Obamacare Prompting Great Resignation

… apparently access to affordable health insurance outside of the workplace gives the “job creators” much less power over employees. “Job lock” due to health insurance concerns is a thing of the past for the well-informed.

Millions of Americans have quit their jobs. Is Obamacare helping them?
https://www.cnbc.com/2022/01/31/obamacare-great-resignation-…

While the pandemic may have helped spur the Great Resignation, it also brought about new legislation that could make an insurance policy from the marketplace more affordable for most Americans. But only 30% of people are aware that you can get financial aid to pay for their plans.

It’s even better than that.

If you understand how the US tax system punishes wage earners while giving inherited wealth a free ride and those living off an investment portfolio much lower tax rates, you can get your Obamacare almost for free.

Minimize the skim
https://retireearlyhomepage.com/minimizing_the_skim.html

intercst

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The Affordable Care Act, also called Obamacare, allowed my wife to start her own Real Estate service company. Cutting her annual health insurance premiums in half the ACA allowed her to leave a dead end job and start a company that has become so busy that she has had to turn away customers.

I wonder if there are any figures as to how many business have been started or expanded because their health insurance is now affordable?

OTFoolish

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I’ve whined for years that the economic costs of job lock aren’t being accounted for. At least one member of a couple (often the more grounded, sensible, businesslike one) needed a job with health insurance - presumably with the result that many fewer businesses were started in a garage.

The waste of human capital/innovation wasn’t of the magnitude of the bygone era of keeping women restricted to teaching/secretarial, but is I suspect nontrivial nonetheless. Maybe a 2% bump in GDP?
An economic PhD thesis awaits

  • sutton
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The pressure is still very much on for those who have health issues in the immediate family. ACA doesn’t provide the special sauce that many decent jobs provide.

If you don’t have health, you don’t have much.

ACA doesn’t change that since many larger health concerns aren’t covered as well in the market place (even with gold plans)

Example: Steroid supplements are covered for Addison’s disease, however, the Secondary impacts of poor physiological control of glucocorticoids are significant and not well covered.

More fun facts:

Mayo Clinic does not accept ACA plans from our area marketplace.
IV therapy drugs are not covered by ACA plans in our marketplace.
Some specialist care providers do not take ACA plans in our marketplace.

Stay healthy! (if you can…)

The pressure is still very much on for those who have health issues in the immediate family. ACA doesn’t provide the special sauce that many decent jobs provide.

And why should jobs provide medical-care insurance?

(I know why they DO - it was a way around some of the bad effects of certain government regulations during WWII, and then it had inertia.)

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(I know why they DO - it was a way around some of the bad effects of certain government regulations during WWII, and then it had inertia.)

iirc, the ACA requires employers above a certain size to provide an employee health plan, because, as you say, employer provided health coverage has been normalized, and an industry has grown up dependent on that model for it’s profits.

I have seen surveys showing that the majority of “JCs” would prefer a national health plan, so they didn’t have to bother administering a program, and health care providers would prefer a national health plan, because they would be paid more promptly, without all the paperwork and pushback of the current, for-profit, insurance model.

But nothing happens.

Remember this clause from he “Declaration of Independence”?

He has erected a multitude of New Offices, and sent hither swarms of Officers to harrass our people, and eat out their substance.

We are surrounded by for-profit parasites, who demand money for nothing.

Steve

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I have seen surveys showing that the majority of “JCs” would prefer a national health plan, so they didn’t have to bother administering a program,

I am not sure that is accurate. One of the ways that employers can differentiate themselves as it pertains to recruiting and retaining employees is via their insurance coverage. They also get a tax write off on it that is better than simply paying a salary.

This thread is about employers both losing employees and being unable to recruit new ones due to a better healthcare safety net than what previously existed. Why would an employer, all else being equal, want to lose even more is there was no employer healthcare handcuff at all?

https://www.marketplace.org/2021/06/10/why-dont-u-s-business…

Despite the costs of health care, our current system is advantageous for some companies. Chad Stecher, an assistant professor of health economics at Arizona State University, said big tech companies like Amazon or Facebook can attract star talent by offering compelling benefits, including health care.

“It’s in their interest to preserve that advantage over upstart companies that certainly won’t be able to compete with them on health insurance,” Stecher said.


health care providers would prefer a national health plan, because they would be paid more promptly, without all the paperwork and pushback of the current, for-profit, insurance model.

Also not convinced on this point. There is no guarantee that they would be paid any quicker (Medicare takes roughly 30 days to pay a claim), and with SP, providers would very very likely face a significant cut in compensation. For-profit insurance is good for their for-profit business model.

>>health care providers would prefer a national health plan, because they would be paid more promptly, without all the paperwork and pushback of the current, for-profit, insurance model.<<

Also not convinced on this point. There is no guarantee that they would be paid any quicker

Members of this board, over the years, have described how national health systems have wrung administrative overhead out of their systems. One member, a Brit relocated to France and using the French system, noted how the Doc’s clerk would scan his national health card, type in the codes for what the Doc did, and the money was in the Doc’s bank account before he was out the office door. In contrast, the USian private insurance industry is nothing but administrative overhead.

US doctors support universal health care - survey

WASHINGTON, March 31 (Reuters) - More than half of U.S. doctors now favor switching to a national health care plan and fewer than a third oppose the idea, according to a survey published on Monday.

Of more than 2,000 doctors surveyed, 59 percent said they support legislation to establish a national health insurance program, while 32 percent said they opposed it, researchers reported in the journal Annals of Internal Medicine.

“Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy,” Ackermann said in a statement.

The Indiana survey found that 83 percent of psychiatrists, 69 percent of emergency medicine specialists, 65 percent of pediatricians, 64 percent of internists, 60 percent of family physicians and 55 percent of general surgeons favor a national health insurance plan.

https://www.reuters.com/article/idUSN31432035

One of the ways that employers can differentiate themselves as it pertains to recruiting and retaining employees is via their insurance coverage. They also get a tax write off on it that is better than simply paying a salary.

There would be nothing wrong with employers offering “add on” coverage, like vision or dental, like health insurance companies used to offer Medicare add-on coverage, until Medicare Advantage sent all the Medicare cash flow through their hands for skimming. A national health plan would be a boon to small employers, with only a handful of staff, to whom administering a health insurance plan would be one more burden for an already stretched entrepreneur to deal with.

Why Some CEOs Figure ‘Medicare For All’ Is Good For Business

https://khn.org/news/a-large-employer-frames-the-medicare-fo…

And, if there was a single, national, plan, that covered everyone, there would be no need for fifty separate Medicaid plans, with fifty redundant sets of administrative overhead.

Steve

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Members of this board, over the years, have described how national health systems have wrung administrative overhead out of their systems. One member, a Brit relocated to France and using the French system, noted how the Doc’s clerk would scan his national health card, type in the codes for what the Doc did, and the money was in the Doc’s bank account before he was out the office door. In contrast, the USian private insurance industry is nothing but administrative overhead.

Then I posit you make an assumption that we would not keep such administrative overhead under a national SP. If in doubt, I point you to the VA and existing Medicare/Medicaid. Neither of those existing SP systems are anywhere as efficient what you describe above. I think it more likely we keep our current administrative processes under an expanded program vs. switching to something entirely foreign to what we know.

More than half of U.S. doctors now favor switching to a national health care plan

Sure they do; until you ask them if they are willing to take a pay cut to accomplish such. From six days ago:

Why Do So Many Doctors Oppose Single-Payer Health Care?
https://www.kqed.org/news/11902591/why-do-so-many-doctors-op…

The California Nurses Association, the state’s nurses union, is leading the effort to pass AB 1400. But the state’s largest association of doctors, the California Medical Association, opposes the bill.

In nearly all previous attempts to create a single-payer health system in the United States, the fiercest objections have come from doctors, said Dr. Micah Johnson, co-author of the book “Medicare for All: A Citizen’s Guide” and a practicing internal medicine physician in Boston.

Doctor opposition to single-payer may seem counterintuitive — but Johnson said doctors cannot help but view health reform through the lens of what’s best for them as well as what’s best for their patients. To the extent they’re most concerned with changes to their own pay and autonomy, Johnson called doctors “double agents in the health reform debate for the last century.”


It is easy to find support for a lot of things (SP, reduction in carbon emissions, etc.) until you ask people to pay for it.

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But the state’s largest association of doctors, the California Medical Association, opposes the bill.

The AMA has historically opposed a national health plan too, but how influenced by the for-profit hospital operators are they?

I think it more likely we keep our current administrative processes under an expanded program vs. switching to something entirely foreign to what we know.

That would be a start. Medicare has lower overhead than for-profit insurance companies, and a national health plan would also eliminate 50 separate state Medicaid programs, because they would be redundant.

Bureaucracies can change too. Years ago, Michigan required everyone to troop to the Secretary of State office at the end of every year to renew their car registration. Then they changed registration expiration to the car owner’s birthday, to level out the work load. Then they added renewal by mail. Then they added renewal by internet. Now, you can make an appointment at the SoS office via internet, ahead of time, so you don’t sit there for four hours for the things you still need to go to the office for.

Steve

but how influenced by the for-profit hospital operators are they?

I honestly don’t know.

I do know two things though.

  1. Healthcare is about 16% of our GDP so it is a big deal
  2. We are 0-3 in every state that has tried to do this - and every time the failure has been how to pay for it. My guess is that unwillingness to reduce existing compensation is a big part of that.

That would be a start. Medicare has lower overhead than for-profit insurance companies,

Your argument was not about cost, it was about speed of reimbursements. Eliminating redundancy doesn’t speed up reimbursements. Existing Medicare currently takes 30 days on average.

I don’t doubt that things can be made more efficient. That should be obvious to anyone. What I argue is that simply expanding the existing programs to cover everyone will not necessarily result in a more efficient process. In fact, if we use history as a guide, it would likely initially result in a much slower process as we don’t tend to budget enough dollars for back-end operations.

And why should jobs provide medical-care insurance?

(I know why they DO - it was a way around some of the bad effects of certain government regulations during WWII, and then it had inertia.)

It’s not just inertia anymore. Today it is also used to have a form of price discrimination based on what the employee can afford. Many companies subsidize health insurance differently depending on annual wage. I know a few that have significantly different prices (“employee share”) for people earning under $50k, between $50k and $100k, between $100k and $200k, and earning above $200k. So the person earning $47,300 pays ~$50 per pay period, while the person earning $217,300 pays ~$350 per pay period for the same exact healthcare plan.