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Old 03-24-2010, 03:30 PM   #61
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Originally Posted by donheff View Post
Hey, if the incoming, subsidized masses substantially raise their costs, then they have to raise their rates. But they have to spend 80% of proceeds on health care so they won't be able to arbitrarily raise them beyond that threshold.
The most important previous cost containment mechanism on that health care spending will be gone. In the past, medical spending was "bounded" (however ineffectively) by consumers electing not to buy the product. With heavily subsidized third-party payers (private insurance companies), there will be much less of this. The insurance companies will have absolutely no incentive to reduce medical spending overall--their 20% "share" is now locked in, and every company will get the same 20%. Instead of a supply/demand based check on medical costs, we'll be substituting government cost controls. That might work, or it might not (history has an answer on this), but we should be aware that we are consciously abandoning whatever market-derived price moderation there was in favor of rulemaking and regulations-based controls.

Again, maybe it will work really well and people will love it. I hope it does!
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Old 03-24-2010, 03:39 PM   #62
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That is dated January 2010. Is this the exact same bill that was passed into law? And is the bill that was passed and signed into law the final health care bill? What is the deal with reconciliation amendments and handshake deals between the house and senate to agree to change the law?

I'm really confused and was hoping for some common sense concise explanations of what was just passed so that the common person (like me) could read a few pages (maybe 10 pages) and understand how they and their business would be impacted generally. I saw these concise summaries months ago when they were selling the House and Senate flavors of the bill, but have not seen anything concise that summarizes what was passed (with or without reconciliation/amendments etc).
This is what was passed and is now law. A summary of the reconciliation bill is here http://www.kff.org/healthreform/upload/8023-R.pdf

Look here for well organized and presented info, including a tool to calculate subsidies. The Henry J. Kaiser Family Foundation - Health Policy, Media Resources, Public Health Education & South Africa - Kaiser Family Foundation

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Links please?
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Old 03-24-2010, 03:40 PM   #63
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The problem with all these online calculators is that they only focus on single individuals or families of 4. I've not seen any that reflect other household situations. Would love to see a link if anyone has seen any such beast.
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Old 03-24-2010, 04:07 PM   #64
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This is what was passed and is now law. A summary of the reconciliation bill is here http://www.kff.org/healthreform/upload/8023-R.pdf

Look here for well organized and presented info, including a tool to calculate subsidies. The Henry J. Kaiser Family Foundation - Health Policy, Media Resources, Public Health Education & South Africa - Kaiser Family Foundation

You want fries with that?
Thanks for the links! I was coming up empty before in my searches. So the 8023-R pdf basically presents the bill that is now law, plus those changes/amendments passed by the House and pending approval of the Senate? The 8023-S is the Senate bill that was passed and is currently law.

I didn't follow the backroom dealing too much. Is it safe to say that the Senate will pass the House Amendment bill substantially unchanged? They just need the 51 votes?
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Old 03-24-2010, 04:50 PM   #65
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Thanks for the links! I was coming up empty before in my searches. So the 8023-R pdf basically presents the bill that is now law, plus those changes/amendments passed by the House and pending approval of the Senate? The 8023-S is the Senate bill that was passed and is currently law.
Aye laddie...

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I didn't follow the backroom dealing too much. Is it safe to say that the Senate will pass the House Amendment bill substantially unchanged? They just need the 51 votes?
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Old 03-24-2010, 05:24 PM   #66
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Just heard that the new bill will cost big pharmaceutical companies $90 billion. Any ideas on where the next blockbuster drugs will come from that take billions to develop and get clinical trials on?
I heard the opposite, since additional 30 million with
medical insurance, means millions more perscriptions.
Guess it depends on who is doing the math.
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Yeah, what about this?
Old 03-24-2010, 05:29 PM   #67
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Yeah, what about this?

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Ordinarily, income would be considered as line 22 total income, or perhaps line 37 adjusted gross income. But there is a problem using this - what about folks who are converting a traditional IRA to a Roth IRA? They haven't taken any money out, so it really isn't income. Conversely, what about folks who take a withdrawal from a Roth IRA? In that situation, they would not have any additional amount on lines 22 & 37.
Does anyone happen to know if a conversion to a Roth IRA is currently considered to be income for the purposes of Medicaid or other government benefits? I've googled on this for almost an hour now and can't find anything.
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Old 03-24-2010, 05:37 PM   #68
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This is what was passed and is now law. A summary of the reconciliation bill is here http://www.kff.org/healthreform/upload/8023-R.pdf

Look here for well organized and presented info, including a tool to calculate subsidies. The Henry J. Kaiser Family Foundation - Health Policy, Media Resources, Public Health Education & South Africa - Kaiser Family Foundation

You want fries with that?


I went to the first link.... and WOW.... what a typo!!!! (I added the color...)


"The Congressional Budget Office estimates that the legislation will reduce the number of uninsured by 32 million in 2019 at a net cost of $938 over ten years, while reducing the deficit by $124 billion during this time period."
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Old 03-24-2010, 08:09 PM   #69
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So, they will just jack up the 20 year old cost to cover the 60 year old cost. That's what I'd do.
I recently started posted in the Politics and Religion section of a computer games industry forum. It is fascinating to see the difference in reaction between the two forums.

The games industry forum is made of primarily of 20 or 30 something who are involved as programmers, designers, and founders of computer/video game companies and journalist who cover the field. (I was investor/business guy of a game company for a few years right after retirement.)

Compared to this forum they are far more liberal and supportive of the bill. Very few (I maybe the only one) are retired, and while most are covered by insurance via their companies, quite a few are contractors and will probably be forced to buy insurance. I suspect that most have incomes that will put them well outside of the subsidy ranges. If insurance companies end up raising the price of insurance for young people to keep the maximum age differential at 3x, I guess the alternative is to lower it for us older folks , the young folks will end up subsidies is us older wealthier folks.

I guess the good news is they really like the bill.
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Old 03-24-2010, 08:24 PM   #70
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This is a great discussion. Thanks.
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Old 03-24-2010, 09:49 PM   #71
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I recently started posted in the Politics and Religion section of a computer games industry forum. It is fascinating to see the difference in reaction between the two forums.

The games industry forum is made of primarily of 20 or 30 something who are involved as programmers, designers, and founders of computer/video game companies and journalist who cover the field. (I was investor/business guy of a game company for a few years right after retirement.)

Compared to this forum they are far more liberal and supportive of the bill. Very few (I maybe the only one) are retired, and while most are covered by insurance via their companies, quite a few are contractors and will probably be forced to buy insurance. I suspect that most have incomes that will put them well outside of the subsidy ranges. If insurance companies end up raising the price of insurance for young people to keep the maximum age differential at 3x, I guess the alternative is to lower it for us older folks , the young folks will end up subsidies is us older wealthier folks.

I guess the good news is they really like the bill.
They will not figure out that their wealth will be transferred to the old and the less productive. They only hear that "things are fair now", everyone will have health care. Wait till they see the cost to them.

Being old and less productive I welcome their contributions.

Baby boomers still have a lot of votes!

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Old 03-24-2010, 10:36 PM   #72
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They will not figure out that their wealth will be transferred to the old and the less productive. They only hear that "things are fair now", everyone will have health care. Wait till they see the cost to them.(snip)
Maybe they just think the cost to them is worth it, in the same way most people think that the cost of public schools, public roads, etc, are worth it.
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Old 03-24-2010, 11:01 PM   #73
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This is a great discussion. Thanks.
I second this. Having worked in the actuarial profession for 23 years (specializing in personal auto insurance) before I retired in 2008 at age 45, I do plan to chime in soon on this thread. I have a long, busy day ahead tomorrow so it will have to wait until Friday.

Keep on posting here, everyone. I am finding this a great read in the meantime.
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Old 03-25-2010, 12:56 AM   #74
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Does anyone happen to know if a conversion to a Roth IRA is currently considered to be income for the purposes of Medicaid or other government benefits? I've googled on this for almost an hour now and can't find anything.
Yes, that was basically my question. I am trying to get some clarification via my Congressman (who has passed the buck on my state legislator ...)
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Old 03-25-2010, 05:26 AM   #75
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Maybe they just think the cost to them is worth it, in the same way most people think that the cost of public schools, public roads, etc, are worth it.
I am sure that some of them do, but I doubt its many. I have yet to hear a young person say "I sure am glad my social security payments are helping the old people live better." I have only heard them complain that they are unlikely to get anything out of it.

Much of the cost of the heath care bill will have to come from the young and healthy to make it work.

Working class to middle class are going to take a hit. Working poor are going to benefit.

As to the school taxes for public schools. No I don't think they are worth it. I would have been happy to pay for my children to go to school and let everyone else do the same for theirs.
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Old 03-25-2010, 07:09 AM   #76
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My children and their friends all late 20s and early 30s are very supportive and see this not as a cost but as a fairness issue.

People on this board are asset gatherers we are older, more focused on accumulating and preserving that most. Young people have much less and are more focused on earning.

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The problem with all these online calculators is that they only focus on single individuals or families of 4. I've not seen any that reflect other household situations. Would love to see a link if anyone has seen any such beast.
I would imagine we will see more detailed calculators and other aids now that the final (well, almost final) version has been passed. Same for things like income definition for subsidy, etc. My bet's on MAGI. Itll take a month for the bureaucrats to break down the law, assign it to respective govt agencies and write the specific language needed to answer some of the questions here.
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Old 03-25-2010, 07:11 AM   #77
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I went to the first link.... and WOW.... what a typo!!!! (I added the color...)


"The Congressional Budget Office estimates that the legislation will reduce the number of uninsured by 32 million in 2019 at a net cost of $938 over ten years, while reducing the deficit by $124 billion during this time period."
What a difference one word makes! Looks like you get the prize for actually reading the thing.
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Old 03-25-2010, 07:32 AM   #78
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The most important previous cost containment mechanism on that health care spending will be gone. In the past, medical spending was "bounded" (however ineffectively) by consumers electing not to buy the product. With heavily subsidized third-party payers (private insurance companies), there will be much less of this. The insurance companies will have absolutely no incentive to reduce medical spending overall--their 20% "share" is now locked in, and every company will get the same 20%. Instead of a supply/demand based check on medical costs, we'll be substituting government cost controls. That might work, or it might not (history has an answer on this), but we should be aware that we are consciously abandoning whatever market-derived price moderation there was in favor of rulemaking and regulations-based controls.

Again, maybe it will work really well and people will love it. I hope it does!
I don't buy that argument. It is tantamount to saying the free market doesn't work. Everybody has to buy food but Giant and Safeway are competing down to fractions of a penny. The same can be said for lots of things. A larger market and a requirement to post your balance sheets won't stifle the market. The companies will have as much motivation to attract customers as ever but they won't be able to use the same set of reprehensible tactics they use now to trick people into signing up (e.g. searching for technical falsehoods in application but only exercising them when a big claim is filed). Granted, they will find other ways to game the system but that is part of a free market too.
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Old 03-25-2010, 07:39 AM   #79
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Originally Posted by clifp View Post
I recently started posted in the Politics and Religion section of a computer games industry forum. ..
The games industry forum is made of primarily of 20 or 30 something who are involved as programmers, designers, and founders of computer/video game companies ...Compared to this forum they are far more liberal and supportive of the bill.

I guess the good news is they really like the bill.
That surprises me. Slashdot sounds like the same demographic and it is chock full of libertarians. Maybe they can see the dangerous crap shoot they are in without robust health insurance. I would not want to be a free lance contractor, left to my own devices and never sure whether my carrier might dig out some reason to rescind.
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Old 03-25-2010, 07:46 AM   #80
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I went to the first link.... and WOW.... what a typo!!!! (I added the color...)


"The Congressional Budget Office estimates that the legislation will reduce the number of uninsured by 32 million in 2019 at a net cost of $938 over ten years, while reducing the deficit by $124 billion during this time period."
I can't follow this back to the lead-in post. What is the typo? This bill has always been portrayed as costing close to $1T in the first decade. Thus the regular contrast with the Bush $1T tax cut deficit that non of the health care deficit hawks seems to get crazy about. The $1.2T savings allegedly comes in the second decade as cost cutting impact takes hold.
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