MRG
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
- Joined
- Apr 9, 2013
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Thanks for a very reasonable explanation.
MRG
MRG
Right or wrong it is nothing specific to ACA. All insurance having tobacco usage surcharges but they don't test for smoking other substances. ACA was somewhat patterned after existing group health plans which typically include a tobacco usage question. In group plans they would probably deny claims for things found to be tobacco related. In the individual market they would cancel your policy. But why would you be using nicotine gum unless you were a smoker.
Government declared war on tobacco almost 40 years ago, obesity is just now getting attention so it may get a hit in the future.
Maybe it would be better to put a health tax on the actual tobacco product at point of sale rather than penalties on the insurance premium.
Note that the Texas High Risk pool used to have 2 sets of rates one for smokers and one for non smokers. Which is an example of what was cited above
But why would you be using nicotine gum unless you were a smoker.
IMHO This should apply to Medicare also. Smokers should pay more as they are a far greater burden on the system. Seems straight forward to me.
Right or wrong it is nothing specific to ACA. All insurance having tobacco usage surcharges but they don't test for smoking other substances. ACA was somewhat patterned after existing group health plans which typically include a tobacco usage question. In group plans they would probably deny claims for things found to be tobacco related. In the individual market they would cancel your policy. But why would you be using nicotine gum unless you were a smoker.
Government declared war on tobacco almost 40 years ago, obesity is just now getting attention so it may get a hit in the future.
Maybe it would be better to put a health tax on the actual tobacco product at point of sale rather than penalties on the insurance premium.
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Then, one can also say, "why single out smoking? Why not target alcohol, junk foods, supersized portions, et cetera?" Pretty soon we'd have a bureaucracy calculating the "public cost" of everything we do and don't do.
Well, I don't want this to stray too far into ideology of things -- this isn't the place for it -- but I would say that if we're going to go down this road, we have to realize that "healthy" lifestyles put a greater burden on Social Security and public pensions because they are living several years longer on average, thus collecting more benefits. So shouldn't they receive lower benefits to compensate for it?
Then, one can also say, "why single out smoking? Why not target alcohol, junk foods, supersized portions, et cetera?" Pretty soon we'd have a bureaucracy calculating the "public cost" of everything we do and don't do.
We need to be really careful about opening Pandora's Box, as applying principles (like "their lifestyles are costing me money!") consistently can create a *lot* of unintended consequences. This is why, for now, we should just keep it simple and perhaps "health care surcharges" for using unhealthy products might be better levied on the products themselves (at some point in the future). But for now, we deal with what we actually have, and how we prepare for it.
Given how often the discussion veers toward Porky, it would be best to either [a] just allow partisan political comments, or for moderators to simply delete any and all positive or negative appraisals posted. The latter would be more "useful". If this is truly to be a news update thread, and comments for or against the program not permitted, then such bias should simply be eliminated, excised, to cut off the progression of such conversation. The repeated process of allowing some appraisal, and then getting all concerned about bringing Porky on, and back and forth and back, almost seems to add more meta-discussion to the thread than there is partisan discussion!Let's try to keep Porky at bay & stay OT. As Oct 1 fast approaches, I think it's still useful to have a thread to stay abreast of Marketplace updates.
I wasn't aware that MA was on that list. Thanks.Agree or not, the smoking surcharge is an optional part of ACA but not a requirement. States can choose NOT to use it to set HI premiums (e.g. VT, RI, MA).
Given how often the discussion veers toward Porky, it would be best to either [a] just allow partisan political comments, or for moderators to simply delete any and all positive or negative appraisals posted. The latter would be more "useful". If this is truly to be a news update thread, and comments for or against the program not permitted, then such bias should simply be eliminated, excised, to cut off the progression of such conversation. The repeated process of allowing some appraisal, and then getting all concerned about bringing Porky on, and back and forth and back, almost seems to add more meta-discussion to the thread than there is partisan discussion!
So, without dropping into the political side of things, what are the odds of the ACA actually taking effect on January 1st as scheduled and, in general, as currently written with regards to the guaranteed coverage and subsidies? If, somehow, it goes unfounded, will other parts. (I.e., guaranteed coverage) still go into effect?
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So, a discussion about not implementing a law, but not dipping into politics? I don't see how that can happen, but in any case it is not the topic of this thread. If you feel it can be done please feel free to start that thread topic. Probably best in another sub-forum, though, such as FIRE Related Political Topics - Early Retirement & Financial Independence Community
I can understand why you'd say that but, given all of the changes that have already been made in terms of timing, etc., just wondering what happens if, for example, we sign up thru the exchanges on October 1 but then the subsidies aren't approved thru the budget process. Do we think that the ACA will still offer the guaranteed coverage or will that be contingent on the subsidy piece?
I think those possibilities could be narrowly addressed in a different thread; if something actually happened, it would be appropriate here, but not until it was being implemented (the focus of this thread). I.e., something that might happen vs. something that has been put into motion.
I'm not sure this belongs in this thread or another dealing with ACA and its impact on jobs and Clinics. This article was in our local news today. Cleveland Clinic is a big employer in the area and one of two "go to" places for specialty care.
Looks like there will be a large number of newly retired.
"Clinic Cuts: Cleveland Clinic slashes budget, layoffs loom Posted: Sep 18 2013 10:03 AM EDT Updated: Sep 18 2013 5:24 PM EDT CLEVELAND, OH (WOIO) - The Cleveland Clinic confirms they will be cutting a total of $330M from their 2014 budget. A Clinic spokesperson tells 19 Action News there will be reduction in the workforce including early retirements, layoffs and vacant positions left unfilled. No hard number will be known until late October. The Clinic released the following statement: "To prepare for healthcare reform, Cleveland Clinic is transforming the way care is delivered to patients. Over the past several years, we have had an ongoing focus on driving efficiencies, lowering costs, reducing duplication in services and enhancing quality to make healthcare affordable to patients. Although we have made progress, we need to further reduce costs to the organization by $330 million in 2014. We are carefully evaluating all aspects of our system to accomplish this. Some of the initiatives include offering early retirement to 3,000 eligible employees, reducing operational costs, stricter review of filling vacant positions, and lastly workforce reductions. Through these changing times, we are focused on providing the highest quality of care to our patients in the most efficient and cost-effective manner."
Cleveland Clinic recently released its 225-page Form 990 for fiscal year 2011, the most recent data available. Here are the 10 Cleveland Clinic executives and physicians who earned at least $1 million in FY 2011.
• Delos Cosgrove, MD, president and CEO: $2.56 million
• Joseph Hahn, MD, chief of staff: $1.28 million
• Marc Harrison, MD, CEO of Cleveland Clinic Abu Dhabi: $1.31 million
• Bruce Lytle, MD, chair of the Heart and Vascular Institute: $1.34 million
• John Costin, MD, chair of Cleveland Clinic Lorain: $4.04 million
• Victor Fazio, MD, former chair of colorectal surgery: $1.42 million
• Andrew Fishleder, MD, former CEO of Cleveland Clinic Abu Dhabi: $3.30 million
• Constantine Mavroudis, MD, former chair of pediatrics and congenital heart surgery: $1.62 million
• Daniel Martin, MD, chair of ophthalmology: $1.35 million
+1
Please, let's keep this thread open!
I am a daily, faithful reader of this forum, and of this discussion in particular, since the implementation
of the health care act will dovetail with my husband's decision to take a break from work come January.
I really, really appreciate the efforts of the moderators to keep the discussion courteous!
Martha
Wow. I'm speechless.
Well maybe not all.....we need to further reduce costs to the organization by $330 million in 2014. We are carefully evaluating all aspects of our system to accomplish this.