passed without a public option included, ensuring the insurance exchange would be inevitably composed purely of the private health insurers.[9]"
Good lord....