[themuzicman]

The prevailing analysis will be the corporate response to this bill, which we are already seeing. Waxman is just trying to provide cover for the bill, implying that somehow this whole revision thing is a farce.

However, falsely revising your earnings expectations will earn you a visit from the SEC for an anal exam. These companies don't do this kind of thing lightly. Regardless of what Waxman wants, companies are bracing for a major cost hit, will be passing those costs on to employees (to some extent), and raising prices to compensate. They're already doing it.

[nacht]

	Originally Posted by themuzicman To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	The prevailing analysis will be the corporate response to this bill, which we are already seeing. Waxman is just trying to provide cover for the bill, implying that somehow this whole revision thing is a farce.

Again, what has happened is they have closed loophole for making something tax deductible that was also tax exempt that is specifically part of Medicare Part D.

So, more accurately, they are not able to claim a deduction that they used to be able to claim, which is costing them more money (starting in 2013, which under modern account rules they may have to declare now, but which doesn't actually take effect for 3 more years). This has nothing whatsoever to do with the rest of the bill, just the specific piece about Part D, and is a loophole that would probably need to be closed anyways.

[themuzicman]

Originally Posted by nacht To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.

Again, what has happened is they have closed loophole for making something tax deductible that was also tax exempt that is specifically part of Medicare Part D. So, more accurately, they are not able to claim a deduction that they used to be able to claim, which is costing them more money (starting in 2013, which under modern account rules they may have to declare now, but which doesn't actually take effect for 3 more years). This has nothing whatsoever to do with the rest of the bill, just the specific piece about Part D, and is a loophole that would probably need to be closed anyways.

I'm fairly sure there is more to it than just this.

However, even if this is the case, it means higher prices and increased costs which will lead to some combination of decreased wages and increased in health insurance costs for employees.

What Democrats seem to forget is that businesses don't experience increases in taxes that aren't passed on to the middle and lower classes either through wages or price increases or job losses.

[INTJRyan]

	Originally Posted by themuzicman To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	Solution: Enact tort reform to limit frivolous and extravagant lawsuits.

Yeah, THAT will work.
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Aside from being a miniscule portion of overall healthcare costs, we have had "tort reform" on medical malpractice in California for 35 years now. In 1975, in response to claims of "out of control malpractice insurance premiums," California enacted "MICRA" (or the "Medical Injury Compensation Reform Act"). For the last 35 years, we've had in California the limitations the Republicans in Congress keep claiming we should have nationwide. These provisions include:

--A $250,000 cap on non-economic damages (i.e., pain and suffering, emotional distress, etc.) in med-mal cases. Go in for an appendectomy and doctor negligently cut off your nuts by mistake? Here's $250K, that's all you get (plus wage losses, which there probably aren't any unless you formerly worked as a porn star). This has not been raised or indexed for inflation since it was passed in 1975.

--Caps on contingent fees for lawyers in med-mal cases, 40% of the first $50,000 recovered; 33% of the next $50,000; 25% of the next $500,000, and 15% of any amount exceeding $600,000. In other words, government regulation of private contracts. Considering how incredibly expensive med-mal cases are to litigate (hiring expert witnesses, etc.), most California lawyers won't take them any more because they don't make enough money.

--No recovery for medical expenses paid by the injured party's health insurer. In any other personal injury tort action (such as a car crash, an assault, etc.), the rule across the country is that the injured party can recover the medical expenses he incurs even if his health insurer paid the bills, because you buy health insurance to protect your own finances, not to protect the finances of the person who injured you (though your health insurer will have a contractual right to place a lien on the recovery, and claim a right to share in the proceeds). In California med-mal cases, the defendant doctor gets to claim credit for the extra expenses caused by his negligence that are paid by the injured party's health insurer (or Medicare, or Medicaid).

--Installment payments of awards--if the doctor does get hit for a judgment, he (or his malpractice insurer) can opt to pay it over years, rather than all up front.

--Short statute of limitations, only one year after the doctor's negligent acts.

As you might imagine, this has cut the number of med-mal cases filed in California to a small fraction of what they were pre-MICRA. Because non-economic damages are limited to $250K and the plaintiff won't recover medical expenses unless they had no insurance, it's not even worth it to file a lawsuit unless there are huge wage-loss claims, such as when the plaintiff is badly handicapped by the doctor's malpractice and had a high-paying job before the malpractice. Especially with the cap on contingent fees, unless the plaintiff can afford to pay hourly fees to the attorney win or lose, it's hard to find a lawyer to take any med-mal claim unless the economic damages are sky-high and liability is a slam-dunk.

The effects on health care costs, and on med-mal insurance premiums? Virtually none. 35 years after enacting the most extreme med-mal tort reform measures in the country, California has some of the highest health care costs in the nation, and some of the highest medical malpractice insurance premiums. The malpractice insurers are making plenty of money, though, and so are the health care providers, so at least it's been a good deal for some groups.

This isn't speculation. This the documented, demonstrated reality, 35 years after medical tort reform was passed in the nation's largest state. It's been a complete scam, and a windfall to the malpractice insurance and health care industries.

Tell me again why we would want to take this nationwide?

[nacht]

An
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with companies such as AT&T:

Health policy. In 2003, the Medicare Modernization Act added a prescription drug benefit to Medicare. Some employers already provided prescription drug coverage to their retirees, and Congress worried that they would stop these programs and move all those people onto the government nickel. Congress thus created a subsidy to encourage employers to maintain those benefits. The government pays 28% of the cost of qualifying prescription drug coverage for employer-provided prescription drug coverage for retirees who are at least 65. Nothing in the new health legislation would change that.

Tax policy. Congress had to make two decisions in creating this subsidy.

First, would the subsidy be treated as taxable income to recipients? Quite reasonably, Congress answered no.

Second, would for-profit employers still be able to deduct from their taxable income any spending on retiree prescription drug coverage that was covered by the subsidy? For reasons I don’t understand, Congress answered yes. As a result, the AT&Ts of the world could spend $100 on coverage, receive a $28 subsidy, and still deduct $100 in expenses from its income for tax purposes (rather than, say, $72).

That's the loophole that is being closed by this bill. That AT&T can pay $100 on coverage, receive $28 in subsidy, and then continue to deduct $100 from income taxes. To quote this analysis: "the subsidy is actually more valuable to for-profit firms than to other types of employers."

It also explains the accounting detail on why this is an issue today:

This change doesn’t actually go into effect until 2013. So why all the hullabaloo now? Two words: accrual accounting. Corporations must report the cost of future retiree health benefits as liabilities on their balance sheets. The associated tax subsidies show up as corresponding assets. The value of those tax assets got slashed by the new health legislation. Firms have to report that hit in the quarter in which the law was signed. That’s why we’ve seen this rash of announcements warning shareholders of a surprise hit to first quarter profits. The charges are non-cash at this point—no money is going out the door of these firms just yet—but will turn into real cash (i.e., higher tax payments) in the future.

In short: They aren't losing any money yet and, as reported previously, are rolling several years worth of expenses into one report. If I read this right: these aren't actual loses (no wealth was harmed--yet--in the making of this production).

As to the wealth that will be "taken": They are currently receiving what amounts to a handout from the government in the form of a subsidy *and* a tax deduction. You seriously support the continuing of this practice?

[hubcap]

Originally Posted by nacht To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.

Again, what has happened is they have closed loophole for making something tax deductible that was also tax exempt that is specifically part of Medicare Part D. So, more accurately, they are not able to claim a deduction that they used to be able to claim, which is costing them more money (starting in 2013, which under modern account rules they may have to declare now, but which doesn't actually take effect for 3 more years). This has nothing whatsoever to do with the rest of the bill, just the specific piece about Part D, and is a loophole that would probably need to be closed anyways.

So, the bottom line is that the corporations have an increased tax liability.

Sounds like a tax increase to me.

[tp6626]

	Originally Posted by hubcap To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	That's good news for your friend. Who is going to pay the other $450 / month that his supplies cost?

(This might not be relevant, but...)When you go out for a nice meal with a group of people, who here fits into which category below?

a) I look at the bill, and put in <FULL AMOUNT> / <NUMBER OF GUESTS>

b) I add up everything I've had personally, and put in that amount

I'm not saying one is better or worse than the other. But I do feel that it is an immoral thing to pick and choose each time, depending on how much you spent that night. That definitely causes problems and isn't sustainable.

But choosing one strategy, and sticking to it all the time, I think does work well.

[hubcap]

Originally Posted by tp6626 To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.

(This might not be relevant, but...)When you go out for a nice meal with a group of people, who here fits into which category below? a) I look at the bill, and put in <FULL AMOUNT> / <NUMBER OF GUESTS> b) I add up everything I've had personally, and put in that amount I'm not saying one is better or worse than the other. But I do feel that it is an immoral thing to pick and choose each time, depending on how much you spent that night. That definitely causes problems and isn't sustainable. But choosing one strategy, and sticking to it all the time, I think does work well.

Actually I don't think its relevant at all. If I choose to go out with friends for dinner we will either pay our own way or take turns picking up the entire tab. On the other hand, I have never went out to dinner and been asked to pick up the tab for the strangers sitting at the next table over. THAT is totally unsustainable.

---------- Post added 03-30-2010 at 05:15 PM ----------

	Originally Posted by plotthickens To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	Weasley politicians weaseled. Wow. It's not like the politicos have been subject to regular healthcare before, either, so why would they do it to themselves now? Went through indignation and right to "SSDD". Now, if you have a solution instead, let's talk. Otherwise, yeah, this "are you indignant too?" has been beat to death.

Yes, I have a solution. Amend the Constitution so that Congress cannot exempt themselves or any other government employee or elected official from any law that applies to the American public.

[Yhor]

In regards to increased taxes and loss of profit for many of the nation's largest employers: what is the likelihood we'll see more and more of the jobs here in the US shipped over seas, including manufacturing, managerial, and headquarters? It has been a trend already, what is to say that they would profit less by moving? There will likely be many cases of such moves, imo.

[tp6626]

Happened in the UK. Our manufacturing base is pretty shot. We're only now talking about building it back up again, but it's been severely low for a generation, and lots of the skills have simply gone.

Our company struggles to even find good draughtsmen, let alone hire them. But they are ten a penny in India. Hence why we opened a Bangalore office recently, and are shipping out non-sensitive drawing work to them.

Shame really.

[hubcap]

	Originally Posted by Yhor To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	In regards to increased taxes and loss of profit for many of the nation's largest employers: what is the likelihood we'll see more and more of the jobs here in the US shipped over seas, including manufacturing, managerial, and headquarters? It has been a trend already, what is to say that they would profit less by moving? There will likely be many cases of such moves, imo.

The corporate tax rate in the United States is already the 2nd highest in the developed world. With this additional burden we may just shoot up to numero uno. Our high corporate tax burden has already sent plenty of jobs overseas. The additional burden to pay for the new healthcare law will likely send more jobs overseas not to mention reducing federal revenue........that sounds like a downward spiral.

[rufsketch1]

	Originally Posted by hubcap To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	That's good news for your friend. Who is going to pay the other $450 / month that his supplies cost?

I'll pay part of it. You will too. Thanks for helping
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.

Beside that, insulin isn't actually that expensive to make, it just goes through numerous private iterations before sale, and each of those iterations need to make a profit. Shipping of raw goods, synthesis, bottling, printing, packaging, shipping of final product, distributing, marketing, etc. It's not all done by one company, so there's quite a bit of overhead. I don't know if the bill does anything to reduce any of that overhead, just saying that the price isn't really as low as it could be.

	Originally Posted by Yhor To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	$50 a month, for insurance with a pre-existing condition AND supplies that used to cost $500? I'm doubtful. I'm doubtful one could find an insurance policy for $50 a month, much less one including free supplies/prescriptions.

As other's have said, he will now be able to get insurance, and the supplies will cost around $50 a month.

---------- Post added 04-01-2010 at 09:55 PM ----------

	Originally Posted by Tristan To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	If medicine is providing some means of extortion, then it sure is a hell of an effort for commonplace gains. ( To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts. ) The drugs companies are looking at a 5-18% margin on their products, and insurer profits are 3.4%. You're probably dead-wrong.

Companies go through quite a few loopholes to legally make their profit appear less than it actually is. I would laugh my ass off at the ridiculous inefficiency of private insurance companies in a system where the prices are the highest in the world, customer satisfaction is 50th, and profit is only 3.14%.

[Tristan]

Liability is the biggest single monster in the cost problem.

	Originally Posted by nacht To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	Please prove this. To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts. indicates that this is simply not true.

After all my poo-pooing the CBO, they in fact made the estimate in 2008 (
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) that the cost of unnecessary medical procedures is 30 percent of the entire market, or 5 percent of GDP (!), or 700 billion dollars running per year at the time of the report.

Frankly, you ask me to prove the impossible because it is so difficult to peg proportions to this huge figure. But intuitively, the over-abundance of procedures derives almost purely from the fact that patients are insulated from procedures' discrete cost by insurance, medicaid, medicare, and the prescription drug entitlement (yes, prescriptions follow procedures). Well, it happens that Orszag says so in the CBO report. But liability enters more insidiously, but is the key mechanic driving this: each procedure is a liability, and each liability warrants more procedures. Each neglected procedure is also a liability. If patients are protected from the cost of procedures, this vicious cycle is given totally free reign. The absolute maximum number of procedures will occur, and the costs-- the price of our collective greed-- do not incur themselves upon any one person, because all the costs are pooled.

Everybody pays. Our duty as insured patients is to drink as deeply and greedily from that risk pool as possible, since we're paying. It's not really a risk pool. It's a cost pool. Thus we are saddled with somewhere ~30 percent of our procedures being unnecessary. Liability drives these prices.

[hubcap]

	Originally Posted by rufsketch1 To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	I'll pay part of it. You will too. Thanks for helping To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts. .

Yeah, thanks for asking first. Next time don't bother asking, just pick my pocket to get the money.

[Yhor]

	Originally Posted by hubcap To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	Yeah, thanks for asking first. Next time don't bother asking, just pick my pocket to get the money.

You could always refuse, but they'd just seize everything you own, including bank accounts.

I refuse, but I have nothing listed in my name, only deposit the money I need for online transactions (bills), and I don't care if I'm arrested. I just got my 2nd IRS notice this year yesterday, I hear they are 'cracking down' on those who are like me. As long as I get access to books and news, I don't care what they do.

I know it isn't logical, but if you don't stand for something, you'll fall for anything. At least I can be happy knowing I stand by my principles. Idiotic path to do so, or not.

[Tristan]

	Originally Posted by rufsketch1 To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.
	Companies go through quite a few loopholes to legally make their profit appear less than it actually is. I would laugh my ass off at the ridiculous inefficiency of private insurance companies in a system where the prices are the highest in the world, customer satisfaction is 50th, and profit is only 3.14%.

So after I tried to furnish data, you're now saying that the insurance companies (as a league, without fail, and indetectably) cook the books, and that's why health care is expensive. Does it seem reasonable to you that a group of people could hide cash flows on 16 percent of the United States' GDP from the IRS?

I think a more plausible explanation is that demand for medicine has been outpacing supply. The methods so far (in the last 40 years or so) of our beloved interventionist government has been to constrict supply in order to improve the quality-- good intentions which have demonstrably paved the road to hell. Then, with supply holding steady in the face of mounting demand, we insulate ourselves from the price levels with pension plans, insurance, and gov't entitlements. (What we don't KNOW we're spending won't bother us as much.) But now that the price seems simply to high to screen anymore, there's a massive, stupid, political dogpile on the suppliers. Your own response demonstrates it, right enough. The government is looked to for the solution, even though it was the original vehicle of mismanagement. It's all %#$!ed-up.

[Yhor]

We (Oklahoma) are looking to sue over the new mandated insurance bill. Hopefully other states with issues against the bill will take similar action. None of our representatives in congress supported the bill by vote.

Our local ABC news affiliate's youtube posting of the story.

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[zibber]

Originally Posted by Tristan To view links or images in this forum your post count must be 2 or greater. You currently have 0 posts.

So after I tried to furnish data, you're now saying that the insurance companies (as a league, without fail, and indetectably) cook the books, and that's why health care is expensive. Does it seem reasonable to you that a group of people could hide cash flows on 16 percent of the United States' GDP from the IRS? I think a more plausible explanation is that demand for medicine has been outpacing supply. The methods so far (in the last 40 years or so) of our beloved interventionist government has been to constrict supply in order to improve the quality-- good intentions which have demonstrably paved the road to hell. Then, with supply holding steady in the face of mounting demand, we insulate ourselves from the price levels with pension plans, insurance, and gov't entitlements. (What we don't KNOW we're spending won't bother us as much.) But now that the price seems simply to high to screen anymore, there's a massive, stupid, political dogpile on the suppliers. Your own response demonstrates it, right enough. The government is looked to for the solution, even though it was the original vehicle of mismanagement. It's all %#$!ed-up.

That's pretty convoluted. The private insurance companies are owned by a wealthy few, who primarily work to protect (and constantly enlarge) their wealth. You are describing them as neutral parties and ascribing the high costs to some kind of disembodied market effect.
There is nothing disembodied about this; these are very wealthy people who have profit maximization as their main goal.