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Old 07-01-2007, 06:34 PM   #21
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Although many on this forum probably do not realize it, many to most countries outside of the first world have taxation systems where the primary input to the taxation equation is 'wealth' rather than 'income', due to endemic non/under reporting of incomes. Pray that such a system never graces our fair shores as it would readily enable the institution of health care premiums based on one's net worth as opposed to one's realized income.

Such a system would pretty much end the possibility of FIRE for anybody with a pre-existing health condition.
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Old 07-01-2007, 06:35 PM   #22
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With respect to Kaiser and other HMOs it has always struck me as irrational that people choose them over PPO arrangements since they are MOST likely to deny you (or lack the ability to provide) the catastrophic and expensive high tech services that are the whole raison d'etat of health insurance. I'm sure they do great with soccer injuries, perhaps better than other models, but they have an enormous incentive towards cost containment that leads to a large number of scary incentives contrary to my health and welfare.
The HMO model is not perfect, BUT as someone who's wife used to work for Kaiser (as an RN), the one thing they did try very hard to do, was keep you healthy...the healthier you were, they less they saw you, the more money they made....on the other hand, after Kaiser left Massachusetts, the DW stayed at the same doctors office (which became independent), and the modus operandi was to tell people they needed to come in to be seen by the doctor, no matter what the complaint on the phone was. The logic being of course, the only time the doctors made money, was when they saw patients...and the sicker they were, the more money they made...and the more tests they ordered the more money they made, and if the patient stayed sick for years, even more money was made...etc etc.

Big turning point for profitability for this practice was when they purchased a few sigmoid machines to do colonoscopies instead of sending them to a specialist...apparently they are very profitable...so now all the patients are taking it up the @ss and the doctors make even more money... (true story).
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Old 07-01-2007, 06:44 PM   #23
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I stick by what I predicted...

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Are you serious? If that was even remotely true, "virtually all" the companies in the state should then drop their hourly wage rate to $5.15/hour for all their employees....
My comment references the newly created mandate that virtually all employers in MA must either provide health care coverage to their workers or pay a fine/fee for not doing so.

In most service industry jobs the work and the workers are both commodities, e.g. it isn't necessary to offer high wages or comprehensive benefits to attract workers with sufficient skills to do the job. Companies in MA just got a HUGE break out of this new law that they can suddenly shift the health care costs to their workers rather than being forced to offer health care coverage themselves. Do you really think that for businesses paying people $8 to $12 an hour it would be cheaper to offer BCBS health insurance as a benefit or instead pay the state $200 odd per year per employee. I'm thinking that $200 per MONTH might make that a more breakeven equation...

As to all businesses dropping the prevailing wage to legal minimum, I don't see that happening nor do I see it as a plausible conclusion to the point I made. Workers will receive the wage at which supply for their skills meets demand. MA is a high cost of living locale and I doubt very many people make the minimum wage now, nor do many jobs offer it. I am only pointing out that very few businesses are likely to offer health insurance to workers given this new program under which the workers can buy it themselves.
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Old 07-01-2007, 06:54 PM   #24
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My comment references the newly created mandate that virtually all employers in MA must either provide health care coverage to their workers or pay a fine/fee for not doing so.

In most service industry jobs the work and the workers are both commodities, e.g. it isn't necessary to offer high wages or comprehensive benefits to attract workers with sufficient skills to do the job. Companies in MA just got a HUGE break out of this new law that they can suddenly shift the health care costs to their workers rather than being forced to offer health care coverage themselves. Do you really think that for businesses paying people $8 to $12 an hour it would be cheaper to offer BCBS health insurance as a benefit or instead pay the state $200 odd per year per employee. I'm thinking that $200 per MONTH might make that a more breakeven equation...

As to all businesses dropping the prevailing wage to legal minimum, I don't see that happening nor do I see it as a plausible conclusion to the point I made. Workers will receive the wage at which supply for their skills meets demand. MA is a high cost of living locale and I doubt very many people make the minimum wage now, nor do many jobs offer it. I am only pointing out that very few businesses are likely to offer health insurance to workers given this new program under which the workers can buy it themselves.
But they already don't have to offer health insurance...why would the addition of a fine for not offering it make it more likely to not offer it? I don't get it....:confused:
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sorry I wasn't clear...
Old 07-01-2007, 06:59 PM   #25
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sorry I wasn't clear...

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But they already don't have to offer health insurance...why would the addition of a fine for not offering it make it more likely to not offer it? I don't get it....:confused:

One of the varied proposals floating around MA that led to this law would have forced all employers to offer health insurance to most/all employees, with no provision for paying a low fee to avoid it. Obviously if something like this had been enacted businesses would get hit with a much higher cost than the $200 or whatever per year that the final law provided for.
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Old 07-01-2007, 09:24 PM   #26
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From what I can understand from the links, health insurance would be free for me if I lived in Massachusetts, since our income is less than $20,000 per year. Is that how it would work for retirees who are living off their after-tax assets?
It looks that way to me. Come on over, everyone else will.

...And the taxpayer gets juiced again.
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