Impeding changes to our Health Care system

[ZenGum]

Ibica? Isn't that where the Spanish go for their holidays?

[DanaC]

No idea

Ibram + Erica (I get that right?) = Ibica.

or Eram.

Ibica sounds nicer.

[Undertoad]

Originally Posted by Ibram

it's waiving it in states that want to do nothing instead that I have a problem with.

Choice "B" it is. Penalties to be collected by the IRS.

[Ibby]

i don't understand your point, UT. Of course i'm going to have to pay for insurance or a penalty for not having it. That's the whole point. I'd just rather be paying for government insurance than private insurance under a single-payer system. I don't favor the mandate, as opposed to single-payer or to a lesser degree socialized medicine (sorry brits, i think single-payer works better than your commie shit (<3)), but a mandate is still better than nothing at all. Just because I'm a reckless young'un who WOULDN'T buy insurance if there WASN'T a mandate, doesn't mean I have a problem paying for it or paying the fee as i should.

[ZenGum]

Originally Posted by DanaC

No idea

Ibram + Erica (I get that right?) = Ibica.

or Eram.

Ibica sounds nicer.

Ibiza .. pronunced with the z as that lispy c/th/s sound they use, sounded a bit like Ibica.

The nun did faint, but not from the joke.

[DanaC]

Oh yeah...

[Undertoad]

Hey man like I said devil's advocate.

My guess is that you won't pay, and will take the fine instead, saving yourself between $700 and $1400 per year depending on what kind of money you make.

We won't really know what to hate about the system until we are knee-deep in it and people are hustling it.

[DanaC]

Originally Posted by Undertoad

We won't really know what to hate about the system until we are knee-deep in it and people are hustling it.

Very well put.

[Ibby]

Ibica? hm. I kinda like it actually.

[Lamplighter]

Originally Posted by Ibram

...and there is nothing else in obamacare to hate. Is there?

Originally Posted by Undertoad

<snip>
We won't really know what to hate about the system until we are knee-deep in it and people are hustling it.

I found the following Timeline to be a relatively easy way to follow
what is in the PPACA (Obamacare) and, of course, when it is to be implemented.

Maybe this will be a way to identify those aspects that people
feel are so onerous they should be eliminated.

Cato Institute
Updated & Revised for 2011
Michael D Tanner
2011

Patient Protection and Affordable Care Act Timeline for Implementation

2010 (already in place)
Five percent tax imposed on tanning salons.

Seniors with prescription drug costs of at least $2,700 receive a check for $250.
If seniors reach the $2,700 ceiling later in the year, they will receive the check at the
end of the quarter in which they reach the ceiling.

$5 billion for temporary reinsurance program for employers who provide health
insurance coverage for retirees over age 55 who are not yet eligible for Medicare.
The program ends in 2014.
Insurers required to provide coverage for children regardless of preexisting condi-
tions. The prohibition on excluding preexisting conditions does not apply to adults
until 2014.

High-risk pools established to cover adults with preexisting conditions. Pools will
be eliminated after the ban on excluding preexisting conditions goes into effect in
2014.

Parents may keep children on their insurance plan until the child reaches age 26.

Lifetime caps on insurance benefits prohibited.

2011 ============
Medicare payroll tax increases from 1.45 percent to 2.35 percent for individuals
earning more than $200,000 and married filing jointly above $250,000.

A three-year phase-out of subsidies to Medicare Advantage begins. Some seniors
may be forced back into traditional Medicare.

States must expand Medicaid eligibility to all individuals with incomes below
133 percent of the poverty line. The federal government will cover the cost of this
expansion until 2017.

Businesses with fewer than 25 employees and average wages below $50,000 be-
come eligible for a tax credit to help offset the cost of providing insurance to their
workers. The credit applies to 2010 taxes filed in 2011.

Maximum contributions to flexible spending accounts (FSAs) reduced from
$5,000 to $2,500. FSAs and health savings accounts (HSAs) cannot be used to
purchase over-the-counter medications.

Workers begin contributing to the CLASS Act long-term care program, or may
opt out of the program.

$2.5 billion in new taxes are imposed on the pharmaceutical industry. The tax,
or assessment, rises to $4.2 billion by 2018, and is imposed on manufacturers
according to a formula based on the company’s aggregate revenue from branded
prescription drugs.

2012 ============
Businesses required to complete 1099 forms for every business-to-business trans-
action of $600 or more.

2013 ============
2.3 percent excise tax imposed on sale of medical devices.

Floor for deducting medical expenses from income taxes rises from 7.5 percent of
income to 10 percent.

The Employer Medicare Part D subsidy deduction for employers eliminated. Em-
ployers will lose the tax deduction for subsidizing prescription drug plans for
Medicare Part D–eligible retirees.

The 3.8 percent Medicare tax is applied to capital gains and interest and dividend
income if an individual’s total gross income exceeded $200,000 or a couple’s
income exceeds $250,000.

An $8 billion tax is imposed on insurers, based on market share. The tax rises to
$14.3 billion by 2018.

2014 Individual mandate imposed. With few exceptions, every American is required to
have a government-designed minimum insurance package. Failure to comply will
result in a fine equal to 1 percent of income. The penalty increases to 2 percent in
2015, and finally to 2.5 percent in 2016.

Employer mandate imposed. Companies with 50 or more employees must offer
coverage to employees or pay a $2,000 penalty per employee after their first 30
if at least one of their employees receives a tax credit. Employers who offer cov-
erage but whose employees receive tax credits will pay $3,000 for each worker
receiving a tax credit.

All insurance must meet federal minimum benefit requirements.

Prohibition on preexisting condition exclusions applies to adults.

Health plans prohibited from imposing annual limits on coverage.

Subsidies begin for individuals and families with incomes up to 400 percent of
the poverty line. Refundable tax credits limit the percent of income that must be
paid for either insurance premiums or out-of-pocket expenses.

Insurance exchanges become operational.

2015 ============
Independent Medical Advisory Commission (IMAC) established.

2016 ============
Individuals may begin collecting benefits from CLASS Act long-term care pro-
gram.

2017 ============
States have option to allow large employers to participate in exchanges.

States must begin covering part of the cost of Medicaid expansion.

2018 ============
“Cadillac” insurance tax imposed on high-cost, employer-provided health plans
with an actuarial value exceeding $27,500 for family coverage and $10,200 for individual coverage.

[ZenGum]

Roll a double six to start.

Collect MRSA each time you pass "go".

[DanaC]

Originally Posted by Ibram

Ibica? hm. I kinda like it actually.

*smiles* good!

It keeps you as as the Ibs we know and love, but gives it a feminine tweak. And I think it suits you.

[Lamplighter]

So this is where ObamaCare is headed ?

Years ago, the Maternity Wing of Buffalo Children's Hospital served lobster every Friday.
This was well known through out the city, and generated a lot of business for the hospital.


NY Times
1/22/12
Chefs, Butlers, Marble Baths: Hospitals Vie for the Affluent

<snip>


It was Greenberg 14 South, the elite wing on the new penthouse floor
of NewYork-Presbyterian/Weill Cornell hospital.
Pampering and décor to rival a grand hotel, if not a Downton Abbey,
have long been the hallmark of such “amenities units,”
often hidden behind closed doors at New York’s premier hospitals.

But the phenomenon is escalating here and around the country, health care design specialists say,
part of an international competition for wealthy patients willing to pay extra,
even as the federal government cuts back hospital reimbursement
in pursuit of a more universal and affordable American medical system.

“It’s not just competing on medical grounds and specialties,
but competing for customers who can go just about anywhere,” said Helen K. Cohen,
a specialist in health facilities at the international architectural firm HOK,
which recently designed luxury hospital floors in Singapore and London
and renovated NewYork-Presbyterian’s elite offerings in the McKeen Pavilion in Washington Heights.
“These kinds of patients, they’re paying cash
— they’re the best kind of patient to have,” she added. “Theoretically, it trickles down.”
<snip>

At Mount Sinai Medical Center, where the aesthetic of the Eleven West wing
is antique mahogany rather than contemporary sleek, and the best room costs $1,600,
William Duffy, the hospital’s director of hospitality, said his favorite entree was Colorado rack of lamb,
adding, “We pride ourselves on getting anything the patient wants.
If they have a craving for lobster tails and we don’t have them on the menu, we’ll go out and get them.”

Oh, wait a minute. Don't the Republicans want to repeal ObamaCare ?

[Clodfobble]

I'm confused what it is you think this article has to do with Obamacare, one way or the other.

[Lamplighter]

Primarily just being facetious...

There are comments in the article about Medicare patients not being served,
and the coming standards for reimbursements, and physicians' practice
of accepting only private-pay (or private insurance) patients.

I do think that unless something is done to ultimately require physicians and hospitals
to accept Medicare reimbursements, this direction of seeking the wealthy patients
will only increase, so more and more patients will be turned away.

The smaller hospitals will probably see this as their way to go,
and so those ER's will only stabilize the patients and transport them
to larger "teaching" and "county" facilities that do accept Medicare.
.